Clinical HIV Management

Introduction to Clinical HIV and the Initial Evaluation

  • Describe the global epidemiology of HIV and its history.
  • Conduct an initial history and physical of a newly diagnosed HIV-infected patient.
  • Stage patients’ HIV disease severity based on both CDC and WHO HIV classifications.
  • Explain the challenges of delivering HIV care in resource-limited settings and the current strategies for meeting these challenges.

HIV Testing and Prevention

  • Answer the question “Who needs an HIV test”: Describe strategies for testing and testing requirements for different populations.
  • Outline the strategies to reduce secondary HIV transmission, starting with the infected patient.
  • Recognize the indications for post-exposure prophylaxis for both occupational and sexual HIV exposures and review PEP delivery.
  • Describe the role of pre-exposure prophylaxis and identify the patients most likely to benefit from PrEP and review PrEP delivery.

Antiretroviral Therapy (ART)

  • Describe the goals of antiretroviral therapy
  • Discuss key considerations related to the timing of antiretroviral therapy initiation.
  • List the classes of antiretroviral drugs and identify their distinguishing features, including key drug-drug interactions and potential adverse effects.
  • Identify recommended first-line antiretroviral regimens, as well as the pros/cons of different regimens
  • Describe the adverse effects of antiretroviral agents, both common and severe

Treatment Failure

  • Discuss the most common underlying causes of treatment failure
  • Describe the evaluation and management of treatment failure, including how the approach may differ based on the availability of HIV resistance testing
  • Outline the most common HIV resistance mutations and their implications for selecting an appropriate treatment regimen
  • Summarize the epidemiology and significance of non-communicable diseases (NCDs) among PLHIV
  • Describe the benefits and current approaches to integrating NCD care into routine HIV services

Tuberculous (TB)

  • Describe the epidemiology of TB and the epidemiologic relationship between HIV and TB
  • Describe the pathogenesis of TB in PLHIV, clinical manifestations, and algorithms for screening and diagnosis
  • Explain the principles of TB treatment for PLHIV
  • Outline modalities for TB prevention among PLHIV
  • Explain LTBI diagnosis and treatment among PLHIV

Opportunistic Infectious (OI)

  • Describe the approach to diagnosis and management of OIs affecting the CNS
  • Review the clinical features, diagnosis, and management of common non-CNS OIs
  • Discuss the benefits of co-trimoxazole prophylaxis and the rationale for its expanded role in resource-limited settings
  • Describe the significance of IRIS, including key diagnostic and management principles

HIV-Associated Malignancies

  • Review the epidemiology and clinical features of both AIDS-defining and non-AIDS-defining HIV-associated malignancies
  • Describe key factors that influence cancer treatment outcomes among PLHIV

Dermatology

  • Identify common clinical presentations and themes in HIV-related skin disease
  • Recognize important drug hypersensitivity syndromes that may occur more commonly in PLHIV

Pediatric HIV

  • Contrast the natural history and manifestations of HIV in infants and children versus that in adults
  • Explain key principles in the diagnosis and management of HIV infection in infants and children
  • Discuss approaches to preventing mother-to-child HIV transmission (PMTCT), as well as the progress and challenges of PMTCT efforts globally
  • Describe the unique challenges, considerations, and strategies in the management of HIV in adolescents and how adolescents’ needs differ from those of pediatric or adult patients.

STIs

  • Describe how sexually transmitted infection (STI) syndromes can present in persons living with HIV and review STI etiologies.
  • Differentiate between the syndromic versus etiologic approach to management of STIs in HIV-infected patients.
  • Explain the significance of common psychosocial barriers experienced by PLHIV, including stigma.

Psychosocial

  • Discuss the role of behavioral and psychosocial support interventions for improving HIV outcomes.
  • Identify and describe the epidemiology of mental health conditions that are common among PLHIV.

Special Population

  • Appreciate the unique issues central to caring for an HIV-infected woman. (Women)
  • Describe key (high-risk) populations and understand their unique challenges and needs (CSW, MSM, Transgender, PWID)

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Ekundayo Educonsult for Healthcare Professionals.


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