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

EMplify - July 2021

Announcements: 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 Egan

See 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 infections

* People living with HIV visit the ED 3 x per year on average

* HIV infected patients accounted for 6 in 1000 ED visits in 2017

* New 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?

* History

* Ask about cd4 and viral load and last test

* Ask about he of opportunistic infections

* Ask about medication side effects

* What else?

* Exam

* Labs - rapid testing, 4th gen, viral load and cd4, etc

* Imaging

* Treatment

* Table 1

* Highly 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 Disease

* Heart Failure and CAD

* PCP (role of LDH)

* TB

* COPD

* Renal Disease - stones , radiolucent

* Neurologic- CVA, cryptococcal meningitis, toxo, progressive multi focal leukoencephalopathy, HAND

* GI - diarrhea causes, c diff, hep C

* Heme- cytopenia

* Endocrine - metabolic syndrome

* Musculoskeletal

* Psychiatric table 3

* Derm

* Special Circumstances

* PEP

* PrEP