Episode 59 – HIV – An Interview With Dr. Daniel Egan

EMplify – July 2021Announcements: Be on the lookout for an announcement regarding the new EB Medicine app, coming to an App Store near you this month !!HIV- An Interview With Dr. Daniel EganSee the EB Medicine Article @ https://www.ebmedicine.net/topics/infectious-disease/HIV* Why HIV? 2018 , 1,2 million people living with HIV, almost 40k new infectionsPeople living with HIV visit the ED 3 x per year on averageHIV infected patients accounted for 6 in 1000 ED visits in 2017New Transmission of HIV, Figure 1* What does acute infection look like ?* What about chronic infection ?The chronic phase can last 10 years or more and be asymptomatic.* Are people with HIV more likely to develop: CAD, COPD, DVT and why?What if they are on medication for HIV?* Screening in the ED, everyone? Do they have to have symptoms or risks?What does universal screening mean?What does risk based screening mean?* What are the risk factors? What if I see someone on PrEP who is in the ED for an unrelated complaint?* HistoryAsk about cd4 and viral load and last testAsk about he of opportunistic infectionsAsk about medication side effectsWhat else?* Exam* Labs – rapid testing, 4th gen, viral load and cd4, etc* Imaging* TreatmentTable 1Highly effective and reduces transmission* Medication side effects (we don’t have to dwell on each Med and side effect and just reference the charts)* hep B virus deactivation* System Based DiseaseHeart Failure and CADPCP (role of LDH)TBCOPDRenal Disease – stones , radiolucentNeurologic- CVA, cryptococcal meningitis, toxo, progressive multi focal leukoencephalopathy, HANDGI – diarrhea causes, c diff, hep CHeme- cytopeniaEndocrine – metabolic syndromeMusculoskeletalPsychiatric table 3Derm* Special CircumstancesPEPPrEP