Podcast
Questions and Answers
What is the indicator of immune function that is significant in HIV therapy?
What is the indicator of immune function that is significant in HIV therapy?
Which of the following groups is included in the special considerations for HIV therapy regimens?
Which of the following groups is included in the special considerations for HIV therapy regimens?
Which statement is true regarding initial HIV therapy?
Which statement is true regarding initial HIV therapy?
What should be tested during the initial evaluation if an individual is HIV positive?
What should be tested during the initial evaluation if an individual is HIV positive?
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Which actor was one of the first to die of HIV-related complications?
Which actor was one of the first to die of HIV-related complications?
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Which integrase strand inhibitor is associated with hypersensitivity reactions?
Which integrase strand inhibitor is associated with hypersensitivity reactions?
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What side effect is specifically associated with Dolutegravir in patients with hepatitis?
What side effect is specifically associated with Dolutegravir in patients with hepatitis?
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What should be done first when a patient experiences an Immune Reconstitution Inflammatory Syndrome?
What should be done first when a patient experiences an Immune Reconstitution Inflammatory Syndrome?
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Which drug interaction is a concern with Elvitegravir/Cobicistat?
Which drug interaction is a concern with Elvitegravir/Cobicistat?
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Which of the following medications requires the patient to avoid antacids for a specific period around its administration?
Which of the following medications requires the patient to avoid antacids for a specific period around its administration?
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Which side effect is associated with Elvitegravir when boosted?
Which side effect is associated with Elvitegravir when boosted?
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Which single-tablet regimen is appropriate for once daily use in HIV therapy?
Which single-tablet regimen is appropriate for once daily use in HIV therapy?
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What should patients taking TAF/TDF consider supplementing with?
What should patients taking TAF/TDF consider supplementing with?
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What year did highly active antiretroviral therapy (HAART) become the standard of care?
What year did highly active antiretroviral therapy (HAART) become the standard of care?
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Which combination is found in Stribild®?
Which combination is found in Stribild®?
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What is a defining characteristic of AIDS?
What is a defining characteristic of AIDS?
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Which key side effect is associated with NNRTIs?
Which key side effect is associated with NNRTIs?
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What is the preferred treatment for occupational exposure post-exposure prophylaxis (PEP)?
What is the preferred treatment for occupational exposure post-exposure prophylaxis (PEP)?
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What is the recommended initial screening test for HIV?
What is the recommended initial screening test for HIV?
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What is the duration of treatment for post-exposure prophylaxis (PEP)?
What is the duration of treatment for post-exposure prophylaxis (PEP)?
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Which of the following is NOT a key counseling point for patients on HIV therapy?
Which of the following is NOT a key counseling point for patients on HIV therapy?
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When is the first positivity for HIV antibody typically detectable?
When is the first positivity for HIV antibody typically detectable?
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Who is eligible for Pre-Exposure Prophylaxis (PrEP)?
Who is eligible for Pre-Exposure Prophylaxis (PrEP)?
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What is a contraindication for using Atazanavir?
What is a contraindication for using Atazanavir?
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What is the purpose of confirmatory testing in HIV diagnosis?
What is the purpose of confirmatory testing in HIV diagnosis?
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Which populations are recommended to undergo annual HIV testing according to WHO guidelines?
Which populations are recommended to undergo annual HIV testing according to WHO guidelines?
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How often should follow-up occur for patients using Pre-Exposure Prophylaxis (PrEP)?
How often should follow-up occur for patients using Pre-Exposure Prophylaxis (PrEP)?
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Which of the following is considered a first-line therapy for treatment-naïve patients?
Which of the following is considered a first-line therapy for treatment-naïve patients?
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What is the significance of a CD4 count less than 200 cell/mm3 in an HIV-positive patient?
What is the significance of a CD4 count less than 200 cell/mm3 in an HIV-positive patient?
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Which medication is a one-pill, once-daily option for initial treatment?
Which medication is a one-pill, once-daily option for initial treatment?
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What serious side effect is associated with Abacavir?
What serious side effect is associated with Abacavir?
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Which two medications form a two-pills, once-daily regimen?
Which two medications form a two-pills, once-daily regimen?
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What is a common side effect associated with Integrase Strand Inhibitors?
What is a common side effect associated with Integrase Strand Inhibitors?
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Which of the following is NOT a Nucleoside Reverse Transcriptase Inhibitor listed for initial treatment?
Which of the following is NOT a Nucleoside Reverse Transcriptase Inhibitor listed for initial treatment?
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What side effect is specifically highlighted for Tenofovir in comparison to Tenofovir alafenamide?
What side effect is specifically highlighted for Tenofovir in comparison to Tenofovir alafenamide?
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Which medication is specifically indicated for transitioning treatment with a stable viral load?
Which medication is specifically indicated for transitioning treatment with a stable viral load?
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What condition can worsen upon discontinuation of Nucleoside Reverse Transcriptase Inhibitors?
What condition can worsen upon discontinuation of Nucleoside Reverse Transcriptase Inhibitors?
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Study Notes
HIV Treatment Overview
- HIV treatment aims to achieve a normal CD4+ cell count, an indicator of immune function.
- Treatment also aims to prevent infection from opportunistic illnesses.
- Achieving an undetectable viral load is a key goal, which reduces the risk of transmission.
- Regimen selection, compliance, and resistance are also important factors.
- The goal is to delay disease progression.
Learning Objectives
- Recognize current first-line therapies for treatment-naive HIV patients.
- List key counseling points for current first-line regimens.
- Identify a monitoring plan for HIV therapy patients.
- Choose appropriate regimens for pre- or post-exposure prophylaxis (PrEP/PEP).
HIV History Quiz
- The first HIV cases were identified in 1981.
FDA Approval of HIV Medicines
- Lists various drugs, classes, and dates of FDA approval for HIV.
New HIV Infections
- HIV infections fell by 8% from 2015 to 2019 after a period of stability.
- The annual number of new HIV infections is decreasing.
New HIV Diagnoses by Transmission Category
- Male-to-male sexual contact accounts for the highest proportion of new HIV diagnoses.
HIV vs. AIDS
- HIV is the presence of the HIV virus.
- AIDS occurs when the CD4+ cell count falls below 200 cells/mm³ and/or opportunistic infections are present.
HIV Timeline
- Illustrates the progression of HIV infection from primary infection to AIDS over time, with corresponding CD4+ cell counts and viral loads.
HIV Testing
- WHO recommends testing for all individuals aged 13-64 in all healthcare settings and annually for high-risk groups.
- Tests include virus isolation, antiviral antibodies, and viral nucleic acid or antigens.
Initial HIV Screening
- Initial screening uses HIV antibody and p24 antigen testing.
- Positivity may be delayed, sometimes up to 3-6 months after infection.
- Confirmatory testing is needed to confirm a positive result.
Antibody Self-Tests
- OraQuick In-Home HIV Test is a common example of an antibody self-test.
Antibody Point-of-Care
- Various antibody point-of-care tests for HIV are available.
HIV-1/2 Antigen/Antibody Combination Immunoassay
- This immunoassay test helps determine HIV-1 and HIV-2 status, including acute HIV infection.
Review Question
- The CDC recommends testing for everyone aged 13-64.
HIV History Quiz
- Rock Hudson was a famous actor who died due to HIV-related complications.
Goals of HIV Therapy
- Normal CD4+ cell counts, avoidance of opportunistic infections, undetectable viral load, and delayed disease progression.
Initial Evaluation of HIV+ Patients
- Identifying the HIV strain, CD4+ cell count, viral load via NAT, HIV resistance testing, blood chemistry, CBC, liver function test, lipid panel, urinalysis, pregnancy test, and drug-specific testing.
Initial HIV Therapy
- Recommended treatment for all HIV positive individuals that is not curative.
- 95% adherence to treatment is required.
Initial Tx - Most Common Regimens
- List various medication classes (Integrase Strand Inhibitors, Nucleoside Reverse Transcript Inhibitors) in commonly used single-pill, once-daily and two-pill, once-daily formats.
Transition Tx
- Treatment for patients stable on ART with undetectable viral load, which are single-pill, once-daily and injectable, once-monthly medications.
Initial Tx - Side Effects
- Lists various side effects from various medication classes.
Initial Tx - Immune Reconstitution Inflammatory Syndrome
- Explains how to manage flares of opportunistic infections that may occur during treatment.
Drug Interactions
- Lists drug-drug interactions for various classes of medications used to treat HIV.
Key Counseling Points
- Patients should not stop their medication, store and keep them in their original containers, and report symptoms to their doctor.
Review Question
- Truvada is an appropriate single-tablet regimen for initiating HIV therapy.
HIV History Quiz
- In 1997, combination/highly active antiretroviral therapy (HAART) became the standard of treatment for HIV.
Initial Tx - Other Pts
- Lists additional Integrase Strand Inhibitors, Nonnucleoside Reverse Transcriptase Inhibitors, and Protease Inhibitors, and combinations for HIV treatment, including brand names.
Key Side Effects
- Includes side effects for each class of medication, highlighting important warnings like rashes, and cautions to take medications with meals and to avoid overlapping medications.
Initial Tx - Pregnancy
- Lists some NRTI combinations that are compatible for HIV+ patients who are pregnant.
Post-Exposure Prophylaxis (PEP)
- PEP is for occupational and non-occupational exposures to HIV. It should be initiated within 72 hours of exposure.
- The preferred treatment is a combination of Dolutegravir and Emtricitabine/Tenofovir.
Pre-Exposure Prophylaxis (PrEP)
- PrEP is for HIV-negative individuals at high risk who want to prevent HIV infection.
- The preferred regimens are a combination of Emtricitabine/Tenofovir AF or Emtricitabine/Tenofovir DF.
Review Question
- During PEP in an HIV positive patient after a needle stick would likely include Truvada and Insentress in combination.
HIV History Quiz
- Magic Johnson is a famous athlete who retired when diagnosed with HIV but returned to his sport career later.
Opportunistic Infections
- Lists various opportunistic infections based on CD4+ cell counts.
HIV History Quiz
- The first drug approved for treating HIV is Zidovudine.
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Description
This quiz provides an overview of HIV treatment, focusing on key goals like achieving an undetectable viral load and proper regimen selection. Participants will learn about first-line therapies, monitoring plans, and the historical context of HIV infections and treatment developments. Test your knowledge on the essential aspects of managing HIV effectively.
