QuestionSBA
QuestionChoice
There is no link with hepatitis B and oesophageal candidiasis or dysphagia
31996
d
Hepatitis B antigen
QuestionChoice
This would investigate systemic lupus erythematosus (SLE), which is a cause of dysphagia, but the endoscopy image above clearly shows oesophageal candidiasis, which would not be explained by SLE
31995
c
Anti-nuclear antibodies (ANA)
QuestionChoice
The endoscopy image above shows a severe case of oesophageal candidiasis. The most common cause of this includes HIV and topical steroid treatment such as steroid inhalers
31993
a
HIV testing
QuestionChoice
This would investigate systemic lupus erythematosus (SLE), which is a cause of dysphagia, but the endoscopy image above clearly shows oesophageal candidiasis, which would not be explained by SLE
31997
e
Anti-dsDNA
QuestionChoice
This would investigate for myasthenia gravis which may be a cause of dysphagia. However, the endoscopy image above shows oesophageal candidiasis
31994
b
Antibodies against acetylcholine receptor (AChR)
QuestionComment
My thought process: Esophageal dysmotility -> CREST syndrome -> Sclerosis -> Autoimmune -> ANA
25333
QuestionComment
This is undergrad med bro 
27637
User
subscriber
Relapse CT
QuestionComment
Same
45416
User
subscriber
RNA Benign
User
subscriber
Outpatient Migraine
QuestionComment
For a second i thought this was IBD lmaoo
26431
User
subscriber
BeethovenVirus-ed
Concept
Chapter
# Summary
 

Certain diseases are considered clinical indicator diseases for adult HIV infection. Patients that present with these diseases are considered at risk of underlying HIV infection, and are thus routinely tested for HIV infection. Similarly, certain conditions can be complicated by HIV infection, for example pregnancy and TB, so HIV testing is commonplace in these situations. 
 

# Who should be offered a HIV test?
 
As per NICE & BASHH guidelines, the following groups of patients should be offered a HIV test:

|Classification   |Examples   |
|---|---|
|Increased risk of exposure to HIV   |Men who have sex with men; injected drug users; sex workers; people from a country with high seroprevalence; children of HIV-positive mothers; sexual partners of those with HIV   |
|Healthcare services   |Sexual health; addiction & substance misuse; antenatal; termination of pregnancy; hepatitis, tuberculosis, lymphoma; chemotherapy & immunosuppression; areas with high HIV seroprevalence   |
| AIDS-defining conditions  | Kaposi's sarcoma; Cryptosporidiosis diarrhoea; severe candidiasis; non-Hodgkin lymphoma; cervical cancer; cytomegalovirus; cerebral toxoplasmosis; progressive multifocal leukencephalopathy; pneumocystis pneumonia; mycobacterial diseases  |
|HIV indicator conditions |Oral hairy leukoplakia; exanthema; herpes zoster; seborrhoeic dermatitis; mononucleosis-like illness; anal & cervical dysplasias; viral hepatitis; sexually transmitted infections; pneumonias & invasive pneumococcal disease; chronic/unexplained lymphadenopathy, diarrhoea, renal impairment, neurological symptoms, weight loss |
 
NB: Repeat tests may be indicated, taking into account the window period. The window period is the time between becoming infected and antibodies appearing - HIV antibodies usually appear 4-6 weeks after infection but can take up to 12 weeks.


# NICE guidelines
 

 [Click here to see the NICE guidelines on HIV testing](https://cks.nice.org.uk/topics/hiv-infection-aids/diagnosis/asymptomatic-hiv-infection/)
 
# References
 

 [Click here for the BIVA/BASHH guidelines on HIV testing ](https://www.bashhguidelines.org/current-guidelines/hiv/hiv-testing-guidelines-with-bhivabia-2020)
2593
1
Routine HIV testing
Topic
27
Genitourinary medicine
6399
Oesophageal candidiasis often suggests underlying immunosuppression, such as HIV infection, and individuals presenting with this condition should be tested for HIV.
Picture
360
oesophageal candidiasis.jpg
images/m77xypqr1639016526554.jpg
images/m77xypqr1639016526554_256.jpg
images/m77xypqr1639016526554_512.jpg
4icODYKyWXhwiYeXhod4iPic9FM0
Topic
27
Genitourinary medicine
A 25 year old woman presents with pain in her throat on swallowing. She has no significant past medical history.

She has an endoscopy which shows the following:

[lightgallery]

Which of the following blood tests is best to do next in this patient?
a