INFORMATION  ON HIV

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HIV Overview

Stages of HIV Infection

Late Symptomatic HIV Infection

The development of an "AIDS defining" illness really does not alter the general management. With the use of combination therapies, many patients do not develop the classical "AIDS defining" conditions. The patients at the late symptomatic stage of HIV infection are now at an increased risk of Pneumocystis carinii pneumonia (PCP), cryptosporidiosis, Toxoplasma encephalitis, and esophageal candidiasis. Constitutional symptoms usually worsen. Wasting and AIDS Dementia Complex may be other serious problems encountered.

Human papilloma virus associated malignancies (cervical and anal) may occur.

Neurological problems are frequent and numerous and include: 

  • peripheral neuropathies
  • myelitis
  • cranial nerve palsies
  • transient ischemic attacks
  • Thrombocytopenia, anemia, neutropenia and isolated elevations of lactate dehydrogenase (LDH) are common. Hypogonadism and menstrual irregularities are frequently seen.
  • Management includes the detection, treatment and prevention of these conditions. PCP Prophylaxis with TMP-SMX is started when the CD4 count reaches 200 cells/mm3 or earlier if oral candidiasis is present.
  • Antiretroviral therapy is adjusted to minimize adverse reactions, drug interactions and to enhance adherence and the maintenance of the lowest possible viral load and highest CD4 count for that individual.

 

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