• Viral load is the value that indicates adherence to ARVs (rather than CD4 count)
  
  
  
  

  Posted 05/29/16 03:09:51 PM by Matthew Cummings

• Differential diagnosis for febrile diarrhea similar in HIV/AIDS patient vs non-HIV/AIDS patient with a few exceptions:
  • Parasitic infections (Cyclospora, Microspora, Isospora, Giardia) --> tend to be subacute/chronic in onset 
  • Mycobacterial infections (e.g. MAC) tend to be more chronic
  • MAC and CMV colitis usually occur in patients with CD4 count < 50-100 cells/mm3
  • Concomitant infections are common so need to work up for C. diff (if risk factors), other enteric bacteria, and O&P
  
  
  
  

  Posted 05/29/16 03:10:33 PM by Matthew Cummings

• Abacavir hypersensitivity syndrome: occurs in patients with haplotype HLA-B*5701 --> fever, diarrhea, rash, typically within 6 weeks of starting abacavir 
  • All patients now tested for this HLA haplotype prior to being started on abacavir (negative predictive value is 100% for developing the hypersensitivity syndrome)
  
  
  
  

  Posted 05/29/16 03:10:54 PM by Matthew Cummings

• Bacillary angiomatosis: rare AIDS-defining illness characterized by unique vascular lesions caused by infection with Bartonella henselae or quintana 
  • Can appear similar to KS
  • Gold standard: skin biopsy for histopathology
  • Treat with macrolides as first line (erythomycin) > doxycycline
  
  
  
  

  Posted 05/29/16 03:11:48 PM by Matthew Cummings

• For further reading...

  Review: etiology, investigation and management of diarrhea in the HIV-positive patient
  Abacavir hypersensitivity reaction
  Molecular Epidemiology of Bartonella Infections in Patients with Bacillary Angiomatosis–Peliosis
  
  
  
  
  

  Posted 05/29/16 03:14:49 PM by Matthew Cummings

Created by Christopher Kelly

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