HUMAN IMMUNODEFICIENCY VIRUS INFECTION – MANAGEMENT

Detailed information on management is not covered in this handbook. Patients with HIV infection require considerable support, counselling and regular assessment. There is no effective therapy for the immunodeficiency. Several drugs inhibit HIV viral replication in vitro. For patients with AIDS, zidovudine (azidothymidine — AZT) has been shown to decrease mortality, reduce the incidence of opportunistic infections, decrease viraemia and increase the number of T4 lymphocytes. Severe adverse reactions occur with this drug including anaemia and neutropaenia in up to 25% of patients.

Some opportunistic infections can be successfully treated. Treatment of others such as the atypical mycobacteria is usually ineffective. Chemotherapy may be effective in malignancies such as KS and lymphoma particularly if immune function is good.

Hospitalisation and nursing

Patients with HIV infection may be cared for in any hospital and strict isolation is unnecessary. Detailed recommendations can be obtained from publications such as the Infection control guidelines published by the AIDS Task Force.

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