HIV/AIDS Treatment and Care : Clinical protocols for the European ...

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Contents I. Epidemiology and natural course of HBV infection ............................................................ 277 1. Prevalence of chronic hepatitis B........................................................................................ 277 2. Modes of transmission and risk factors............................................................................... 277 3. Genotypes............................................................................................................................ 278 4. Epidemiology of HBV infection in HIV-infected patients.................................................. 278 5. Natural course of HBV infection ........................................................................................ 278 5.1. Complications of chronic hepatitis B........................................................................... 278 5.2. Evolutionary phases of chronic hepatitis B ................................................................. 279 6. Reciprocal impact of HIV and HBV................................................................................... 280 6.1. Impact of HIV infection on HBV disease progression ................................................ 280 6.2. Impact of HBV infection on HIV disease progression ................................................ 280 II. Identification of HBV/HIV .................................................................................................... 281 1. Assessment of HBV risk and diagnosis of hepatitis B in HIV-infected patients................ 281 1.1. Initial laboratory assessment of HBV status................................................................ 281 1.2. Evaluation of HBV disease severity ............................................................................ 281 1.2.1. Clinical evaluation for signs and symptoms of advanced liver disease ............. 281 1.2.2. ALT level ............................................................................................................ 282 1.2.3. Determination of HBeAg.................................................................................... 282 1.2.4. HBV DNA level.................................................................................................. 282 1.2.5. Ultrasound and other evaluations ....................................................................... 283 1.2.6. Histological evaluation....................................................................................... 283 1.2.7. Clinical situations not requiring histological evaluation .................................... 284 2. Evaluation of comorbidities and co-conditions .................................................................. 284 2.1. Psychiatric disorders.................................................................................................... 284 2.2. Alcohol abuse............................................................................................................... 284 2.3. Drug use....................................................................................................................... 284 2.4. Other comorbidities and co-conditions........................................................................ 285 3. Assessment of HIV risk and diagnosis of HIV/AIDS in HBV patients.............................. 285 III. Clinical management of HBV/HIV patients ...................................................................... 286 1. Coinfected patients not requiring treatment........................................................................ 286 2. Coinfected patients requiring only hepatitis B treatment ................................................... 286 2.1. Anti-HBV drugs for treatment of hepatitis B in HIV-coinfected patients not requiring ART (doses and schedules) ........................................................................... 287 2.1.1. IFN and PEG-IFN............................................................................................... 287 2.1.2. Adefovir.............................................................................................................. 287 2.2. Evaluation and treatment algorithms for chronic hepatitis B in HIV-infected patients not requiring ART ........................................................................................... 288 2.2.1. Algorithm 1......................................................................................................... 288 2.2.2. Algorithm 2......................................................................................................... 289 2.2.3. Treatment options for HBV/HIV-coinfected patients with decompensated liver disease................................................................................ 290 3. Coinfected patients requiring only HIV or both hepatitis B and HIV treatment ................ 290 3.1. Considerations regarding treatment of hepatitis B ...................................................... 290 3.1.1. Symptomatic patients with a CD4 count of 200–350 cells/mm 3 ........................ 290 3.1.2. Patients with CD4 count
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HIV/AIDS TREATMENT AND CARE Clinica
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© World Health Organization 2007 A
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iv Acknowledgements The editors wou
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vi Marco Vitoria (WHO headquarters)
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viii CRP C-reactive protein CS caes
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x LFT liver function test LGE linea
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xii TDM therapeutic drug monitoring
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xiv Introduction HIV is a chronic i
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Annex 7. Glossary .................
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HIV/AIDS TREATMENT AND CARE CLINICA
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HIV/AIDS TREATMENT AND CARE CLINICA
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10 HIV/AIDS TREATMENT AND CARE CLIN
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1 HIV/AIDS TREATMENT AND CARE CLINI
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I. Principles management of opportu
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management of opportunistic infecti
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Table 8. pcp second-line treatment
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Table 12. oesophageal and dissemina
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5.9.1.2. Treatment Table 15. treatm
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palliative care for people living w
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III. Initial evaluation palliative
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IV. Treatment palliative care for p
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Fig. 2. who analgesic ladder for ma
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Type of pain or treatment Usual sta
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Table 5. prevalence of symptoms in
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Type Symptoms Possible causes Disea
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Type Symptoms Possible causes Disea
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Table 22. Management of mania and B
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Table 24. Management of cough or di
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V. Special advice for terminal care
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Table 27. common manifestations in
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References palliative care for peop
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VI. Suggested minimum data to be co
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136 HIV/AIDS TREATMENT AND CARE CLI
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Contents I. Policy and principles .
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I. Policy and principles HIV/AIDS T
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HIV/AIDS TREATMENT AND CARE FOR INJ
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° bacterial pneumonia ° endocardi
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Social factors are: • homelessnes
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Table 3. Interactions between ARV d
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Other medications Use Rifampicin (R
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Table 5. Interactions of illicit dr
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ANNEX 1 ASI6 C © 2004 University o
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• Cardiovascular Hypertension Tac
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Page 233 and 234: HIV/AIDS TREATMENT AND CARE FOR INJ
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Page 238 and 239: Contents I. Epidemiology and natura
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Page 312 and 313: I. Prevention strategies Prevention
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I. Policy issues Prevention of Hiv
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III. Initial evaluation Prevention
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Prevention of Hiv transmission from
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6. Fungal infections...............
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• Disseminated non-tuberculous my
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Annex 3. Rabies vaccines ..........
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442 hIv/aIds tReatment and caRe clI
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Contents I. Policy issues .........
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I. Policy issues post-exposure prop
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post-exposure prophylaxis for hiv i
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° condom use ° presence of STIs (
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Table 3. thre- drug arv regimens Pr
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VI. Suggested minimum data to be co
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History of antiretroviral treatment
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Test results: HBV: HCV: HIV: Post-t
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Infection control standard precauti
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The World Health Organization (WHO)
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