Adult Antiretroviral Guidelines

US DHHS Guidelines with Australian Commentary

Guidelines

TB-associated immune reconstitution inflammatory syndrome

TB-associated immune reconstitution inflammatory syndrome (TB-IRIS) occurs in two forms, unmasking and paradoxical. Case definitions have been published for resource-limited settings. Disease pathogenesis mechanisms are similar for both forms of TB-IRIS and reflect restoration of an immune response against M. tuberculosis after administration of cART that results in an exaggerated inflammatory response to live or …

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Treatment delivery and monitoring

Close collaboration among clinicians, health-care institutions and public health programs involved in the diagnosis and treatment of patients with HIV infection and TB is necessary in order to integrate care and improve patient outcomes. A specialist or specialists with appropriate expertise should supervise the management of all patients with HIV-TB co-infection in Australia. Hospital admission …

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References

World Health Organization. Global tuberculosis report 2018. Geneva: WHO; 2018. Available at: https://www.who.int/tb/publications/global_report/en/ Majumdar SS, Marais BJ, Denholm JT, Britton WJ. Drug-resistant tuberculosis: collaborative regional leadership required. Med J Aust 2014;200:241–2. Toms C, Stapledon R, Douglas P, National Tuberculosis Advisory Committee, for the Communicable Diseases Network Australia, Australian Mycobacterium Reference Laboratory Network, (null), et al. …

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Respiratory tract infections in patients with HIV infection

Dani Lin1, Ian Woolley1,2, Jeffrey Post3 Monash Infectious Diseases Department of Medicine, Monash University, Melbourne VIC Prince of Wales Hospital and Prince of Wales Clinical School, UNSW Last reviewed: October 2019 Introduction Respiratory complaints amongst people with HIV infection are common with a wide range of aetiologies, although the majority will be caused by common …

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Sinusitis

Sinusitis is a common problem in people with HIV infection. In one retrospective review, 11% of hospitalised patients were affected by this disorder.18 Sinusitis is more common with immunodeficiency (CD4+ T cell count < 200/μL), and it is more likely to be extensive and chronic in very immunodeficient patients. Up to one-third of cases may be …

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Bacterial pneumonia

Bacterial pneumonia is a significant cause of morbidity and mortality in people with HIV infection. It is predominantly caused by S. pneumoniae. People with HIV are at much higher risk of invasive pneumococcal infection than the general population, with the incidence of pneumococcal bacteraemia 100 times that of age-matched populations, and pneumococcal pneumonia rates five …

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References

Segal LN, Methe BA, Nolan A et al, HIV-1 and Bacterial Pneumonia in the Era of Antiretroviral Therapy,Proc Am Thorac Soc 2011;8:282-287 Grubb JR, Moorman AC, Baker RK, et al. The changing spectrum of pulmonary disease in patients with HIV infection on antiretroviral therapy. AIDS 2006;20:1095-107 ↑ Stansell JD, Osmond DH, Charlebois E, et al. …

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Primary HIV Infection

Nick Gazy1 and Anthony D Kelleher1,2 1. Dept of HIV and Immunology, St Vincent’s Hospital, Darlinghurst, NSW 2. Kirby Institute, UNSW Sydney Introduction Primary HIV infection (PHI) usually refers to the critical six-month period following the acquisition of HIV. This period, immediately following initial infection, is associated with a highly dynamic series of virological and immunological …

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