Academic Day Seminar – HIV

I really enjoyed this session by Dr. Sandra Chang! 🙂 I thought she provided a very practical and comprehensive overview on HIV and did an excellent job in helping us form an approach to managing patients with HIV!

Some key points from this session are:

  • Initial therapy consist of triple drugs – combining medications for different HIV targets helps decrease the risk of resistance…but also requires pts to be able to commit/adhere to a regimen. Assess and help address any barriers!
    • Ensure seamless administration with 100% adherence with good tolerability:
      (1) Continuing from home
      (2) While in hospital
      (3) On discharge
  • Drug interactions – consider ALL types of medications, including street drugs
    • Useful resources: liverpool, HIVclinic
    • Lexicomp: not the most accurate, but can be used for comparison with above resources
      • Do not use lexicomp for renal dose adjustment!
    • RAL has more data in chemo DDIs, but DTG likely tno expected to interact with chemo

(Misc) Blood work to consider in hospital:

  • HIV plasma viral load, CD4 cell count, hsCRP, RPR
  • Investigation of hepatitis immune status
    • Hepatitis A (anti-HAV, total)
    • Hepatitis B (anti-HBs)
  • Acute viral hepatitis undefinited etiology:
    • Hepatitis A (anti-HAV, IgM)
    • Hepatitis B (HBsAg, plus anti-HBc if required)
    • Hepatitis C (anti-HCV)
  • Chronic viral hepatitis undefined etiology:
    • Hepatitis B (HBsAg, anti-HBc, anti-HBs)
    • Hepatitis C (anti-HCV)