1. Maia Pinsky, MD-R3 Family Medicine Residency of Idaho
Chronic disease management of patients with HIV
Maia Pinsky, MD-R3 Family Medicine Residency of Idaho

2. Disclosures
I have no financial relationship or interest with any proprietary entity producing health
care good or services to disclose

3. Outline ● Overview of HIV care ● Chronic disease management
● Conclusion

13. Chronic disease management of HIV
● HIV infection
● Cardiovascular
● Pulmonary
● Neuropsychiatric
● Renal
● Hepatic
● Bone
● Cancer
● Immunizations
● OI Prophlyaxis

15. Factors that influence chronic disease
Viral infection/immunosuppression
○ Long-term infection may have effects despite normal CD4 count
○ Not completely understood, but may be related to chronic inflammation
● Medication side effects
○ Many different manifestations
○ May be magnified with prolonged used
○ Drug-drug interactions
● Associated risks
○ May be related to how HIV was contracted

26. Cancer ● Cervical cancer ○ 4-5x increased risk of CIN
○ PAP testing for lifetime, more frequent testing interval
● Anal Cancer
○ Anal pap if high-resolution anoscopy is available in community
○ No consensus screening guidelines currently
● Colon, breast, prostate, lung
○ No change in screening recommendations

30. Resources for physicians
● FMRI
● HIVMA/IDSA Guidelines
● CDC
● AIDSinfo.nih.gov
● National HIV Clinicians Consultation Center - UCSF
● Clinicians Warmline
● HIV Drug Interaction Checker - University of Liverpool

31. Summary ● HIV has largely become a chronic disease in the US
● Role of primary care physician in coordination with HIV
specialist
● Chronic disease states in pts with HIV - some different
considerations (viral infection, medication side effects,
associated risks) but we can often use the same models for tx
● Prevention is still the key!!

32. THANK YOU