HIV Essentials 2012

by Sax, Paul E., M.D.; Cohen, Calvin J., M.d.; Kuritzkes, Daniel R., M.D.

• ISBN13: 9781449650926
• ISBN10: 1449650929
• Edition: 5th
• Format: Paperback
• Copyright: 2011-11-18
• Publisher: Jones & Bartlett Learning

Summary

The world's leading experts provide all the 'Essentials' needed to manage patients in the office, on the ward, and in the ICU. Completely revised and updated, HIV Essentials 2012 incorporates the latest clinical guidelines into a step-by-step guide to the diagnosis, evaluation, management, and prevention of HIV infection and its complications. Topics include: opportunistic infections and other HIV complications, treatment of HIV and pregnancy, antiretroviral drug summaries, post-exposure prophylaxis, as well as commercially available dosage forms for all ARVs.New to HIV Essentials 2012: 2011 DHHS Guidelines 2011 Pregnancy Guidelines New Drugs: Edurant, Complera, Incivek, Victrelis, and more.

Table of Contents

Overview of HIV Infection	p. 1
Overview	p. 2
Stages of HIV Infection	p. 3
Acute HIV Infection	p. 4
Differential Diagnosis	p. 4
Signs and Symptoms	p. 4
Laboratory Findings	p. 4
Diagnostic Testing	p. 5
Management	p. 5
Diagnosis and Evaluation of HIV Infection	p. 6
HIV Antibody Testing	p. 7
ELISA	p. 7
Western Blot	p. 7
Others	p. 7
HIV Viral Load Assays	p. 9
Uses	p. 9
Assays and Interpretation	p. 9
Indications	p. 11
Initial Assessment of HIV-infected Patients	p. 12
Clinical Evaluation	p. 12
Laboratory Testing	p. 12
CD4 Cell Count	p. 17
Treatment of HIV Infection	p. 18
Initiation of Antiretroviral Therapy	p. 19
Selection of an Optimal Initial Antiretroviral Regimen	p. 25
Complications of HIV Therapy	p. 34
Lipodystrophy Syndrome	p. 34
Antiretroviral Therapy Adverse Effects	p. 38
Bleeding Events	p. 39
Bone Marrow Suppression	p. 39
Cardiovascular Disease (CVD)	p. 39
Central Nervous System (CNS) Effects	p. 40
Diabetes Mellitus (DM)/lnsulin Resistance	p. 41
Dyslipidemia	p. 41
Gastrointestinal (Gl)	p. 41
Hepatic Effects	p. 41
Hypersensitivity Reaction (HSR)	p. 42
Lactic Acidosis	p. 43
Lipodystrophy	p. 44
Myopathy/Elevated CPK	p. 44
Nephrotoxicity/Urolithiasis	p. 44
Osteopenia/Osteoporosis	p. 45
Peripheral Neuropathy	p. 45
Rash	p. 45
Stevens-Johnson Syndrome	p. 45
References and Suggested Readings	p. 46
Treatment Failure and Resistance Testing	p. 49
Antiretroviral Treatment Failure	p. 50
Virologic Failure	p. 50
Immunologic Failure	p. 51
Clinical Failure	p. 51
Usual Sequence of Treatment Failure	p. 51
Principles of Resistance Testing	p. 55
Types of Resistance Testing	p. 56
Genotype Testing	p. 57
Phenotype Testing	p. 57
Other Options for Resistance Testing	p. 58
Co-Receptor Tropism Assay	p. 58
Indications for and Approach to Resistance Testing	p. 58
Important Genotype-Resistant Patterns	p. 60
Nucleoside Reverse Transcriptase Inhibitors (NRTI's)	p. 60
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI's)	p. 62
Protease Inhibitors (PI's)	p. 63
Prophylaxis and Treatment of Opportunistic Infections	p. 65
Prophylaxis of Opportunistic infections	p. 66
Treatment of Opportunistic Infections	p. 73
Aspergillosis, Invasive	p. 74
Bacterial Respiratory Diseases	p. 75
Bartonella Infections	p. 77
Campylobacteriosis	p. 78
Candidiasis (Mucosal)	p. 79
Chagas Disease	p. 81
Clostridium difficile Diarrhea/Colitis	p. 81
Coccidioidomycosis	p. 82
Cryptococcal Meningitis	p. 84
Cryptosporidiosis	p. 85
Cytomegalovirus (CMV) Disease	p. 86
Hepatitis B Virus (HBV)	p. 89
Hepatitis C Virus (HCV)	p. 91
Herpes Simplex Virus (HSV) Disease	p. 97
HHV-6 Infection	p. 98
HHV-8 Infection	p. 99
Histoplasma capsulatum	p. 99
Human Papillomavirus (HPV) Disease	p. 101
Isospora belli Infection	p. 102
Leishmaniasis, Cutaneous	p. 103
Leishmaniasis, Visceral	p. 103
Malaria	p. 104
Malaria, Severe	p. 104
Malaria, Uncomplicated	p. 105
Microsporidiosis	p. 105
Mycobaterium avium Complex (MAC) disease	p. 107
Mycobaterium tuberculosis	p. 108
Penicilliosis	p. 110
Pneumocystis Pneumonia (PCP)	p. 111
Progressive Multifocal Leukoencephalopathy (PML)	p. 113
Salmonellosis	p. 114
Shigellosis	p. 115
Toxoplasma gondii Encephalitis	p. 116
Treponema pallidum (Syphilis)	p. 117
Varicella-Zoster Virus (VZV) Disease	p. 120
Complications of HIV Infection	p. 122
Hematologic Complications	p. 123
Thrombocytopenia	p. 123
Anemia	p. 123
Neutropenia	p. 124
Eosinophilia	p. 125
Oncologic Complications	p. 125
Kaposi's Sarcoma	p. 125
Non-Hodgkin's Lymphoma	p. 126
Primary CNS Lymphoma	p. 126
Cervical Cancer	p. 127
Anal Cancer	p. 127
Endocrine Complications	p. 127
Adrenal Insufficiency	p. 127
Hypogonadism	p. 128
Thyroid Disease	p. 128
Pancreatitis	p. 129
Hyperglycemia	p. 129
Hypoglycemia	p. 129
Ovarian Complications	p. 130
Bone Disease	p. 130
Gastrointestinal Complications	p. 131
Anorexia	p. 131
Nausea/Vomiting	p. 131
Diarrhea	p. 132
Oral or Esophageal Ulcers	p. 132
HIV Cholangiopathy	p. 133
Renal Complications	p. 133
HIV-Associated Nephropathy	p. 133
Medication-Related Renal Disease	p. 134
HCV-Associated Renal Disease	p. 135
Heroin Nephropathy	p. 135
Cardiac Complications	p. 135
HIV-Related Cardiomyopathy	p. 135
Pericarditis/Pericardial Effusion	p. 136
Tricuspid Valve Endocarditis	p. 136
Pulmonary Complications	p. 137
Pulmonary Hypertension	p. 137
Lymphocytic Interstitial Pneumonitis	p. 137
Emphysema	p. 137
Pulmonary Kaposi's Sarcoma	p. 138
HEENT Complications	p. 138
Aphthous Ulcers	p. 138
Oral Hairy Leukoplakia	p. 138
Salivary Gland Enlargement	p. 138
Lymphoepithelia! Cysts	p. 138
Gingivitis/Periodontitis	p. 139
Musculoskeletal Complications	p. 139
HIV Arthropathy	p. 139
Reiter's Syndrome	p. 139
Pyomyositis	p. 139
HIV/NRTI-Related Myopathy	p. 140
Rhabdomyolysis	p. 140
Neurologic Complications	p. 140
Distal Sensory Neuropathy	p. 140
Other Forms of Neuropathy	p. 141
HIV-Associated/AIDS Dementia	p. 141
Psychiatric Complications	p. 142
Depression	p. 142
Mania	p. 143
Insomnia	p. 143
Dermatologic Complications	p. 143
Herpes Simplex Infection	p. 143
Varicella-Zoster Infection	p. 144
Molluscum Contagiosum	p. 144
Oral Hairy Leukoplakia	p. 144
Warts	p. 144
Staphylococcal Infections	p. 145
Bacillary Angiomatosis	p. 145
Fungal Infections	p. 146
Seborrheic Dermatitis	p. 146
Psoriasis	p. 146
Eosinophilic Folliculitis	p. 147
Xerosis/Ichthyosis	p. 147
HIV Infection and Pregnancy	p. 148
Overview	p. 149
Initial Evaluation	p. 149
Initiation of Antiretroviral Therapy in Pregnancy	p. 150
Goals of Therapy and Monitoring	p. 150
Management of HIV-infected Pregnant Women Currently Receiving Antiretroviral Therapy	p. 155
Other Management and Monitoring Considerations	p. 155
Postpartum Management	p. 156
Post-Exposure and Pre-Exposure Prophylaxis	p. 167
Occupational Post-Exposure Prophylaxis	p. 168
Nonoccupational Post-Exposure Prophylaxis	p. 174
Evaluation	p. 174
Use of Antiretroviral Therapy	p. 174
Follow-Up Testing	p. 175
Pre-Exposure Prophylaxis	p. 177
Antiretroviral Drug Summaries	p. 179
Appendix 1	p. 231
IAS-USA Drug Resistance Mutations in HIV-1: December 2010	p. 232
IAS-USA Drug Resistance Mutations in HIV-1: User Notes	p. 236
Appendix 2	p. 240
Selected Key Internet Resources	p. 241
Reference	p. 242
Index	p. 243
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