HIV - AIDS (main) - Revision history

Rossdonaldson1 at 18:02, 15 April 2026

2026-04-15T18:02:22Z

← Older revision		Revision as of 18:02, 15 April 2026
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	==Background==		==Background==
	*In HIV+ patient presenting to ED, absolute lymphocyte count (ALC) can be used as surrogate for CD4 count <ref> Napoli AM, Fischer CM, Pines JM, Soe-lin H, Goyal M, Milzman D. Absolute
	lymphocyte count in the emergency department predicts a low CD4 count in admitted HIV-positive patients. Acad Emerg Med. 2011 Apr;18(4):385-9. doi:10.1111/j.1553-2712.2011.01031.x. Erratum in: Acad Emerg Med. 2011 May;18(5):565.</ref>
	**A CD4 count of <200 is very likely if the ED ALC is <950 and less likely if the ALC is >1700
	**ALC is useful to confirm, but not exclude a low CD4
	*Approximately 1.2 million people in the US are living with HIV <ref name="HIV">CDC. Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data. HIV Surveillance Report. 2015; 20(2):1-70.</ref>		*Approximately 1.2 million people in the US are living with HIV <ref name="HIV">CDC. Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data. HIV Surveillance Report. 2015; 20(2):1-70.</ref>
	**13% of people with HIV in US aren't aware <ref name="HIV"></ref>		**13% of people with HIV in US aren't aware <ref name="HIV"></ref>
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	**Screening test: ELISA		**Screening test: ELISA
	**Confirmatory test: Western blot		**Confirmatory test: Western blot
			*In HIV+ patient presenting to ED, absolute lymphocyte count (ALC) can be used as surrogate for CD4 count <ref> Napoli AM, Fischer CM, Pines JM, Soe-lin H, Goyal M, Milzman D. Absolute
			lymphocyte count in the emergency department predicts a low CD4 count in admitted HIV-positive patients. Acad Emerg Med. 2011 Apr;18(4):385-9. doi:10.1111/j.1553-2712.2011.01031.x. Erratum in: Acad Emerg Med. 2011 May;18(5):565.</ref>
			**A CD4 count of <200 is very likely if the ED ALC is <950 and less likely if the ALC is >1700
			**ALC is useful to confirm, but not exclude a low CD4
	*Maintain low threshold for additional testing in setting of suspicion of opportunistic infections		*Maintain low threshold for additional testing in setting of suspicion of opportunistic infections
	*CDC (2006) recommends routine HIV screening in health care settings using an opt-out approach <ref>Branson B, Handsfield H, Lampe M. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. MMWR. 2006; 55: 1-17.</ref>		*CDC (2006) recommends routine HIV screening in health care settings using an opt-out approach <ref>Branson B, Handsfield H, Lampe M. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. MMWR. 2006; 55: 1-17.</ref>

Rossdonaldson1: /* Clinical Features */

2023-01-25T17:18:43Z

Clinical Features

← Older revision		Revision as of 17:18, 25 January 2023
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	==Clinical Features==		==Clinical Features==
	[[File:PMC3218701 hiv-2-089f1.png\|thumb\|View of posterior pharynx showing [[pseudomembranous oropharyngeal candidiasis]] in a patient with HIV, with a distribution concerning for esophageal candidiasis (later found on scope).]]		[[File:PMC3218701 hiv-2-089f1.png\|thumb\|View of posterior pharynx showing [[pseudomembranous oropharyngeal candidiasis]] in a patient with HIV, with a distribution concerning for esophageal candidiasis (later found on scope).]]
	[[File:Kaposis sarcoma 01.jpg\|thumb\|Kaposi sarcoma. Characteristic purple lesions on the nose in an HIV-positive female.]]		[[File:Kaposis sarcoma 01.jpg\|thumb\|[[Kaposi sarcoma]]. Characteristic purple lesions on the nose in an HIV-positive female.]]
	[[File:Kaposis Sarcoma Lesions.jpg\|thumb\|Kaposi's sarcoma skin lesion]]		[[File:Kaposis Sarcoma Lesions.jpg\|thumb\|[[Kaposi's sarcoma]] skin lesion]]
	[[File:Patch stage Kaposi's sarcoma.jpg\|thumb\|Patch stage Kaposi's sarcoma. Red to brownish irregularly shaped macules and plaques.]]		[[File:Patch stage Kaposi's sarcoma.jpg\|thumb\|Patch stage [[Kaposi's sarcoma]]. Red to brownish irregularly shaped macules and plaques.]]
	[[File:Kaposi’s sarcoma intraoral AIDS 072 lores.jpg\|thumb\|An HIV-positive person presenting with a Kaposi's sarcoma lesion with an overlying candidiasis infection in their mouth.]]		[[File:Kaposi’s sarcoma intraoral AIDS 072 lores.jpg\|thumb\|An HIV-positive person presenting with a [[Kaposi's sarcoma]] lesion with an overlying candidiasis infection in their mouth.]]
			[[File:Fundus photograph-CMV retinitis EDA07.jpg\|thumb\|Fundus photograph of [[CMV retinitis]]]]
	===Acute Infection===		===Acute Infection===
	*Misdiagnosed frequently as "mononucleosis" or "flu"		*Misdiagnosed frequently as "mononucleosis" or "flu"

Rossdonaldson1: /* Evaluation */

2023-01-25T17:17:46Z

Evaluation

← Older revision		Revision as of 17:17, 25 January 2023
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	==Evaluation==		==Evaluation==
			[[File:PMC4536784 ccrpm-suppl.1-2015-019f3.png\|thumb\|CT of [[Pneumocystis jirovecii pneumonia]], showing small nodular lesions surrounded by diffuse GGO.]]
	*Typical lab testing for HIV:		*Typical lab testing for HIV:
	**Screening test: ELISA		**Screening test: ELISA

Rossdonaldson1: /* Clinical Features */

2023-01-25T17:16:43Z

Clinical Features

← Older revision		Revision as of 17:16, 25 January 2023
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	==Clinical Features==		==Clinical Features==
	[[File:PMC3218701 hiv-2-089f1.png\|thumb\|View of posterior pharynx showing [[pseudomembranous oropharyngeal candidiasis]] in a patient with HIV, with a distribution concerning for esophageal candidiasis (later found on scope).]]		[[File:PMC3218701 hiv-2-089f1.png\|thumb\|View of posterior pharynx showing [[pseudomembranous oropharyngeal candidiasis]] in a patient with HIV, with a distribution concerning for esophageal candidiasis (later found on scope).]]
			[[File:Kaposis sarcoma 01.jpg\|thumb\|Kaposi sarcoma. Characteristic purple lesions on the nose in an HIV-positive female.]]
			[[File:Kaposis Sarcoma Lesions.jpg\|thumb\|Kaposi's sarcoma skin lesion]]
			[[File:Patch stage Kaposi's sarcoma.jpg\|thumb\|Patch stage Kaposi's sarcoma. Red to brownish irregularly shaped macules and plaques.]]
			[[File:Kaposi’s sarcoma intraoral AIDS 072 lores.jpg\|thumb\|An HIV-positive person presenting with a Kaposi's sarcoma lesion with an overlying candidiasis infection in their mouth.]]
	===Acute Infection===		===Acute Infection===
	*Misdiagnosed frequently as "mononucleosis" or "flu"		*Misdiagnosed frequently as "mononucleosis" or "flu"

Josgood: /* AIDS */

2023-01-03T01:36:48Z

AIDS

← Older revision		Revision as of 01:36, 3 January 2023
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	**[[Pruritic papular eruption of HIV]]		**[[Pruritic papular eruption of HIV]]
	**[[Primary CNS lymphoma\|Lymphoma]]		**[[Primary CNS lymphoma\|Lymphoma]]
	**MAC		**[[Mycobacterium avium\|MAC]]
	**[[PCP pneumonia]]		**[[PCP pneumonia]]
	**[[Progressive multifocal leukoencephalopathy]]		**[[Progressive multifocal leukoencephalopathy]]

Kfarzam: /* Seroconversion */

2022-08-20T06:16:40Z

Seroconversion

← Older revision		Revision as of 06:16, 20 August 2022
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	===Seroconversion===		===Seroconversion===
	*HIV Ab detectable 3-8wk after infection		*HIV Ab detectable 3-8wk after infection (sometimes sooner)
	*If negative Ab test but high suspicion, can HIV viral load.		*If negative Ab test but high suspicion, can HIV viral load.

Rossdonaldson1: /* Clinical Features */

2021-12-02T18:50:12Z

Clinical Features

← Older revision		Revision as of 18:50, 2 December 2021
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	==Clinical Features==		==Clinical Features==
			[[File:PMC3218701 hiv-2-089f1.png\|thumb\|View of posterior pharynx showing [[pseudomembranous oropharyngeal candidiasis]] in a patient with HIV, with a distribution concerning for esophageal candidiasis (later found on scope).]]
	===Acute Infection===		===Acute Infection===
	*Misdiagnosed frequently as "mononucleosis" or "flu"		*Misdiagnosed frequently as "mononucleosis" or "flu"

Jmf300: /* Asymptomatic */

2020-12-21T18:46:32Z

Asymptomatic

← Older revision		Revision as of 18:46, 21 December 2020
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	**Recurrent [[Herpes Zoster]]		**Recurrent [[Herpes Zoster]]
	**[[ITP]]		**[[ITP]]
			**Unexplained weight loss

	===AIDS===		===AIDS===

Elcatracho: /* See Also */

2020-12-14T14:59:09Z

Mholtz: Text replacement - "* " to "*"

2017-07-11T08:15:46Z

Text replacement - "* " to "*"

← Older revision		Revision as of 08:15, 11 July 2017
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	*Maintain low threshold for additional testing in setting of suspicion of opportunistic infections		*Maintain low threshold for additional testing in setting of suspicion of opportunistic infections
	*CDC (2006) recommends routine HIV screening in health care settings using an opt-out approach <ref>Branson B, Handsfield H, Lampe M. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. MMWR. 2006; 55: 1-17.</ref>		*CDC (2006) recommends routine HIV screening in health care settings using an opt-out approach <ref>Branson B, Handsfield H, Lampe M. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. MMWR. 2006; 55: 1-17.</ref>
	** Opt-out screening: performing the test after notifying the patient it will be performed & giving them the option to decline		**Opt-out screening: performing the test after notifying the patient it will be performed & giving them the option to decline

	==Management==		==Management==

← Older revision		Revision as of 17:18, 25 January 2023
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	==Clinical Features==		==Clinical Features==
	[[File:PMC3218701 hiv-2-089f1.png\|thumb\|View of posterior pharynx showing [[pseudomembranous oropharyngeal candidiasis]] in a patient with HIV, with a distribution concerning for esophageal candidiasis (later found on scope).]]		[[File:PMC3218701 hiv-2-089f1.png\|thumb\|View of posterior pharynx showing [[pseudomembranous oropharyngeal candidiasis]] in a patient with HIV, with a distribution concerning for esophageal candidiasis (later found on scope).]]
	[[File:Kaposis sarcoma 01.jpg\|thumb\|Kaposi sarcoma. Characteristic purple lesions on the nose in an HIV-positive female.]]		[[File:Kaposis sarcoma 01.jpg\|thumb\|[[Kaposi sarcoma]]. Characteristic purple lesions on the nose in an HIV-positive female.]]
	[[File:Kaposis Sarcoma Lesions.jpg\|thumb\|Kaposi's sarcoma skin lesion]]		[[File:Kaposis Sarcoma Lesions.jpg\|thumb\|[[Kaposi's sarcoma]] skin lesion]]
	[[File:Patch stage Kaposi's sarcoma.jpg\|thumb\|Patch stage Kaposi's sarcoma. Red to brownish irregularly shaped macules and plaques.]]		[[File:Patch stage Kaposi's sarcoma.jpg\|thumb\|Patch stage [[Kaposi's sarcoma]]. Red to brownish irregularly shaped macules and plaques.]]
	[[File:Kaposi’s sarcoma intraoral AIDS 072 lores.jpg\|thumb\|An HIV-positive person presenting with a Kaposi's sarcoma lesion with an overlying candidiasis infection in their mouth.]]		[[File:Kaposi’s sarcoma intraoral AIDS 072 lores.jpg\|thumb\|An HIV-positive person presenting with a [[Kaposi's sarcoma]] lesion with an overlying candidiasis infection in their mouth.]]
			[[File:Fundus photograph-CMV retinitis EDA07.jpg\|thumb\|Fundus photograph of [[CMV retinitis]]]]
	===Acute Infection===		===Acute Infection===
	*Misdiagnosed frequently as "mononucleosis" or "flu"		*Misdiagnosed frequently as "mononucleosis" or "flu"

← Older revision		Revision as of 14:59, 14 December 2020
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	*[[HIV post-exposure prophylaxis]]		*[[HIV post-exposure prophylaxis]]
	*[[Immune reconstitution inflammatory syndrome]]		*[[Immune reconstitution inflammatory syndrome]]

			==External Links==
			*http://www.cdc.gov/hiv/

	==References==		==References==