3758 : MANAGEMENT OF HIV IN ADULTS AND ADOLESCENTS IN PRIMARY HEALTH CARE

Author(s): 
Gusso, Gustavo
Text: 
Poster
INTRODUCTION: Based on principles of access, coordination, continuity and integrality, it is essential that the family physician or general practitioner concentrate their actions in primary and secondary prevention. They must know the right moment to delivery the patient.
OBJECTIVE: Guide primary health care professional for adequate initial management of HIV positive or AIDS patients.
METHODS: A review of American and Brazilian guidelines and related articles and the building of a flow chart of actions.
RESULTS: The actions of family physician or general practitioner are primary prevention, pre and post test counsel, request HIV test, active search for partners and first management. The first screening include b-HCG. Pregnants must be delivery to specialised service. The patients are divided in three groups: non symptomatic and with CD4 more than 350 are not treated; non symptomatic and CD4 between 200 and 350 are counselled to not treat at this moment; and CD4 less than 200 or symptomatic should be treated. Taking into account adherence, posology and side effects the suggested scheme is zidovudine, lamivudine plus efavirenz for men and nevirapine for women. The CD4 e viral load should be measure in 8 and 24 weeks to evaluate treatment failure. In this case, after dismiss biological factors, non-adherence, or immunologic recovery syndrome, the patient is delivered to the specialist.
CONCLUSION: Taking into account the health-disease process, the family physician or general practitioner has a central role for the success of the epidemiological and complication control involved in the HIV/AIDS complex.
Topic: Clinical Practice