Screen with 4th-generation HIV-1/2 Ag/Ab immunoassay (detects p24 capsid antigen + antibodies); confirm with HIV-1/HIV-2 antibody differentiation + HIV RNA PCR.
Pneumocystis jirovecii: diffuse ground-glass infiltrates, elevated LDH & β-D-glucan, GMS silver stain; Rx: TMP-SMX + Prednisone if PaO2 < 70 or A-a ≥ 35.
Toxoplasma gondii = multiple ring-enhancing lesions in basal ganglia (Rx: Pyrimethamine + Sulfadiazine + Leucovorin); Primary CNS Lymphoma = solitary periventricular lesion + CSF EBV PCR+.
Cryptococcus neoformans: subacute headache/meningismus + severely elevated LP opening pressure + CrAg / India ink / mucicarmine; Rx: Amphotericin B + Flucytosine → Fluconazole.
CMV (owl's-eye inclusions; retinitis, linear esophageal ulcers, colitis; Rx: Ganciclovir/Valganciclovir); MAC (fever, night sweats, pancytopenia, high ALP; Rx: Clarithromycin/Azithromycin + Ethambutol).
Both cause violaceous vascular skin papules in AIDS! Kaposi = HHV-8 (spindle cells + lymphocytic infiltrate); Bacillary angiomatosis = Bartonella henselae (cat scratch, neutrophilic infiltrate; Rx: Doxycycline).
Standard initial ART = INSTI (Bictegravir or Dolutegravir) + 2 NRTIs (Tenofovir + Emtricitabine); Abacavir requires HLA-B*5701 test; Tenofovir TDF = Fanconi proximal RTA.
Delay starting ART for 4–6 weeks after initiating antifungal therapy for Cryptococcal meningitis (and 2 weeks in severe TB meningitis) to prevent fatal intracranial IRIS!
Opportunistic Infections by CD4 Nadir & Management Guidelines
In patients living with Human Immunodeficiency Virus (HIV-1, an enveloped diploid ssRNA lentivirus that binds CD4 and CCR5/CXCR4 coreceptors on helper T lymphocytes, macrophages, and microglia), the absolute CD4+ T-lymphocyte count is the single strongest predictor of opportunistic infection (OI) susceptibility. Memorizing the three canonical CD4 thresholds (<200, <100, and <50 cells/mm3) governs both clinical diagnosis of AIDS-defining illnesses and antimicrobial prophylaxis.
| CD4 Cell Count Threshold | Opportunistic Pathogen & Disease | Classic Clinical Presentation & Diagnostics | First-Line Treatment & Prophylaxis |
|---|---|---|---|
| CD4 < 200 / μL | Pneumocystis jirovecii (PJP) | Subacute exertional dyspnea, dry cough, hypoxemia disproportionate to exam; bilateral perihilar ground-glass infiltrates; ↑ LDH | High-dose TMP-SMX (IV/PO) × 21 days; add prednisone if PaO2 < 70 mmHg or A-a gradient ≥ 35; Prophylaxis: TMP-SMX 1 DS daily |
| CD4 < 100 / μL | Toxoplasma gondii | Headache, focal neurologic deficits, seizures; Brain MRI: multiple ring-enhancing lesions with surrounding vasogenic edema in basal ganglia | Sulfadiazine + Pyrimethamine + Leucovorin; Prophylaxis: TMP-SMX 1 DS daily (covers both PJP and Toxoplasma) |
| CD4 < 100 / μL | Cryptococcus neoformans | Subacute meningoencephalitis, fever, elevated ICP; India ink / cryptococcal antigen (CrAg) in CSF; Sabouraud agar growth | Induction: Liposomal Amphotericin B + Flucytosine × ≥ 2 weeks → Consolidation: Fluconazole; serial lumbar punctures to relieve ICP |
| CD4 < 50 / μL | Mycobacterium avium complex (MAC) | Fever, night sweats, severe weight loss, chronic watery diarrhea, hepatosplenomegaly; elevated alkaline phosphatase; acid-fast bacilli on blood culture | Clarithromycin + Ethambutol ± Rifabutin; Primary prophylaxis: Azithromycin 1200 mg weekly (only if suppressive ART delayed) |
| CD4 < 50 / μL | Cytomegalovirus (CMV) Retinitis | Painless visual blurring, floaters, scotomas; Funduscopy: 'ketchup and cottage cheese' (perivascular retinal hemorrhages + white necrotic exudates) | IV Ganciclovir / Valganciclovir or intravitreal Foscarnet; routine ophthalmologic monitoring to avoid permanent blindness |
CD4 <200 Tier: Pneumocystis jirovecii Pneumonia (GMS Stain, Steroid PaO2 <70 Cutoff & TMP-SMX) & Cryptococcal Meningitis
When the CD4+ count falls below 200 cells/mm3, initiate primary prophylaxis against Pneumocystis jirovecii Pneumonia (PJP, formerly PCP) using oral Trimethoprim-Sulfamethoxazole (TMP-SMX, Bactrim) (alternatives for sulfa allergy or G6PD deficiency: Dapsone [check G6PD first!], Atovaquone, or Inhaled Pentamidine). PJP is an atypical yeast-like fungus presenting subacutely over weeks with progressive exertional dyspnea, fever, non-productive ('dry') cough, hypoxia that desaturates markedly with ambulation, elevated serum LDH and 1,3-β-D-glucan, and bilateral diffuse symmetric ground-glass ('bat-wing') interstitial infiltrates on chest radiograph/CT (can also form upper-lobe pneumatoceles precipitating spontaneous pneumothorax!). Definitive diagnosis requires bronchoalveolar lavage (BAL) or induced sputum stained with Gomori Methenamine Silver (GMS) showing disc-shaped ('crushed ping-pong ball') yeast cysts. First-line treatment for PJP is high-dose IV/PO TMP-SMX for 21 days. CRITICAL BOARD RULE FOR ADJUNCTIVE STEROIDS IN PJP: Administer Systemic Corticosteroids (Prednisone taper) alongside TMP-SMX whenever the patient has severe PJP defined by room-air arterial PaO2 <70 mmHg OR an Alveolar-arterial (A-a) oxygen gradient ≥35 mmHg (or SpO2 <92%), because antibiotic-induced fungal lysis triggers fatal alveolar inflammation! Below CD4 100–150 cells/mm3, Cryptococcus neoformans (heavily encapsulated yeast inhaled from pigeon droppings) causes subacute meningoencephalitis (headache, fever, cranial nerve palsies, extreme opening pressure >250–400 mmH2O requiring serial therapeutic lumbar punctures!) diagnosed by CSF Cryptococcal Antigen (CrAg), India Ink stain (clear halo around budding yeast), or Mucicarmine stain. Treat Cryptococcal meningitis with 3 phases: (1) Induction with Liposomal Amphotericin B + Flucytosine for 2 weeks → (2) Consolidation with Fluconazole (8 weeks) → (3) Maintenance with Fluconazole (1 year)—and delay starting Antiretroviral Therapy (ART) for 4 to 6 weeks in Cryptococcal Meningitis to prevent fatal CNS Immune Reconstitution Inflammatory Syndrome (IRIS)!
CD4 <100 (Toxoplasma Ring-Enhancing vs. CNS Lymphoma EBV) & CD4 <50 (MAC, CMV Retinitis & Cryptosporidium)
At a CD4+ count below 100 cells/mm3 (and positive Toxoplasma IgG serology), initiate primary prophylaxis with TMP-SMX against Cerebral Toxoplasmosis (Toxoplasma gondii reactivation from cat feces/undercooked meat). On Brain MRI, boards routinely ask you to distinguish the two causes of Ring-Enhancing Brain Lesions in AIDS: Cerebral Toxoplasmosis typically presents with MULTIPLE subcortical/basal ganglia ring-enhancing lesions, whereas Primary CNS Lymphoma (a diffuse large B-cell lymphoma uniformly driven by Epstein-Barr Virus [EBV]) typically presents as a SOLITARY periventricular/corpus callosum ring-enhancing lesion with positive CSF EBV PCR (if empiric Pyrimethamine + Sulfadiazine + Leucovorin for 2 weeks fails to shrink the lesions, perform stereotactic brain biopsy for CNS lymphoma!). Other CD4 <100 OIs include Esophageal Candidiasis (odynophagia + oral thrush; treat with Oral/IV Fluconazole, NOT nystatin swish-and-swallow; if odynophagia fails to improve, perform EGD to distinguish CMV Esophagitis [single large linear deep ulcer + intranuclear 'owl's-eye' inclusions → Ganciclovir] from HSV Esophagitis [multiple small punched-out vesicles/ulcers + multinucleated giant cells → Acyclovir]) and Bacillary Angiomatosis (Bartonella henselae from cat scratches causing friable vascular papules that mimic Kaposi sarcoma [HHV-8], but show neutrophilic infiltrate and Warthin-Starry stain bacilli → treat with Doxycycline or Azithromycin). Finally, when CD4 drops below 50 cells/mm3, watch for Disseminated Mycobacterium avium complex (MAC) (fever, drenching night sweats, weight loss, hepatosplenomegaly, pancytopenia, high alkaline phosphatase → treat with Clarithromycin/Azithromycin + Ethambutol; note that primary MAC prophylaxis is no longer recommended if ART is initiated immediately!) and Cytomegalovirus (CMV) Retinitis (painless blurred vision/floaters with perivascular retinal hemorrhages and fluffy white exudates—'pizza-pie / cottage-cheese and ketchup' retinopathy → treat with Valganciclovir / Ganciclovir).
Antiretroviral Pharmacology & Key Board Toxicities
Modern Antiretroviral Therapy (ART) is initiated immediately in all individuals diagnosed with HIV regardless of CD4 count (reducing viral load to undetectable [<20–50 copies/mL] and eliminating sexual transmission: U=U). First-line regimens combine a high-genetic-barrier Integrase Strand Transfer Inhibitor (INSTI: Biktarvy [bictegravir/TAF/emtricitabine] or dolutegravir-based regimens) with two Nucleoside Reverse Transcriptase Inhibitors (NRTIs).
| Drug Class | Representative Agents | Mechanism of Action | High-Yield Board Toxicity / Contraindication |
|---|---|---|---|
| NRTIs (Nucleoside Reverse Transcriptase Inhibitors) | Tenofovir (TDF vs TAF), Emtricitabine, Abacavir, Lamivudine, Zidovudine | Competitively inhibit reverse transcriptase; lack 3'-OH group causing chain termination | Abacavir: Fatal hypersensitivity in HLA-B*5701 positive; TDF: Fanconi nephropathy and bone demineralization (TAF has less renal/bone toxicity); Zidovudine: Macrocytic anemia and bone marrow suppression |
| NNRTIs (Non-Nucleoside) | Efavirenz, Rilpivirine, Nevirapine | Allosterically bind reverse transcriptase near active site; do not require phosphorylation | Efavirenz: Vivid nightmares, neuro-psychiatric disturbances, teratogenicity (neural tube defects); Nevirapine: Fulminant hepatotoxicity, SJS/TEN |
| INSTIs (Integrase Inhibitors) | Bictegravir, Dolutegravir, Raltegravir | Inhibit HIV integrase, blocking proviral DNA integration into host cellular chromosome | Dolutegravir / Bictegravir: Weight gain, insomnia; Raltegravir: Rhabdomyolysis and ↑ CK. Modern first-line backbone due to high resistance barrier |
| Protease Inhibitors (PIs) | Darunavir, Atazanavir, Ritonavir (booster) | Prevent cleavage of Gag-Pol polyprotein, producing immature, non-infectious virions | Metabolic syndrome: Hyperlipidemia, insulin resistance/lipodystrophy; Atazanavir: Indirect hyperbilirubinemia, nephrolithiasis; Ritonavir: Potent CYP3A4 inhibitor |
NRTI Backbone Toxicities: Abacavir HLA-B*5701 Hypersensitivity, Tenofovir (TDF vs. TAF) Fanconi Syndrome & Zidovudine
Every standard HIV regimen includes a dual-NRTI backbone (classically Tenofovir + Emtricitabine [FTC] or Lamivudine [3TC], which are also active against Hepatitis B Virus!), which act as nucleoside/nucleotide analogues lacking a 3'-hydroxyl group to cause competitive DNA chain termination of HIV reverse transcriptase (after intracellular phosphorylation by host kinases; note that Tenofovir is a pre-phosphorylated nucleotide). Memorize the signature board toxicities of individual NRTIs: (1) Abacavir (ABC) is strictly contraindicated in patients who carry the HLA-B*5701 allele; therefore, HLA-B*5701 genetic screening is MANDATORY before ever prescribing Abacavir to prevent a potentially fatal Type IV Abacavir Hypersensitivity Syndrome (fever, rash, GI distress, and respiratory symptoms within 6 weeks; re-challenge causes immediate anaphylactoid shock and death!). (2) Tenofovir Disoproxil Fumarate (TDF) causes proximal renal tubular toxicity (Type 2 Proximal RTA and Fanconi Syndrome: normoglycemic glycosuria, phosphaturia, aminoaciduria) and decreased Bone Mineral Density (osteopenia); switching to the newer prodrug Tenofovir Alafenamide (TAF) concentrates tenofovir inside lymphoid cells with 90% lower plasma exposure, markedly reducing renal and bone toxicity. (3) Zidovudine (AZT / ZDV) (historically used for intrapartum IV infusion during delivery when maternal HIV viral load is >1,000 copies/mL) causes severe Bone Marrow Suppression (macrocytic anemia and neutropenia) and mitochondrial myopathy. Class-wide, older NRTIs (especially stavudine/didanosine) inhibit human mitochondrial DNA polymerase-γ, causing hepatic steatosis, pancreatitis, peripheral neuropathy, and severe Lactic Acidosis.
INSTIs (Dolutegravir/Bictegravir), Protease Inhibitors (Ritonavir CYP3A4 & Lipodystrophy), NNRTIs & Pre/Post-Exposure Prophylaxis
Understand the mechanisms and signature adverse effects of the remaining antiretroviral classes and prevention protocols: (1) Integrase Strand Transfer Inhibitors (INSTIs — '-tegravir': Bictegravir, Dolutegravir, Cabotegravir, Raltegravir, Elvitegravir) block HIV integrase from inserting viral cDNA into the host chromosome; they are the #1 first-line cornerstone of modern ART, with main side effects of weight gain, insomnia/headache, and benign inhibition of renal tubular OCT2 creatinine secretion (dolutegravir/bictegravir cause a mild, non-pathologic 0.1–0.2 mg/dL rise in serum creatinine without changing true GFR!), plus chelation by oral divalent cations (take 2 hours before or 6 hours after calcium/iron/magnesium antacids). (2) Protease Inhibitors (PIs — '-navir': Darunavir, Atazanavir, Lopinavir, Ritonavir) inhibit HIV-1 aspartate protease, preventing cleavage of the gag-pol polyprotein and producing immature, non-infectious virions. Because Ritonavir (and Cobicistat) is a potent CYP3A4 inhibitor, low-dose ritonavir is used as a pharmacokinetic 'booster' for other PIs. PI toxicities include hyperglycemia (insulin resistance), hypertriglyceridemia, lipodystrophy (Cushingoid 'buffalo hump' fat redistribution), unconjugated hyperbilirubinemia and radiolucent nephrolithiasis (Atazanavir and Indinavir). (3) Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs: Efavirenz, Rilpivirine, Doravirine) bind an allosteric hydrophobic pocket on HIV-1 reverse transcriptase without requiring intracellular phosphorylation (ineffective against HIV-2!); Efavirenz causes vivid dreams, dizziness, depression, and suicidality. (4) Entry Inhibitors: Maraviroc blocks host CCR5 (requires tropism assay confirming R5-tropic HIV), while Enfuvirtide (T-20) binds viral gp41 to block membrane fusion. For HIV Post-Exposure Prophylaxis (PEP) after a high-risk needlestick or sexual assault, initiate a 3-drug regimen (Tenofovir/Emtricitabine + Dolutegravir or Raltegravir) within 72 hours (ideally <2 hours) for 28 days; for Pre-Exposure Prophylaxis (PrEP), prescribe daily oral Tenofovir/Emtricitabine (Truvada/Descovy) or long-acting IM Cabotegravir after confirming a negative 4th-generation HIV Ag/Ab screen!
HIV Virology, Structural Genes, Coreceptors & 4th-Generation Diagnostic Algorithm
| CD4+ T-Cell Threshold | Signature Opportunistic Pathogen(s) | Classic Clinical Syndrome | Primary Prophylaxis Regimen | Discontinuation Criteria (on ART) |
|---|---|---|---|---|
| CD4 < 500 cells/μL | Candida albicans, EBV, HHV-8, HPV, M. tuberculosis | Oral thrush (scrapable), Oral hairy leukoplakia (EBV, lateral tongue, unscrapable), Kaposi sarcoma, TB | None (treat latent TB if IGRA/PPD ≥ 5 mm with INH/Rifapentine) | Initiate universal Antiretroviral Therapy (ART) immediately at any CD4 count |
| CD4 < 200 cells/μL | Pneumocystis jirovecii (PJP), Histoplasma capsulatum, Coccidioides, Cryptosporidium | Subacute hypoxia, dry cough, diffuse ground-glass infiltrates; chronic watery diarrhea | TMP-SMX (1st-line); alternatives: Dapsone (check G6PD!), Atovaquone, aerosolized Pentamidine | Stop when CD4 > 200 cells/μL for > 3 months on ART |
| CD4 < 100 cells/μL | Toxoplasma gondii, Cryptococcus neoformans, Candida (esophageal), Bartonella henselae | Multiple ring-enhancing brain lesions; subacute meningitis with high ICP; odynophagia | TMP-SMX DS daily (if Toxoplasma IgG seropositive; covers both Toxo & PJP!) | Stop when CD4 > 200 cells/μL for > 3 months on ART |
| CD4 < 50 cells/μL | Cytomegalovirus (CMV), Mycobacterium avium complex (MAC), JC Virus (PML), EBV (PCNSL) | Pizza-pie retinitis, linear esophageal ulcers; disseminated fever/night sweats/high ALP | No primary MAC prophylaxis if starting ART immediately (Azithromycin 1200 mg weekly only if ART delayed) | Prompt ART initiation + dilated funduscopic screening for CMV |
Structural Genes (gag, env) & Tropism Coreceptors (CCR5 R5 vs. CXCR4 X4)
Acute Retroviral Syndrome, Clinical Latency & AIDS-Defining Thresholds
CDC 4th-Generation HIV Diagnostic Algorithm, Neonatal Testing & Opportunistic Prophylaxis Cutoffs
CNS Opportunistic Infections in AIDS Differential: Toxoplasmosis vs. Primary CNS Lymphoma vs. Cryptococcus vs. PML
| CNS Opportunistic Infection | Etiologic Pathogen & CD4 Cutoff | Brain MRI Appearance | Definitive Diagnostic Test | First-Line Treatment Protocol |
|---|---|---|---|---|
| Cerebral Toxoplasmosis | Toxoplasma gondii (CD4 < 100; cat feces / undercooked meat) | MULTIPLE ring-enhancing lesions in basal ganglia with edema & mass effect | Positive serum Toxo IgG + response to 2-week empiric therapy | Pyrimethamine + Sulfadiazine + Leucovorin (folinic acid) |
| Primary CNS Lymphoma (PCNSL) | Epstein-Barr Virus (EBV) B-cell lymphoma (CD4 < 50–100) | SOLITARY periventricular / corpus callosum ring-enhancing lesion | Positive CSF EBV DNA PCR (or stereotactic biopsy if Toxo Rx fails) | High-dose IV Methotrexate + immediate ART (± rituximab) |
| Cryptococcal Meningitis | Cryptococcus neoformans (CD4 < 100; pigeon droppings) | Leptomeningeal enhancement, 'soap-bubble' Virchow-Robin space cysts | LP: High opening pressure + CSF CrAg, India ink halo, Mucicarmine red capsule | Amphotericin B + Flucytosine (2 wk) → Fluconazole + serial LPs (delay ART 4–6 wk!) |
| Progressive Multifocal Leukoencephalopathy (PML) | JC Polyomavirus infecting oligodendrocytes (CD4 < 200 or Natalizumab) | Asymmetric subcortical white matter T2 lesions with NO contrast enhancement & NO mass effect! | Positive CSF JC Virus DNA PCR | Immediate ART initiation to restore immune function (or stop Natalizumab) |
| HIV Encephalopathy (HAND) | HIV-1 in CNS microglia & macrophages (multinucleated giant cells) | Diffuse symmetric cortical atrophy + symmetric confluent white matter T2 changes (no enhancement) | Clinical diagnosis of exclusion (subcortical dementia + gait/motor slowing) | Antiretroviral Therapy (ART) |
Cerebral Toxoplasmosis vs. Primary CNS Lymphoma (EBV): Ring-Enhancing Lesion Algorithm
Cryptococcal Meningoencephalitis: Opening Pressure, CrAg, India Ink & 3-Phase Antifungal Therapy
Progressive Multifocal Leukoencephalopathy (JC Virus) vs. HIV-Associated Dementia
Pulmonary, GI, Retinal & Cutaneous Opportunistic Infections (PJP, MAC, CMV, Esophagitis, Kaposi vs. Bartonella)
| Opportunistic Entity | Pathogen & CD4 Threshold | Classic Clinical & Endoscopic / Exam Clues | Pathognomonic Histopathology / Stain | First-Line Therapy |
|---|---|---|---|---|
| Pneumocystis Pneumonia (PJP) | Pneumocystis jirovecii (CD4 < 200) | Subacute dyspnea, dry cough, diffuse bilateral ground-glass infiltrates, ↑ LDH, ↑ β-D-glucan | BAL GMS silver stain: disc/cup-shaped cysts in foamy alveolar exudate | TMP-SMX (21d) + Prednisone if PaO2 < 70 or A-a ≥ 35 |
| Candida vs. HSV vs. CMV Esophagitis | Candida (< 100), HSV-1 (< 100), CMV (< 50) | Odynophagia; Candida: white plaques; HSV: small punched-out ulcers; CMV: deep linear ulcers | Candida: pseudohyphae; HSV: Cowdry A; CMV: basophilic 'Owl's-Eye' inclusions | Candida: Oral Fluconazole; HSV: Acyclovir; CMV: Ganciclovir / Valganciclovir |
| Disseminated MAC | Mycobacterium avium complex (CD4 < 50) | Fever, drenching night sweats, weight loss, diarrhea, pancytopenia, ↑↑ ALP | Positive mycobacterial blood culture; macrophages packed with acid-fast bacilli | Clarithromycin (or Azithromycin) + Ethambutol (± Rifabutin) |
| Kaposi Sarcoma | HHV-8 (CD4 < 200–500; MSM) | Violaceous plaques/nodules on skin, hard palate, GI tract, lungs | Spindle cells, slit-like vascular spaces + LYMPHOCYTIC infiltrate | Antiretroviral Therapy (ART) + liposomal doxorubicin if visceral |
| Bacillary Angiomatosis | Bartonella henselae (CD4 < 100; cat scratch/fleas) | Friable violaceous vascular papules/nodules mimicking Kaposi sarcoma + fever | Lobular capillaries + NEUTROPHILIC (PMN) infiltrate + Warthin-Starry silver stain bacilli | Doxycycline or Azithromycin / Erythromycin |
Pneumocystis jirovecii Pneumonia (PJP): Silver Stain, LDH/Beta-D-Glucan & The PaO2 < 70 Steroid Rule
HIV Esophagitis (Candida vs. HSV vs. CMV) & Chronic Diarrhea (Cryptosporidium, MAC)
Kaposi Sarcoma (HHV-8) vs. Bacillary Angiomatosis (Bartonella henselae) & Molluscum Contagiosum
Antiretroviral Pharmacology, Toxicities, IRIS & PrEP / PEP / Peripartum MTCT Protocols
| Antiretroviral Drug / Protocol | Pharmacologic Class & Target | Signature Adverse Effect / Toxicity | High-Yield Clinical & Board Rule |
|---|---|---|---|
| Bictegravir / Dolutegravir / Cabotegravir | Integrase Strand Transfer Inhibitors (INSTIs) | Mild weight gain; benign +0.15 mg/dL creatinine rise (blocks OCT2 secretion, normal GFR) | 1st-line anchor for initial ART and PEP; separate from Ca2+/Mg2+/Fe2+ antacids |
| Abacavir (ABC) | NRTI (guanosine analog chain terminator) | Fatal Type IV Hypersensitivity Syndrome (fever, rash, dyspnea, GI distress) | MANDATORY HLA-B*5701 screening prior to use; strictly contraindicated if positive! |
| Tenofovir (TDF vs. TAF) + Emtricitabine (FTC) | NRTIs (adenosine/cytidine analogs) | TDF causes Fanconi proximal renal tubular acidosis (glucosuria, phosphaturia) & bone loss | Backbone of ART & PrEP; co-treats Hepatitis B (HBV)—stopping abruptly causes HBV flare! |
| Zidovudine (AZT / ZDV) | NRTI (thymidine analog) | Megaloblastic anemia, neutropenia (bone marrow suppression), myopathy | Given IV intrapartum + scheduled C-section at 38 wk if maternal VL > 1,000; given orally to newborn |
| Efavirenz | NNRTI (allosteric RT binder; no phosphorylation) | CNS toxicity (vivid nightmares, insomnia, depression/suicidality), rash, hepatotoxicity | Ineffective against HIV-2; avoid in patients with severe psychiatric history |
| Darunavir / Atazanavir (+ Ritonavir) | Protease Inhibitors (PIs) (block gag-pol cleavage) | Hyperglycemia, hyperlipidemia, lipodystrophy; Atazanavir: indirect hyperbilirubinemia | Ritonavir/Cobicistat potently inhibit CYP3A4 (contraindicated with simvastatin/lovastatin!) |
Antiretroviral Classes, Mechanisms & Signature Board Toxicities
Immune Reconstitution Inflammatory Syndrome (IRIS): Pathophysiology & Cryptococcal / TB Timing
PrEP, PEP (28-Day Rule) & Prevention of Peripartum Mother-to-Child Transmission (MTCT)
Lymphatic Pump Immunology, Pulmonary PJP & Esophageal Autonomics, Chapman Points & Contraindications
- Thoracic Inlet & Lymphatic Pump Techniques in Immunocompromised States: The thoracic duct (draining 75% of the body's lymph into the left junction of the internal jugular and subclavian veins) and right lymphatic duct traverse Sibson fascia at the thoracic inlet (T1–T4, first ribs, manubrium, clavicles). In patients with HIV and opportunistic pneumonia (e.g., Pneumocystis jirovecii once antimicrobial therapy has been initiated), myofascial release of the thoracic inlet (always Step #1!), doming the thoracoabdominal diaphragm, rib raising, and thoracic/pedal lymphatic pump techniques enhance lymph circulation, mobilize antigen-presenting cells and lymphocytes through lymph nodes, and improve mucociliary clearance. (Note: Vigorous lymphatic pump techniques are contraindicated in untreated acute bacterial sepsis with hemodynamic instability, osteolytic bone metastases, or active Primary CNS Lymphoma / visceral Kaposi sarcoma where mechanical pumping could theoretically promote tumor dissemination or fluid overload.)
- Pulmonary & Esophageal Viscerosomatic Reflexes: In PJP pneumonia or pulmonary tuberculosis, afferent visceral fibers trigger T2–T7 sympathetic paraspinal tissue texture changes and anterior Chapman points in the 3rd and 4th intercostal spaces near the sternum (upper/lower lung; posterior: T3–T4), plus C3–C5 (phrenic) and OA/AA (vagal) somatic dysfunctions. In Candida, HSV, or CMV esophagitis, sympathetic viscerosomatic reflexes localize to T3–T6 and parasympathetic reflexes localize to the vagus nerve (CN X) at the occipitoatlantal (OA) junction.
- AIDS Enteropathy & Cryptococcal Meningitis Cranial Considerations: In chronic secretory diarrhea (Cryptosporidium or MAC), T9–L2 paraspinal inhibition reduces sympathetic-mediated gut stasis, while in Cryptococcal meningitis with severely elevated intracranial pressure (> 250 mm H2O), forceful cranial compression techniques (such as CV4) and cervical HVLA are contraindicated during the acute hypertensive phase; gentle venous sinus drainage may be utilized as an adjunct only after therapeutic lumbar puncture has normalized ICP.
- PJP Pneumonia Corticosteroid Rule (PaO2 < 70 mmHg or A-a Gradient ≥ 35 mmHg): Whenever an HIV-positive patient with Pneumocystis jirovecii pneumonia (PJP) presents with a room-air arterial PaO2 < 70 mmHg or an A-a oxygen gradient ≥ 35 mmHg (SpO2 < 92%), you MUST co-administer systemic corticosteroids (Prednisone) alongside TMP-SMX to prevent lethal antibiotic-induced alveolar inflammation and respiratory failure.
- Cryptococcal Meningitis ART Delay & Serial LP Rule: In an AIDS patient newly diagnosed with Cryptococcal meningitis, perform serial therapeutic lumbar punctures if opening pressure is ≥ 250 mm H2O, start Liposomal Amphotericin B + Flucytosine, and DELAY initiating Antiretroviral Therapy (ART) for 4–6 weeks! Starting ART immediately in cryptococcal meningitis precipitates fatal intracranial Immune Reconstitution Inflammatory Syndrome (IRIS) and brain herniation.
- Abacavir & HLA-B*5701 Screening Requirement: Never prescribe Abacavir (an NRTI) without first testing the patient for the HLA-B*5701 allele; HLA-B*5701-positive patients develop a life-threatening Type IV hypersensitivity reaction, and re-challenging a patient after a suspected Abacavir reaction can cause rapid anaphylactic shock and death.
- Kaposi Sarcoma (HHV-8) vs. Bacillary Angiomatosis (Bartonella henselae): Do not assume every violaceous vascular skin lesion in an AIDS patient is Kaposi sarcoma! If the patient has cat exposure and biopsy shows a dense NEUTROPHILIC infiltrate with Warthin-Starry silver-staining bacilli (rather than spindle cells and lymphocytes), the diagnosis is Bacillary Angiomatosis—cure with Doxycycline or Erythromycin.
- Oral Thrush vs. Esophageal Candidiasis Treatment Trap: While painless oral thrush is treated with topical nystatin swish-and-swallow or clotrimazole troches, the presence of odynophagia or dysphagia indicates Esophageal Candidiasis (an AIDS-defining illness at CD4 < 100), which requires systemic oral Fluconazole (topical nystatin is ineffective!). If odynophagia fails to improve after 72 hours of fluconazole, perform EGD with biopsy to rule out CMV or HSV esophagitis.
- Peripartum HIV Viral Load > 1,000 Copies/mL Delivery Rule: If an HIV-positive pregnant woman has a plasma HIV RNA viral load > 1,000 copies/mL (or unknown viral load) near 36–38 weeks gestation, schedule a Cesarean delivery at 38 weeks (before labor or rupture of membranes) and administer intravenous Zidovudine (AZT) starting 3 hours before delivery, followed by neonatal oral AZT prophylaxis.