[HIV infection: recommendations for the management of asymptomatic adults and of various clinical syndromes].
This paper presents recommendations on the care of HIV infected adults based upon the authors' personal experience with close to 700 patients in a multiprofessional pilot center. This medical care has 5 main objectives: 1) Promotion of good health (through standard recommendation of hygiene, health habits and regular checkups); 2) prevention of infectious complications (through detection of latent pathogens, chemoprophylaxis, vaccination and avoidance of risky exposures); 3) Treatment of complications (mainly infectious, through early diagnosis and proper treatment); 4) Delay of HIV disease progression (through timely and properly chosen antiretroviral therapy); 5) Reduction of HIV infection spread from index case to others (through promotion of responsible behavior and avoidance of pregnancy and HIV exposure to others). Studies for evaluating global health and immunologic status and carriage of potential pathogens are discussed as well as the criteria and timing for chemoprophylaxis for tuberculosis and P carinii pneumonia (PCP). Algorithms for the management of major clinical syndromes are presented: Diarrhea (afebrile, mostly parasitic, versus febrile, frequently bacterial); Pneumonia (lobar mostly bacterial versus interstitial, frequently PCP especially if lymphopenic and not receiving PCP prophylaxis); Brain mass lesion (most commonly toxoplasmosis). Finally, the evaluation and diagnostic possibilities of febrile patients is presented, based upon the immunologic status and associated symptoms.
Wolff
M
M
Departamento de Medicina, Facultad de Medicina (Campus Central), Universidad de Chile, Santiago de Chile.
Northland
R
R
D017088:AIDS-Related Opportunistic Infections; D000328:Adult; D002353:Carrier State; D002985:Clinical Protocols; D015658:HIV Infections / Q000628:therapy*; D015497:HIV-1; D015498:HIV-2; D006801:Humans; D011446:Prospective Studies