Chapter 27. Human Immunodeficiency Virus
Which of the following statements about HIV prevention is TRUE?
a. Condoms are 100% effective in preventing HIV transmission.
b. All pregnant women should be screened for HIV.
c. Only pregnant women who engage in high-risk behaviors should be screened for HIV.
d. IV drug abusers can reuse/share syringe hubs as long as a new needle is used.
Answer b is correct. Pregnant women should be screened for HIV. Patients that are positive should be initiated on ART to decrease her viral load and decrease the chance of transmitting the infection to the infant.
Answer a is incorrect. Abstinence is the only 100% effective way to prevent sexual transmission of HIV. While condoms may reduce transmission rates, they are not 100% effective.
Answer c is incorrect. All pregnant women should be screened for HIV; however, nonpregnant persons engaging in high risk behaviors should be routinely screened for HIV.
Answer d is incorrect. Sharing of any drug paraphernalia can cause HIV transmission (not just needles).
In a patient receiving zidovudine therapy, which of the following could you expect to be elevated on laboratory evaluation?
a. Blood urea nitrogen (BUN)
b. Mean corpuscular volume (MCV)
Answer b is correct. MCV is a marker of RBC size and utilized in the diagnosis of anemia. An elevated MCV is common with zidovudine therapy as a result of macrocytic anemia. This can be used as an indirect marker of patient adherence to therapy.
Answers a and c are incorrect. Zidovudine is not expected to affect BUN levels or SCr creatinine levels. However, the NRTI TFV does affect renal filtration and monitoring of BUN and SCr is required.
Answer d is incorrect. Zidovudine is not expected to impact potassium concentrations.
A treatment experienced patient receiving atazanavir therapy should avoid the addition of which of the following medications?
Answer a is correct. Atazanavir requires an acidic environment for optimal absorption. In treatment experienced patients, combination therapy with proton pump inhibitors is contraindicated. In treatment naïve patients, doses of omeprazole 20 mg equivalence or less, may be used with ...