HIV Prevention and Treatment: The Evolving Role of the Emergency Department - 23/09/17
, Meredith Lora, MD b, Stephen Merjavy, MD b, Jennifer Chang, MD b, Sanjay Arora, MD a, Michael Menchine, MD, MPH a, Kathleen R. Jacobson, MD bAbstract |
Historically, the role of the emergency physician in HIV care has been constrained to treating sick patients with opportunistic infections and postexposure prophylaxis for occupational exposures. However, advances in HIV care have led to medications that have substantially fewer issues with toxicity and resistance, opening up an exciting new opportunity for emergency physicians to participate in treating the HIV virus itself. With this new role, it is crucial that emergency physicians be familiar with the advances in testing and medications for HIV prevention and treatment. To our knowledge, to date there has not yet been an article addressing this expansion of practice. We have compiled a summary of what the emergency physician needs to know, including misconceptions associated with antiretroviral therapy, medication complexity, toxicity, resistance, and usability. Additionally, we review potential indications for prescribing these drugs in the emergency department, including the role of the emergency physician in postexposure prophylaxis, preexposure prophylaxis, and treatment of acute HIV, as well as how emergency physicians can engage with chronic HIV infection.
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| Supervising editor: David A. Talan, MD |
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| All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). Drs. Arora, Menchine, and Jacobson report receiving a grant from FOCUS/Gilead, HIV/HCV on the Frontline of Communities of the US. |
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| Continuing Medical Education exam for this article is available at ACEPeCME/. |
Vol 70 - N° 4
P. 562 - octobre 2017 Retour au numéro
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