AHD Flashcards
(10 cards)
What is AHD
AHD according to WHO is defined as CD count less than 200 cells/mm3 or WHO clinical stage 3 or 4 event in adults, adolescents and children above 5yrs
Children below 5years are with HIV are considered to have AHD
List the common OIs associated with AHD from the commonest
- Tuberculosis
- Cryptococcal meningitis
- Pneumocystis Jirovecci Pneumonia
- Toxoplasmosis
- Histoplasmosis
- Severe Bacterial infections
Statistical relationship between TB and HIv
In 2019, 11% of TB cases diagnosed in Nigeria were co-infected with HIV
Factors responsible for persistent high burden of TB among PLWHIV
- Low ART coverage
- Low uptake of TPT
- Sub optimal case finding and diagnosis of active TB
What are the components of AHD
- Screening and diagnosis of AHD and associated OIs
- Prophylaxis treatment against common OIs associated with AHD
- Pre emptive treatment of OIs associated with AHD
- Diagnosis and treatment of confirmed OIs
- ART initiation
- Intensive adherence counseling
- Vaccination
What are the diagnostic tools for TB
TB LAM - Urine
LF LAM
Gene xpert - sputum, stool, CSF, cold abscess
Diagnostic for cryptococcal meningitis
Cryptococcal Antigen Assay - whole blood, serum, plasma
Lumber puncture and CSF cryptococcal Antigen Assay
CSF opening pressure
CSF with India ink
Prophylaxis for Cryptococcal meningitis
Tab Fluconazole 100mg daily for 8weeks when (I) CD4 count is less than 200cells and (ii)CrAg screening not available;(iii) no evidence of invasive cryptococcal meningitis
When CrAg screening is positive but no evidence of invasive cryptococcal meningitis
Tab Fluconazole 800mg for 2weeks, then 400mg for 8weeks then maintain with 200mg per day
Prophylaxis of choice in PLWHIV and the for Tuberculosis
Tuberculosis
- 6H- Isoniazid 300mg daily for 6months 6H
- 3HR- Isoniazid 300mg and Rifampicin 600mg daily for 3months
- Isoniazid 300mg and Rifapentine 600mg daily for 1month
- 3HP- Weekly Isoniazid 900mg and Rifapentine 900mg for 3months (12doses)
Drugs of choice for prophylaxis for
PCP, Toxoplasmosis, Severe Bacterial infections
Cryptococcal meningitis
Cotrimoxazole
Fluconazole
