University of California, San Francisco |
Case Summary A clinical pharmacist called the CCC regarding a 49 year-old male diagnosed with HIV and hepatitis C (HCV) in 2006. He was started on co-formulated tenofovir DF (TDF)/emtricitabine/efavirenz shortly after diagnosis but then stopped taking it in 2013 after falling out of care. The patient presented in early 2015 to re-engage in care, […]
Case of the Month: Opioid Use and HIV Management During Pregnancy
This month, we feature a case from the Substance Use Warmline, our new clinician-to-clinician telephone consultation service focusing on substance use evaluation and management for primary care clinicians. This case, Opioid Use and HIV Management During Pregnancy, was authored by Joanna Eveland, MS, MD, with contributions from Lealah Pollock, MD, James Gasper, PharmD, and Cristina […]
World AIDS Day 2015: Acting Now to End AIDS
World AIDS Day reminds us that while we have come far in the prevention and management of HIV, we still have progress to make as we strive toward an AIDS-free generation. This year’s federal theme, The Time to Act is Now, urges providers to engage with at-risk and HIV-positive patients on all points of the HIV Care […]
PEP Tips: Laboratory Cadaver Exposures
PEP Tips: Laboratory Cadaver Exposures A treating clinician assessing the risk of transmission for a person stuck by an instrument while handling or studying a cadaver in a laboratory setting should first check for documentation of the cadaver’s bloodborne pathogen (BBP) status. Organ procurement and transplant policy requires that all potential deceased organ donors are […]
Case of the Month: PEP Management and Kidney Disease
Case Summary The Clinician Consultation Center received a call from an occupational health provider caring for a physician who had just been stuck with a needle used to perform an arthrocentesis on a known HIV-positive source patient (SP). The SP was taking combination antiretroviral therapy which consisted of co-formulated abacavir/lamivudine (Epzicom®) and efavirenz (Sustiva®). The […]
PEP Tips: Follow-Up Testing One Year After an Exposure
PEP Tips: Follow-Up Testing After One Year There is only one scenario for which HIV antibody testing of the exposed patient is warranted at one year post exposure. If the exposed patient seroconverts to HCV Ab-positive and has sustained an exposure to a source patient who is known to be HIV-HCV co-infected, the exposed patient […]
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Case of the Month: Exposure Management: Labor and Delivery and Breastfeeding
Case Summary The Clinician Consultation Center received a call from a nurse on labor and delivery (L&D) who was preparing to admit a woman who was actively in labor at 41 weeks gestation. From review of the chart, the patient (who is also a healthcare provider) sustained a needle-stick five to six weeks ago from […]
PEP Tips: Baseline Testing
PEP Tips: Baseline Testing If the exposed patient decides to take PEP medications, the CDC recommends a complete blood count (CBC) and renal and hepatic function tests at baseline and two weeks into treatment. Reference: Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure […]
Case of the Month: Considering PrEP for Sero-Discordant Couples
Case Summary The Clinician Consultation Center received a call from a primary care provider regarding a 34-year-old man who was evaluated in the emergency department three days earlier for a non-occupational exposure after the condom broke during intercourse with his HIV-positive female partner. The patient has completed three days of post-exposure prophylaxis (PEP) medications without […]