What is New in HIV Infection.
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Date
2014-12
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Abstract
Human immunodeficiency virus (HIV) prevention and treatment updates include screening recommendations, fourthgeneration
testing, preexposure prophylaxis, and a paradigm shift; treatment is prevention. The U.S. Preventive Services Task
Force recommends routine HIV screening in persons 15 to 65 years of age, regardless of risk. Fourth-generation testing is
replacing the Western blot and can identify those with acute HIV infection. The U.S. Food and Drug Administration approved
the OraQuick In-Home HIV Test; however, there are concerns about reduced sensitivity, possible misinterpretation of results,
potential for less effective counseling, and possible cost barriers. Preexposure prophylaxis (effective in select high-risk adult
populations) is the combination of safer sex practices and continuous primary care prevention services, plus combination
antiretroviral therapy. Concerns for preexposure prophylaxis include the necessity of strict medication adherence, limited use
among high-risk populations, and community misconceptions of appropriate use. Evidence supports combination antiretroviral
therapy as prevention for acute HIV infection, thus lowering community viral loads. Evidence has increased supporting
combination antiretroviral therapy for treatment at any CD4 cell count. Resistance testing should guide therapy in all patients
on entry into care. Within two weeks of diagnosis of most opportunistic infections, combination antiretroviral therapy should
be started; patients with tuberculosis and cryptococcal meningitis require special considerations.
Description
Keywords
HIV screening, OraQuick In-Home HIV Test, preexposure prophylaxis, combination antiretroviral therapy, CD4 cell count
Citation
Sherin Kevin, Klekamp Benjamin G, Beal Jeffrey, Martin Nicolle. What is New in HIV Infection. Indian Journal of Clinical Practice. 2014 Dec; 25(7): 608-614.