Managing the HIV-infected adult patient in the emergency department

As highly active antiretroviral therapies have advanced, HIV patients who are treatment-adherent can achieve undetectable viral loads, virtual elimination of opportunistic infection, improved quality of life, and normal life expectancy. This issue focuses on emergency department management of HIV patients both with successful disease suppression from long-term therapy as well as the patient with low CD4 counts in the context of lack of engagement with care, nonadherence, or undiagnosed disease. Optimal emergency department management of patients with HIV also includes identifying and treating undiagnosed patients, helping to re-establish care for those who have been lost to followup, and preventing new HIV infections with pre-exposure and postexposure prophylaxis.