Podcast
Questions and Answers
What is one key treatment goal for patients with HIV-1 infection?
What is one key treatment goal for patients with HIV-1 infection?
Which factor is NOT considered when choosing a treatment plan for an individual patient with HIV?
Which factor is NOT considered when choosing a treatment plan for an individual patient with HIV?
What does an undetectable viral load imply in the context of HIV treatment?
What does an undetectable viral load imply in the context of HIV treatment?
Which drug abbreviation refers to long-acting cabotegravir?
Which drug abbreviation refers to long-acting cabotegravir?
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Which of the following is a common laboratory evaluation parameter before starting ART in HIV patients?
Which of the following is a common laboratory evaluation parameter before starting ART in HIV patients?
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What is a consideration regarding the side effect profile of HIV medications?
What is a consideration regarding the side effect profile of HIV medications?
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In the context of HIV treatment, what would be an integrated approach to care?
In the context of HIV treatment, what would be an integrated approach to care?
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Why is resistance testing important in the management of HIV?
Why is resistance testing important in the management of HIV?
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What is one of the goals of the medications mentioned, such as 3TC or ABC?
What is one of the goals of the medications mentioned, such as 3TC or ABC?
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Which of the following screenings is specifically for identifying genetic factors that could influence treatment effectiveness?
Which of the following screenings is specifically for identifying genetic factors that could influence treatment effectiveness?
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What is the recommended CD4 count that indicates a more favorable condition for initiating treatment?
What is the recommended CD4 count that indicates a more favorable condition for initiating treatment?
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Which of the following drugs is classified as a Nucleoside/Nucleotide Reverse Transcriptase Inhibitor (NRTI)?
Which of the following drugs is classified as a Nucleoside/Nucleotide Reverse Transcriptase Inhibitor (NRTI)?
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Which of the following screenings is NOT typically related to HIV treatment management?
Which of the following screenings is NOT typically related to HIV treatment management?
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Which medication is specifically aimed at minimizing HIV-related health complications?
Which medication is specifically aimed at minimizing HIV-related health complications?
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What type of tests are considered essential screenings before initiating certain HIV treatments?
What type of tests are considered essential screenings before initiating certain HIV treatments?
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What is the primary intention of conducting STI screenings in the context of HIV treatment?
What is the primary intention of conducting STI screenings in the context of HIV treatment?
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Study Notes
HIV Pharmacotherapy Review
- Treatment Goals: Achieve and sustain maximum HIV RNA suppression (undetectable levels), restore and maintain immune function (CD4 count >500 cells/mm³), minimize HIV-related complications, and prevent transmission.
Baseline Evaluation
- Essential Tests: HIV RNA level (viral load), CD4 cell count, HIV antigen/antibody, HLA-B*5701 screening, G6PD deficiency screening, genotypic drug resistance testing, hepatitis A, B, and C serologies, opportunistic infection screening, complete blood count, serum lipids, chemistry panel, urinalysis, STI screening, immunization history, pregnancy test, cancer screening.
Initial ART for Most People with HIV
- Recommended Regimens: Biktarvy, Triumeq, Dovato, Dovato + Viread, Tivicay + Truvada/Descovy/Cimduo, Symtuza, Prezcobix + Truvada/Descovy/Cimduo.
- Considerations: Genotypic resistance testing before ART is crucial for individuals with HIV history of using long-acting cabotegravir.
- Important note: Appropriate regimens for females of childbearing age, people without hepatitis B coinfection and those without a viral load > 500,000 copies/mL.
Monitoring
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CD4 Count:
- <300 cells/mm³: Every 3 months
- 300-500 cells/mm³: Every 6 months (first 2 years of ART), then every 12 months (after first 2 years with suppressed viral load).
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500 cells/mm³: Every 6 months (first 2 years of ART), then monitoring optional (after first 2 years with suppressed viral load).
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Viral Load:
- ≥50 copies/mL: Every 4-8 weeks
- <50 copies/mL: Every 3-6 months, obtain upon initiation/modification of ART and repeat in 4-8 weeks
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BMP: Obtain 3-6 months after starting ART.
Prophylaxis Against Opportunistic Infections (OI)
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Pneumocystis pneumonia (PCP): SMX-TMP, Dapsone, Atovaquone.
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Toxoplasmosis: SMX-TMP, Dapsone + pyrimethamine + leucovorin, or Atovaquone.
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Mycobacterium avium complex (MAC): Azithromycin, Clarithromycin.
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Additional Note: Those with G6PD deficiency should not receive SMX-TMP or dapsone.
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Acquired Immunodeficiency Syndrome (AIDS): Defined by a CD4 count < 200 cells/mm³ or the onset of opportunistic infections, regardless of CD4 count. Diagnosis is lifelong.
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Description
This quiz covers essential aspects of HIV pharmacotherapy, including treatment goals, baseline evaluation tests, and initial antiretroviral therapy (ART) regimens. Test your knowledge on recommended treatments, necessary screenings, and considerations for therapy effectiveness.
