RT Book, Section
A1 Prasad, Ramakrishna
A1 Pillala, Praneeth
A1 Liu,, Gordon
A2 South-Paul, Jeannette E.
A2 Matheny, Samuel C.
A2 Lewis, Evelyn L.
SR Print(0)
ID 1173718622
T1 HIV Primary Care
T2 CURRENT Diagnosis & Treatment: Family Medicine, 5e
YR 2020
FD 2020
PB McGraw Hill
PP New York, NY
SN 9781260134896
LK accessmedicine.mhmedical.com/content.aspx?aid=1173718622
RD 2024/04/25
AB ESSENTIALS  OF  DIAGNOSIS  AND  TREATMENTIn  the  United  States  of  America,  the  Human  Immunodeficiency  Virus  (HIV)  Laboratory  Diagnostic  Testing  Algorithm  (Centers  for  Disease  Control  and  Prevention  [CDC])  is  used.  This  algorithm  recommends  initial  testing  with  an  HIV-1/2  antigen/antibody  immunoassay  (step  1).  A  single  HIV  test  result  cannot  provide  a  definitive  HIV-positive  diagnosis.  If  the  initial  test  is  reactive,  specimens  should  be  tested  with  an  HIV-1/HIV-2  antibody  differentiation  assay  (step  2).  In  case  of  negativeorindeterminate  results  at  step  2,  HIV-1  nucleic  acid  amplification  test  (NAAT)  is  recommended.  Globally,  the  World  Health  Organization  (WHO)–recommended  testing  algorithms  are  widely  used.  The  HIV  prevalence  of  the  population—either  high  (≥5%)  HIV  prevalence  or  low  (<5%)  HIV  prevalence—is  used  to  inform  national  HIV  testing  algorithms  (which  may  vary  from  country  to  country).HIV  RNA  level  (viral  load)  should  be  ideally  used  to  monitor  response  to  antiretroviral  therapy.  In  resource-limited  settings  where  access  to  viral  load  monitoring  is  limited,  CD4  measurements  along  with  clinical  assessments  may  be  used  to  monitor  therapy.Absolute  CD4  lymphocyte  count  is  widely  used  for  staging  HIV  disease.  Acquired  immunodeficiency  syndrome  (AIDS)  is  defined  as  a  CD4  <200  cells/mm3.  AIDS  represents  advanced  HIV  disease  that  is  associated  with  opportunistic  infections  or  malignancy  in  the  absence  of  treatment.Although  HIV  infection  cannot  be  cured  currently,  antiretroviral  drugs  are  highly  effective  in  suppressing  viral  replication  and  enable  people  living  with  HIV  to  enjoy  healthy,  long,  and  productive  lives.  Additionally,  they  prevent  transmission  to  others.One  of  the  landmark  recent  advances  with  the  potential  to  combat  stigma  has  been  the  recognition  of  “U  =  U”  (undetectable  =  untransmittable).  There  is  now  evidence-based  confirmation  that  the  risk  of  HIV  transmission  from  people  living  with  HIV,  who  are  on  antiretroviral  therapy  (ART)  and  have  achieved  an  undetectable  viral  load  in  their  blood  for  at  least  6  months,  is  negligible.