At the end of this presentation, the participant should be able to: Cite 3 opportunistic infections where ARV therapy is part of the treatment Cite 5 opportunistic infections where ARV initiation may lead to IRS Give the appropriate management for a newly diagnosed PLWHA on TB therapy who has a CD4 count | Starting ARVs in the setting of Opportunistic Infections Learning Objectives At the end of this presentation, the participant should be able to: Cite 3 opportunistic infections where ARV therapy is part of the treatment Cite 5 opportunistic infections where ARV initiation may lead to IRS Give the appropriate management for a newly diagnosed PLWHA on TB therapy who has a CD4 count Outline of Presentation Introduction In which OIs can you start ARVs right away and in which can you not? Tuberculosis – What therapy can we start? Tuberculosis – When can we start therapy? Tuberculosis – Four treatment scenarios. Cryptococcus – When can we start therapy? Side Effects of ARV and OI medications Starting ARVs in the setting of an active Opportunistic Infection Introduction Introduction The decision to start ARVs is a balance between wanting the immune system to recover in order to fight infection vs. the risk of drug interactions and side effects the risk of immune reconstitution syndrome Introduction Little data exists on the best time to start ARVs when the patient is being treated for an OI. Clinical judgment must be used. Prior starting ARV therapy the patient should be responding to OI therapy, with no fever and no active side effects (rash). It is important to know the drug interactions of all medications before they are prescribed (look it up!) Guiding principles Always treat the acute OI first Begin ARVs when the patient is clinically stable Be vigilant for drug interactions and overlapping toxicities Beware of Immune reconstitution syndrome Do not be afraid to treat! Starting ARVs in the setting of an active Opportunistic Infection In which OIs can you start ARVs right away . | Starting ARVs in the setting of Opportunistic Infections Learning Objectives At the end of this presentation, the participant should be able to: Cite 3 opportunistic infections where ARV therapy is part of the treatment Cite 5 opportunistic infections where ARV initiation may lead to IRS Give the appropriate management for a newly diagnosed PLWHA on TB therapy who has a CD4 count Outline of Presentation Introduction In which OIs can you start ARVs right away and in which can you not? Tuberculosis – What therapy can we start? Tuberculosis – When can we start therapy? Tuberculosis – Four treatment scenarios. Cryptococcus – When can we start therapy? Side Effects of ARV and OI medications Starting ARVs in the .
