Differential diagnosis and management of HIV-associated opportunistic infections
Acquired Immunodeficiency Syndrome
© Cambridge University Press (2008) 2015. Timely recognition and treatment of human immunodeficiency virus (HIV)-associated opportunistic infections (OIs) remains an important skill for practicing physicians worldwide. Whereas the overall incidence of these infections has fallen sharply since the advent of highly active antiretroviral therapy (HAART), OIs remain the single most serious threat to well-being and survival amongst HIV-infected individuals. Despite improved access to testing globally, all too often the first indication of underlying HIV infection is not routine screening but rather overt stigmata of one or more OIs. Lack of familiarity with these disorders delays key HIV interventions – such as safe sex counseling and antiretroviral therapy – and leads to worse clinical as well as public health outcomes. With most OIs, the likelihood of active disease rises sharply at specific CD4-count thresholds (Figure 101.1). Periodic CD4 measurements are therefore an integral part of both OI treatment and prevention. This chapter offers a systems-based overview of presenting signs and symptoms of the most commonly encountered OIs. Current concepts and approaches to management are also discussed.
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