HIV Infection and Antiretroviral Therapy

A 32-year-old man with a confirmed HIV diagnosis attends a sexual-health clinic in Vancouver. His CD4 count is 410 cells/microL, his viral load is 52 000 copies/mL, his eGFR is 96 mL/min and his heart rate is 84/min. The prescriber has ordered an abacavir-containing single-tablet regimen, but no HLA-B5701 result is on the chart. He also asks whether he can stop using condoms once he starts treatment. The nurse has to decide what must be confirmed before the first dose and how to answer him. Clinical priority: confirm the HLA-B5701 result before any abacavir-containing regimen, start ART as soon as possible, and teach that sustained viral suppression below 200 copies/mL on ART prevents sexual transmission. By the end of this lesson you will be able to: - Explain why HIV is confirmed with further testing and which baseline tests are done before and after ART starts. - Describe how ART works and why starting it promptly matters. - Verify ART orders for contraindications and interactions, including the HLA-B*5701 check before abacavir, and hold and query the prescriber when needed. -...