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HIV Part Dos By Alaina Darby.

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Presentation on theme: "HIV Part Dos By Alaina Darby."— Presentation transcript:

1 HIV Part Dos By Alaina Darby

2 WN has a viral load of 2,000 after 24 weeks of therapy and no documented resistance, which of the following would this be considered? Failure Incomplete response Rebound Suppression b

3 Repeat testing in 3 weeks
WN has a viral load of 2,000 after 24 weeks of therapy and no documented resistance. What should not be done as the initial choice? Change regimen Assess adherence Assess DDIs Repeat testing in 3 weeks a

4 WN has a viral load of 2,000 after 24 weeks of therapy and no documented resistance. Her adherence is reassessed and the regimen restarted, after 4 weeks her viral load is now at 28. What is this considered? Failure Incomplete response Rebound Suppression d

5 WN has a viral load of 2,000 after 24 weeks of therapy and no documented resistance. Her adherence is reassessed and the regimen restarted, after 4 weeks her viral load is now at 28. In a few weeks it rises to 250. What is this considered? Failure Incomplete response Rebound Suppression c

6 WN has a viral load of 2,000 after 24 weeks of therapy and no documented resistance. Her adherence is reassessed and the regimen restarted, after 4 weeks her viral load is now at 28. In a few weeks it rises to 250. What should not be done? Resistance testing Confirm levels Confirm adherence Dose adjust d

7 She should switch to a different OCD
KN is a 23 yo WF who has just been diagnosed with HIV. You want to start her on ART. She is currently taking oral contraceptives and wants to stay on the same OCD. What should you tell her? She should switch to a different OCD She should switch to a different form of hormonal contraceptive She can continue her current OCD She should stop taking hormonal contraceptives completely c

8 Higher concentrations No change in concentration Lower concentrations
KN is a 23 yo WF who has just been diagnosed with HIV. You want to start her on ART. She is currently taking oral contraceptives and wants to stay on the same OCD. What effect would you expect to see with her OCD after typical ART regimens? Higher concentrations No change in concentration Lower concentrations c

9 KN is a 23 yo WF who has just been diagnosed with HIV
KN is a 23 yo WF who has just been diagnosed with HIV. You want to start her on ART. She is currently taking oral contraceptives and wants to stay on the same OCD. You decide to start her on TDF/FTC and are trying to decide on the third agent. Which would be best to maintain the activity of her OCD? DRV LPV EVG DTG d

10 KN is a 23 yo WF who has just been diagnosed with HIV
KN is a 23 yo WF who has just been diagnosed with HIV. You want to start her on ART. She is currently taking oral contraceptives and wants to stay on the same OCD. You decide to start her on TDF/FTC and are trying to decide on the third agent. Which agent should definitely be avoided? EFV NVP ATV DRV a

11 Etonorgestrel implant Depot medroxyprogesterone Nuvaring
KN is a 23 yo WF who has just been diagnosed with HIV. You want to start her on ART. If you were to change her hormonal contraceptive, which would you choose? Etonorgestrel implant Depot medroxyprogesterone Nuvaring Desogestrel and ethinyl estradiol combo b

12 OB is a 32 yo AAF who was just confirmed to be HIV positive due to prenatal bloodwork. She is 8 weeks pregnant and you want to start her on ART. Which regimen should be avoided? ABC/3TC + EFV ABC/3TC + RPV TDF/FTC + DRV TDF/FTC + ATV a

13 OB is a 32 yo AAF who was just confirmed to be HIV positive due to prenatal bloodwork. She is 8 weeks pregnant and you want to start her on ART. What should you choose? ABC/3TC + ATV/r ABC/3TC + LPV/r TDF/FTC + ATV/r TDF/FTC + LPV/r a

14 OB is a 32 yo AAF who was just confirmed to be HIV positive due to prenatal bloodwork. She is 8 weeks pregnant and you want to start her on ART. What should you choose if you were concerned about her kidney function and blood sugar? ABC/3TC + ATV/r ABC/3TC + LPV/r ABC/3TC + RAL ABC/3TC + DTG c

15 OB is a 32 yo AAF who was just confirmed to be HIV positive due to prenatal bloodwork. She is 8 weeks pregnant and you want to start her on ART. You start her on ABC/3TC + RAL. Treatment for which of the following pregnancy related conditions could be a problem? Depression GERD Diabetes Frequent urination b… don’t take RAL with antacids

16 RH is 32 weeks pregnant with HIV RNA of 1,200. What should you do?
Reevaluate her in 6 weeks and start ZDV now Schedule C-section for 6 weeks and start ZDV now Reevaluate her in 6 weeks and start ZDV at that time if HIV RNA is still high Schedule C-section for 6 weeks and start ZDV at that time d

17 RH is 38 weeks pregnant now and has come in for her C-section
RH is 38 weeks pregnant now and has come in for her C-section. When should you start ZDV? 1 hour prior 2 hours prior 3 hours prior 4 hours prior d

18 RH is 32 weeks pregnant with HIV RNA of 850. What should you do?
Wait until she goes into labor to start ZDV Schedule C-section for 6 weeks with ZDV Wait until she goes into labor and don’t start ZDV Schedule C-section for 6 weeks without ZDV c

19 When should an infant receive ZDV?
All infants born to HIV positive mothers Infants born to HIV positive mothers through natural birth Infants born to HIV positive mothers through C-section Don’t give it! It’s dangerous! a

20 How long should ZDV continue? 2 weeks 4 weeks 6 weeks 8 weeks

21 When should an infant receive ZDV + NVP?
All infants born to HIV positive mothers Infants born to HIV positive mothers through natural birth Infants born to HIV positive mothers through C-section Infants born to HIV positive mothers not on ART during pregnancy d

22 How many doses of NVP should the infant get?
3 doses, all within the first week 3 doses, spread across 6 weeks 6 doses, all within the first week 6 doses, spread across 6 weeks a

23 Remember… Give the kid “zid” so he “nevir” gets HIV!!
a

24 Which of the following is not true of patients over 50?
ART may produce more ADRs DDIs with ART are more common Response to ART is reduced ART is not recommend due to risk of ADRs d

25 Entecavir + fully suppressive ART
PA is a 44 yo Wm with HBV. Which of the following regimens is preferred? TDF/3TC + EFV ABC/3TC + RPV ABC/FTC + DRV Entecavir + fully suppressive ART a

26 TD is HIV positive on ART and was just diagnosed with TB
TD is HIV positive on ART and was just diagnosed with TB. His CD4 is For which of the following should he receive prophylaxis? Histoplasmosis MAC PJP CMV c

27 TD is HIV positive on ART and was just diagnosed with TB
TD is HIV positive on ART and was just diagnosed with TB. His CD4 is What should he receive to prophylax against PJP? Pyrmethamine Bactrim Azithromycin Flucomazole b

28 TD is HIV positive on ART and was just diagnosed with TB
TD is HIV positive on ART and was just diagnosed with TB. His CD4 is How long should his prophylaxis extend? 1 year For life Until CD4 >200 Until CD4 >400 c

29 For which of the following is prophylaxis not recommended?
Histoplasmosis MAC PJP CMV d

30 Which of the following is not acceptable prophylaxis for Toxoplasmosis encephalitis?
Bactrim DS Q day Bactrim DS TIW Bactrim SS Q day c

31 Which of the following is the regimen to prophylax against MAC?
Rifabutin Ciprofloxacin Ethambutol Azithromycin d

32 When can prophylaxis be stopped for MAC? CD4 >50 CD4 >100
After 3 months After 6 months a & c a & d b & c b & d g

33 When can treatment be stopped for MAC? CD4 >50 CD4 >100
After 3 months After 6 months a & c a & d b & c b & d h

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