Adult Antiretroviral Guidelines

US DHHS Guidelines with Australian Commentary

Guidelines

General approach to the assessment of gastrointestinal symptoms in HIV patients

Gastrointestinal symptoms and illnesses are extremely common in the general population and also in patients with human immunodeficiency virus (HIV) infection. When assessing them it is important to assess:- Detailed history of presenting symptoms including: onset, severity, site/location, frequency and progression, triggering and relieving factors and associated features such as fevers and weight loss. Degree …

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Specific gastrointestinal disorders associated with HIV infection

The following section will discuss the diagnosis and management of a number of common bacterial, viral and parasitic gastrointestinal infections that may be seen in people with HIV infection, and also non-infectious diarrhoea. A number of important HIV-associated conditions are covered elsewhere in the website – Kaposi’s sarcoma and HBV and HCV infections. Readers are …

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References

eTG complete [digital]. Melbourne: Therapeutic Guidelines Limited; 2019 Jun. <https://www.tg.org.au> Saag MS, Pavia AT, Chambers HF, Eliopoulos GM, Gilbert DN. The Sanford Guide to HIV/AIDS and Hepatitis Therapy 2019. Sperryville: Antimicrobial Therapy Inc; 2019  Wilcox CM, Straub RF, CLark WS. Prospective evaluation of oropharyngeal findings in human immunodeficiency virus-infected patients with esophageal ulceration. Am J …

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Non-tuberculous mycobacterial infections in people with HIV infection

Jeffrey J. Post1,2,3 Department of Infectious Diseases, Prince of Wales Hospital, Sydney, NSW The Albion Centre, Sydney, NSW Prince of Wales Clinical School, University of New South Wales, Sydney NSW Last reviewed: November 2019  Introduction  The most common non-tuberculous mycobacteria (NTM) that infect and cause disease in people with HIV infection are members of the …

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Other non-tuberculous mycobacteria

The frequency of other NTM infections in people with HIV infection is lower than infections with MAC. In one retrospective series from Germany over 10 years (2006-2016), there were 87 patients with HIV infection out of a total of 297 (29%) patients with NTM infection.36 Thirty eight per cent of the people with HIV infection …

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References

. Crowe SM, Carlin JB, Stewart KI, et al. Predictive value of CD4 lymphocyte numbers for the development of opportunistic infections and malignancies in HIV-infected persons. J Acquir Immune Defic Syndr 1991; 4:770-6. Phillips P, Bonner S, Gataric N, et al. Nontuberculous mycobacterial immune reconstitution syndrome in HIV-infected patients: spectrum of disease and long-term follow-up. Clin …

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Mycobacterium tuberculosis infection in people with HIV infection

Suman Majumdar, Philipp du Cros  Burnet Institute and Department of Infectious Diseases, Alfred Hospital, Melbourne VIC Last reviewed: October 2019 Introduction Tuberculosis (TB) is an airborne infectious disease caused by Mycobacterium tuberculosis and is an acquired immune deficiency syndrome (AIDS)-defining illness in Australia and other high-income countries. TB remains a global health crisis with an …

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HIV/TB co-infection

HIV co-infection is the most powerful known risk factor for progression of LTBI to active disease. The risk of progression from LTBI to active TB in people with HIV infection is approximately 5 to 8% per year, in contrast to a 10% lifetime risk in HIV-negative people.[1] HIV has an impact on the host-pathogen (M. …

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Diagnosis

Active tuberculosis The optimal diagnosis of active TB involves early and accurate bacteriological confirmation in order to confirm M. tuberculosis infection and to detect potential anti-mycobacterial drug-resistance at baseline. Early diagnosis of HIV-associated TB can be difficult due to the non-specific clinical symptoms, inadequate diagnostic tools available and failure to consider it in the differential …

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Management of active tuberculosis

The management of active TB-HIV co-infection involves prompt initiation of an appropriate multidrug TB regimen that is guided by DST, commencing cART and treatment monitoring. The ASHM Antiretroviral Guidelines, an Australian handbook and several international guidelines include a more complete discussion of the diagnosis and treatment of TB in patients with HIV infection. TB can be a …

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