Howard University Telehealth Training Center

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The AETC Capitol Region Telehealth "Power Podcast" series allows you to listen to experts in the field from your computer or mobile device. Designed for the busy professional, you can learn about cultural competence in the treatment of HIV/AIDS from your office or "On-The-Go."

HIV/AIDS and Chronic Hepatitis Co-Infection: Part IV

Click here to view the slides

    Learning Objectives

    • Describe the epidemiology -- including trends and at-risk groups -- and natural history of infections due to human immunodeficiency virus (HIV) and hepatitis C virus (HCV), respectively, in the United States.
    • Outline the current Centers for Disease Control and Prevention (CDC) guidelines for screening for -- and diagnosing -- HIV and HCV infections.
    • State general principles -- including those concerning recommended initial and follow-up laboratory evaluation and initial and salvage treatment regimens -- for caring for persons infected with HIV or HCV, emphasizing principles of the care of persons co-infected with both of these viruses.
    • Describe emerging treatment options for persons co-infected with both HIV and HCV and how these emerging treatment modalities are expected to enhance patients' acceptance of antiviral treatment and their long-term prognosis.

    Case Studies

    Case 1

    Mr. Jones is a 47 year-old African American who  was diagnosed as HIV+ in 2001.  In 1999 Mr. Jones was diagnosed with a pseudo cerebral tumor that was treated by a lumbar puncture to remove cerebrospinal fluid from his brain. Complications of this tumor resulted in a scotoma of his right eye. His medical history also includes: hypertension, hypothyroidism, hepatitis C, GERD and depression. He is currently taking atripla, lisinopril, levothyroxine, pepcid and Cymbalta, and he is allergic to NSADs.  He has a past history of alcohol abuse and has reported having frequent episodes of migraine.  In a recent visit to the dentist, Mr. Jones was informed he will need to have two of his teeth extracted. Mr. Jones’s father has recently passed away due to Hepatocellular Carcinoma. Mr. Jones smokes 1 pack of cigarettes per day for the past 30 years.

    Case 2

    Esmeralda is a 50 year-old Latina Woman from Ecuador. She had been living in US for 30 years. She is married to James who has hemophilia A. James was diagnosed as HIV+ in 1991 after receiving a blood transfusion due a serious car accident and unknowingly infected his wife. Esmeralda works as a dental assistant in a correctional facility and has recently been diagnosed with Hepatitis B after accidently cutting herself during a dental extraction procedure at work. Her medical history also includes: diabetes, hypercholesterolemia, Hashimoto’s disease, rheumatoid arthritis, Sjögren's syndrome and seasonal allergies. She’s currently taking truvada, metformin, lipitor, levothyroxine, plaquenil and claritin. She drinks socially 1-2 drinks a week. The couple have two daughters who are not HIV+.

    About the Case Study Author

    RambobIsabel Rambob, DDS, received her doctor of dental surgery degree from the State University of Feira de Santana, Brazil in 1997. She completed a one-year Program in Advanced Education in Comprehensive Dentistry at New York University College of Dentistry in 2007. She then pursued and completed a one-year Residency Program in Advanced Education in General Dentistry at Howard University College of Dentistry in 2008.

    Dr Rambob served as an HIV/AIDS & oral health preceptor at Howard University College of Medicine from 2009-2010 while simultaneously serving as dental director for the University’s National Minority AIDS Education and Training Center. She was a dental provider at the HIV+ Clinic, and also served as clinical instructor at Special Needs clinic at University of Maryland School of Dentistry from 2009-2012. She then served as dental director at Health Care for the Homeless Maryland from 2010-2011.

    Currently Dr Rambob is an assistant professor at University of Maryland School of Dentistry at the Department of General Dentistry; the project director at the Access to Dental Care to Domestic Violence Survivors Pilot Project. She is also a guest lecturer at New York University College of Dentistry, Howard University College of Dentistry and VA Medical Center Baltimore. She has been lecturing nationally and internationally, and has been extensively engaged in numerous community-based activities. Dr. Rambob has been practicing as a general dentist for over 16 years. Her main interests are: oral health in vulnerable populations, cultural factors in patient management, emotional intelligence and patient satisfaction, and dental photography.


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