New HIV/AIDS in the U.S.
- In 2015, 39,513 people were diagnosed with HIV infection in the United States.
- The number of new HIV diagnoses fell 19% from 2005 to 2014
- In 2015, 18,303 people were diagnosed with AIDS
- In the MSM population in the U.S. prevalence of HIV is 25% in Whites and 50% in Blacks
Posted 01/12/17 09:52:56 AM by Ying Liu
- Sub-acute course
- Severe hypoxia and respiratory distress
- CXR findings that can be normal or have the classic reticulonodular pattern. Effusions rule out PCP
- Elevated LDH and fungitell are helpful
- BAL with silver staining is gold standard
Posted 01/12/17 09:54:04 AM by Ying Liu
Treatment of PCP
- Sulfamethoxazole – trimethoprim (Bactrim)
- Single-strength tablet (sulfamethoxazole 400 mg; trimethoprim 80 mg)
- Double-strength tablet (sulfamethoxazole 800 mg; trimethoprim 160 mg)
- Mild to moderate: Oral: 15 to 20 mg TMP/kg/day in 3 divided doses for 21 days or alternatively, 320 mg TMP 3 times/day for 21 days
- Moderate to severe: IV: 15 to 20 mg TMP/kg/day in 3 to 4 divided doses for 21 days; may switch to oral therapy after clinical improvement
- Alternate Regimens:
- Clindamycin and Primaquine
- Atovaquone (mild disease)
- Important to start HAART therapy concurrently
Posted 01/12/17 09:54:46 AM by Ying Liu
- 333 patients with AIDS and PCP receiving standard treatment
- Randomized to prednisone 40mg twice daily or no additional therapy
- Steroid group had a lower cumulative 31 day risk of respiratory failure and death as well as death within 84 days
- Only in those with moderate to severe PCP (PAO2 <70)
Posted 01/12/17 09:56:01 AM by Ying Liu
Created by Christopher Kelly
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