Gastrointestinal and hepatobiliary disorders are among the most frequent complaints in patients with HIV disease. Effective antiretroviral therapy and chemoprophylaxis (PCP, MAC, and CMV) has significantly reduced the occurrence of gastrointestinal opportunistic infections.
Diarrhea
Diarrhea is the most common GI symptom in patients with HIV, affecting 0.9 to 14% of outpatients. Protozoal, viral, and bacterial organisms may [...]
There have been three-quarters of a million persons reported with AIDS in the United States, and there have been more than one-third of a million deaths. About 8,000 children have been infected, more than half of whom have died.
Several important changes have occurred in the demographic profile of people with AIDS. There has been an [...]
HIV-associated, non-Hodgkin’s lymphoma occurs in 5-10% of individuals with HIV infection. The incidence of lymphoma in this population has been rising and may reflect prolonged survival related to the use of highly-active antiretroviral therapy and infection prophylaxis.
Pathophysiology
HIV-associated non-Hodgkin’s lymphomas are virtually all of B-cell origin. Most are intermediate- or high-grade lymphomas categorized as large cell [...]
A. Neutropenia occurs in half of all patients with advanced HIV infection. Causes include myelosuppressive medications, opportunistic infections or neoplasms, HIV-induced myelosuppression, deficient production of myeloid growth-stimulating factors, and depletion of hematopoietic progenitor cells.
B. Neutropenia may cause an increased incidence of infections, hospitalization, decreased survival, and discontinuation of medications (or use of suboptimal dosages).
II. Anemia
A. Twenty five percent of patients with AIDS develop severe anemia (hemoglobin <8 g/dl). Anemia is caused HIV-related hematopoietic defects and by zidovudine therapy. Milder forms of anemia develop in 50% of all patients with HIV disease (hemoglobin 8-13 g/dl). The frequency and severity of zidovudine-induced anemia increases with higher dosages and with later [...]
HIV-infected patients frequently develop hematologic abnormalities. Cytopenias often respond to suppression of HIV with antiretrovirals, treatment of infectious diseases and tumors, discontinuation or dosage reduction of myelosuppressive medications, correction of nutritional deficiencies, and treatment with hematopoietic growth factors or other cytokines.
I. Thrombocytopenia
A. Causes of thrombocytopenia include myelosuppression from medications, infections or tumors and increased destruction [...]
Involvement of the nervous system in HIV infection is common, manifesting in about half of patients.
Neurologic complications
Aseptic meningitis. At the time of HIV seroconversion or primary infection, patients may present with symptoms of aseptic meningitis, such as fever, headache, stiff neck, and a lymphocytic pleocytosis.
AIDS dementia complex
AIDS dementia complex is reported in about 6% to [...]
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