People living with HIV in 2018 now have normal life expectancy if receiving Anti-Retroviral Therapy (ART) and often require only one co-formulated pill every day to remain well. However there are still people living with HIV who are unaware of their diagnosis; who may present with a critical illness. Knowing who to test is essential. The population living with HIV are also ageing and often have comorbidities. It is vital that clinical conditions associated with HIV are recognised and for those receiving ART that significant drug-drug interactions are avoided. Pre Exposure prophylaxis (PREP) is widely used to prevent transmission and when to consider post exposure prophylaxis (PEP) should be understood. Although only one person has been cured of HIV ongoing research continues.
Hepatitis C treatment has been revolutionised with Direct Acting Antiretrovirals (DAAs) that are taken in an outpatient settings, however treatment rates in Australia are in decline. Patients living with Hepatitis C need to be identified to be treated. Those patients with established severe liver disease may remain at risk of decompensation and therefore it is considered vital to ensure linkage into adequate follow up. Drug interactions are important to recognise in patients completing DAAs and although Hepatitis C can be cured the management of any coinfections with blood borne viruses requires careful attention.
