HIV Treatment and Testing Overview

Flashcards summarizing key concepts and terminology related to the HIV testing and treatment algorithms.

HIV Testing Algorithm

A systematic approach to diagnosing HIV that includes a 4th generation HIV Ag/Ab test followed by an HIV-1/HIV-2 antibody differentiation immunoassay.

Step 1 Test

4th generation HIV Ag/Ab test; it detects p24 antigen and HIV-1/2 antibodies.

Step 2 Test

HIV-1/HIV-2 antibody differentiation immunoassay; used to confirm diagnosis and type.

Treatment Goal for ART

Achieve a viral load of less than 20-75 copies/ml or undetectable to suppress the virus and prevent disease progression.

NRTIs

Nucleoside Reverse Transcriptase Inhibitors; foundational drugs in HIV treatment regimens.

Initial HIV Regimen Structure

Every regimen consists of 2 NRTIs (backbone) + 1 drug from another class, typically an INSTI.

INSTI

Integrase Strand Transfer Inhibitor; a first-line treatment option in HIV regimens.

Dovato

A 2-drug regimen of dolutegravir and lamivudine, used in select patients with low viral load.

Resistance Testing

Genotype testing recommended before starting ART to identify any drug resistance.

Abacavir Testing Requirement

HLA-B*5701 testing is required before starting abacavir to avoid hypersensitivity reactions.

First-Line HIV Regimen for Most Patients

Biktarvy, which includes bictegravir, TAF, and emtricitabine.

Side Effect of PIs

Protease Inhibitors can cause metabolic effects such as hyperglycemia and dyslipidemia.

Weight Gain Associated ARVs

INSTIs, especially dolutegravir and bictegravir, are associated with weight gain.

Entry Inhibitors

A class that blocks viral entry into host cells, used for treatment-experienced patients.

Tenofovir Comparison

TAF is safer for kidneys and bones compared to TDF, which has risks for renal toxicity.

Acid-Reducing Agent Interactions

Rilpivirine requires an acidic environment for absorption and should not be taken with PPIs.

NRTI Toxicity

Mitochondrial toxicity leading to lactic acidosis and GI upset is a concern with NRTIs.

Monitoring Frequency on ART

CD4 and viral load should be monitored every 3-6 months in patients on ART.

Goals of ART Monitoring

Focus on efficacy (viral load), adherence, and side effects post ART initiation.