#121 HIV Care for the Internist

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 22 October 2018

⏱️ 61 minutes

🔗️ Recording | iTunes | RSS

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Summary

HIV care for the internist with author and HIV expert, Michael Saag MD, Professor of Infectious Diseases at University of Alabama and founder of the 1917 Clinic. We discuss the specifics of screening & diagnostic testing in HIV, monitoring CD4 counts and viral loads, first line antiretroviral therapy, harm reduction, and how to provide excellent HIV care in your primary care clinic.

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Credits

Written & Produced by: Elena Gibson MS4, Justin Berk MD MBA MPH

Artwork by: Elena Gibson MS4

Hosts: Matthew Watto MD, Paul Williams MD, Justin Berk MD MBA MPH

Editor: Matthew Watto MD

Guest: Michael Saag MD

Time Stamps

00:00 Disclaimer, intro, and guest bio
04:35 Getting to know our guest, a movie recommendation, and words of wisdom
08:48 Clinical case, HIV screening, in-depth discussion of HIV testing & diagnosis
15:56 New diagnosis of HIV, counseling after diagnosis, confirmation, follow-up testing, the second visit
24:20 Treatment - what to start and when; some basic comments on therapy
30:05 Primary care after diagnosis, vaccines, cancer screening, cardiovascular disease prevention
34:35 Monitoring CD4 counts and viral load; interpreting CD4 count; time course of response for CD4 and viral load
42:02 Harm reduction counseling; addressing medication non-adherence
47:40 PCP prophylaxis
49:43 The 1917 Clinic, Ryan White Clinics, and linking patients to care
53:10 Take home points
55:40 Plugs
57:45 Will a cure or vaccine for HIV emerge?
59:16 Outro

Transcript

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0:00.0	The first cyber-block has been for entertainment education and information process only.
0:09.2	And the topics discussed should not be used only by industry,
0:10.7	you're ordinary and in these ordinary conditions.
0:12.0	But more than you would say it's expressed on the cyber-block has been so low to those,
0:13.7	should not be interpreted perfectly for official policy,
0:14.8	or for the should of any entity, the cyber-phosphate,
0:16.0	cash-like morons will end up in the outreach programs,
0:17.4	and indeed there are any in fact there are none.
0:18.9	Pretty much we are responsible for this throughout,
0:19.9	but we should always do our homework and let's know when we're ready.
0:21.3	Welcome back to the Curbsiders.
0:37.6	And again, not interrupted, so that must mean that Stuart's not here, Paul.
0:42.4	It's really unsettling.
0:44.6	Paul, let's just get right to it.
0:47.2	Why don't you tell the audience what it is we do on this show?
0:50.1	Sure, I'd be delighted too.
0:51.7	We are an internal medicine podcast,
0:54.1	and we use expert interviews to bring you clinical pearls and practice changing knowledge.
0:58.0	We also, at the outset of the show, like to get to know our guests a little bit,
1:01.6	talk about hobbies and things that sort of relax us when we do outside of medicine.
1:05.1	Listen, you're an adult.
1:07.0	I mean, you make your own decisions.
	...

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