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/HIVWhy 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 1What 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?ExamLabs – rapid testing, 4th gen, viral load and cd4, etcImagingTreatmentTable 1Highly effective and reduces transmissionMedication side effects (we don’t have to dwell on each Med and side effect and just reference the charts)hep B virus deactivationSystem 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 3DermSpecial CircumstancesPEPPrEP