Archive for the 'Primary Care' Category

23 Apr

Cytopenias – III. Neutropenia

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).

18 Apr

Cytopenias – II. Anemia

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 […]

16 Apr

Cytopenias – I. Thrombocytopenia

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, 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 […]

11 Mar

Neurologic Manifestations of HIV Infection

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 […]

09 Mar

Epidemiology of HIV/AIDS

Estimates of Prevalence and Incidence The best current estimates are that between 600,000 and 800,000 Americans are infected with HIV. For a number of years, Public Health Service (PHS) estimates of the number infected ranged between 1 and 1.5 million, about twice as many as the current estimates. Rosenberg used back calculation to estimate 630,000 to 897,000 […]

04 Mar

Psychiatric Disorders in HIV-infected Patients

Delirium Delirium is the clinical manifestation of a CNS metabolic disturbance. Systemic illness, CNS infection or neoplasm, and medications may cause delirium in advanced HIV disease. Hypoxia, dehydration, sepsis, renal failure, hyponatremia, hypercalcemia, and hypoglycemia can cause delirium. Delirium may be caused by HIV encephalopathy, cryptococcal meningitis, neurosyphilis, progressive multifocal leukoencephalopathy, herpes encephalitis, cytomegalovirus encephalitis, […]

02 Mar

Wasting

Wasting syndrome is characterized by weight loss of at least 10% for at least 30 days that is not attributable to a concurrent condition other than HIV infection itself. Weight loss has a negative impact on survival and disease progression in AIDS. The prevalence of wasting has declined significantly since the introduction of protease inhibitors. […]

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