Challenges in Providing Comprehensive and Coordinated Care to HIV/AIDS Patients: A Canadian Perspective

2000 ◽  
Vol 13 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Peter Tsasis
Keyword(s):  
Chronic Illness ◽  
Hiv Infection ◽  
Chronic Conditions ◽  
Opportunistic Infections ◽  
Healthcare Delivery ◽  
Coordinated Care ◽  
Healthcare Delivery System ◽  
Canadian Perspective ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

This article focuses our attention on the means by which healthcare is provided to HIV-infected patients who require comprehensive and coordinated care to address the variety of changing and challenging needs presented by the acquired immunodeficiency syndrome (AIDS). Improved clinical management of HIV infection over the past decade, with antiretroviral agents, protease inhibitors and prophylactic therapies against opportunistic infections has transformed HIV infection from an acute to a chronic illness. Many individuals with AIDS are now living longer with more chronic conditions. Concomitant with the transformation of HIV infection from an acute to a chronic illness comes the challenge to provide effective, humane and economical care to patients with chronic conditions that continue to reside in the community, within a healthcare delivery system that has evolved to treat patients with acute diseases.

scholarly journals HIV Infection: What Should We Know?

2020 ◽  
Vol 2 (1) ◽  
pp. 01-16
Author(s):  
Ridwan Balatif
Keyword(s):  
Hiv Infection ◽  
Hiv Transmission ◽  
Opportunistic Infections ◽  
Antiretroviral Drugs ◽  
People Living With Hiv ◽  
Stigma And Discrimination ◽  
Acquired Immunodeficiency ◽  
To Come ◽  
Immunodeficiency Syndrome ◽  
Living With Hiv

Acquired Immunodeficiency Syndrome (AIDS) was first known in 1981 in homosexual groups who had opportunistic infections and malignancies. In Indonesia the first AIDS case was reported in 1987 to a Dutch citizen living in the province of Bali. Cases of HIV infection in Indonesia are reported to increase every year and most occur at the age of 25-49 years. HIV transmission is not easily transmitted, even when an HIV-infected person takes antiretroviral drugs can reduce the risk of transmission by up to 96%. But one of the biggest challenges in managing HIV infection is facing stigma and discrimination. As many as 1 in 5 people living with HIV are afraid to come to the clinic because they will experience discrimination and stigma from the community if this condition occurs will cause treatment delay until PLWHA (People living with HIV/AIDS) will fall to the AIDS stage and PLWHA will be susceptible to opportunistic infections. A clinic in Namibia, when stigma and discrimination were successfully overcome, there was a 20% reduction in mortality in PLWHA

Bacillary Angiomatosis: A Unique Cutaneous Complication of Hiv Infection

1995 ◽  
Vol 3 (2) ◽  
pp. 1-10
Author(s):  
Joan Lipa ◽  
Walter Peters ◽  
Victor Fornasier ◽  
Benjamin Fisher
Keyword(s):  
Hiv Infection ◽  
Definitive Diagnosis ◽  
Causal Organism ◽  
Bacillary Angiomatosis ◽  
Immunodeficiency Virus ◽  
Confirmatory Tests ◽  
Nodular Lesions ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Erythromycin Therapy

As the prevalence of human immunodeficiency virus (HIV) infection increases, so does the recognition of unusual manifestations of this syndrome. This study describes two patients who presented with a unique, rare, cutaneous manifestion of HIV infection. One patient developed an aggressive atypical cellulitis and ascending lymphangitis of the hand, which failed to improve following multiple courses of several different antibiotics. The other patient presented with multiple, vascular, nodular lesions, clinically resembling Kaposi's sarcoma. Routine biopsies and wound cultures were not helpful for diagnosis. A definitive diagnosis of bacillary angiomatosis (BA) was made using a special silver-staining (Warthin-Starry) histological technique and electron microscopy. Both patients responded completely to oral erythromycin therapy. BA is a newly recognized bacterial infection caused by bacteria of the genus Bartonella. It is seen primarily in patients with acquired immunodeficiency syndrome (AIDS), and less commonly in patients with other immunosuppressed conditions. The term BA describes the lesion's pathogenesis (infective-bacillary) and clinico-histology (angiomatosis). The causal organism cannot be cultured reliably and is resistant to most antibiotics. This study reviews these two patients, the differential diagnosis of BA, specific confirmatory tests used in diagnosis, and the treatment outcome of this condition. It is important for the plastic surgeon to understand BA, because it can resemble other common presentations, but it can also be associated with internal involvement leading to mortality. However, when recognized, it can usually be cured by oral erythromycin therapy (500 mg qid) for several weeks.

Bacillary Angiomatosis

1995 ◽  
Vol 104 (8) ◽  
pp. 668-672 ◽  
Author(s):  
John G. Batsakis ◽  
Jae Y. Ro ◽  
Elizabeth E. Frauenhoffer
Keyword(s):  
Head And Neck ◽  
Acquired Immunodeficiency Syndrome ◽  
Opportunistic Infections ◽  
Epidemiologic Studies ◽  
Cat Scratch Disease ◽  
Bacterial Agent ◽  
Bacillary Angiomatosis ◽  
Mucous Membranes ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

The acquired immunodeficiency syndrome and other causes of immunosuppression have ushered in a variety of opportunistic infections. One of these is bacillary angiomatosis, a vasoproliferative lesion whose principal causative agent is Rochalimaea henselae. Bacillary angiomatosis, while preponderantly a cutaneous affliction, can be systemic, including involvement of the head and neck mucous membranes. Molecular technology and epidemiologic studies used to identify the bacterial agent of bacillary angiomatosis have also uncovered R henselae as the organism responsible for most cases of cat-scratch disease. Why the same organism promotes two different histopathologic lesions, as seen in bacillary angiomatosis and cat-scratch disease, is unknown.

Decreased Thymus Size on Chest Radiography: A Sign of Pediatric Human Immunodeficiency Virus Infection?

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 99-102
Author(s):  
ALAN MEYERS ◽  
NICHOLAS PEPE ◽  
WILLIAM CRANLEY ◽  
KATHLEEN MCCARTEN
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Chest Radiography ◽  
Pediatric Hiv ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Acquired Immunodeficiency ◽  
Generalized Lymphadenopathy ◽  
Immunodeficiency Syndrome ◽  
Thymus Size

The early diagnosis of infection with the human immunodeficiency virus (HIV) in infancy is clinically important but remains problematic in the asymptomatic child born to an HIV-infected mother. In addition, many such women are unaware of their HIV infection until their child manifests symptomatic HIV disease. Nonspecific signs of pediatric HIV infection, such as generalized lymphadenopathy, hepatosplenomegaly, or persistent thrush, may be important in alerting the clinician to consider the possibility of HIV infection in the child whose history of HIV risk is unknown. We report one such sign which may be evident on plain chest radiography. The pathology of the thymus gland in pediatric acquired immunodeficiency syndrome has been described by Joshi and colleagues,1-3 who have reported precocious involution with marked reduction in thymus size and weight.

Pediatric Acquired Immunodeficiency Syndrome: An Unusually High Incidence of Twinning

PEDIATRICS ◽  
1990 ◽  
Vol 86 (5) ◽  
pp. 774-777
Author(s):  
PAULINE A. THOMAS ◽  
STEVEN J. RALSTON ◽  
MARIE BERNARD ◽  
ROSALYN WILLIAMS ◽  
RITA O'DONNELL
Keyword(s):  
New York ◽  
New York City ◽  
Hiv Infection ◽  
York City ◽  
Acquired Immunodeficiency Syndrome ◽  
Early Years ◽  
Pediatric Aids ◽  
High Incidence ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Surveillance data on incidence of twins among reported cases of pediatric AIDS in New York City are presented. Most pairs are concordant for HIV infection. Three discordant pairs have been described elsewhere. Possible reasons for the association are discussed, including the most likely explanation that twins show symptoms early and are overrepresented in the early years of surveillance of pediatric AIDS.

Acquired Circulating Anticoagulants in Children With Acquired Immunodeficiency Syndrome

PEDIATRICS ◽  
1988 ◽  
Vol 82 (5) ◽  
pp. 763-765
Author(s):  
Edward R. Burns ◽  
Ben-Zion Krieger ◽  
Larry Bernstein ◽  
Arye Rubinstein
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
Pediatric Patients ◽  
Opportunistic Infections ◽  
Laboratory Diagnosis ◽  
Activated Partial Thromboplastin Time ◽  
Test Results ◽  
Coagulation Test ◽  
Intrinsic Pathway ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

The mechanism underlying the prolonged activated partial thromboplastin time (APTT) seen in some pediatric patients with acquired immunodeficiency syndrome (AIDS) and opportunistic infections was studied. A circulating inhibitor of coagulation was demonstrated in three patients. The inhibitor appears to be an immunoglobulin that interferes with some of the phospolipid-dependent coagulation reactions of the intrinsic pathway. This "AIDS anticoagulant" does not predispose the patient to clinical bleeding despite its ability to cause a marked prolongation of the APTT. As such, careful laboratory diagnosis of the cause of abnormal coagulation test results is necessary for children with AIDS.

scholarly journals Chronic Cystoisospora belli infection in a Colombian patient living with HIV and poor adherence to highly active antiretroviral therapy

Biomédica ◽  
2021 ◽  
Vol 41 (Supl. 1) ◽  
pp. 17-22
Author(s):  
Ana Luz Galván-Díaz ◽  
Juan Carlos Alzate ◽  
Esteban Villegas ◽  
Sofía Giraldo ◽  
Jorge Botero ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Diarrheal Disease ◽  
Opportunistic Infections ◽  
Poor Adherence ◽  
Highly Active ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Living With Hiv

Cystoisospora belli is an intestinal Apicomplexan parasite associated with diarrheal illness and disseminated infections in humans, mainly immunocompromised individuals such as those living with the human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). An irregular administration of highly active antiretroviral therapy (HAART) in HIV patients may increase the risk of opportunistic infections like cystoisosporiasis.We describe here a case of C. belli infection in a Colombian HIV patient with chronic gastrointestinal syndrome and poor adherence to HAART. His clinical and parasitological cure was achieved with trimethoprim-sulfamethoxazole treatment. Although a reduction in the number of C. belli cases has been observed since the use of HAART, this parasite still has to be considered as a differential diagnosis of diarrheal disease in HIV/AIDS patients.Effective interventions enhancing adherence to HAART should be included in HIV patient care programs.

Unrecognised Human Immunodeficiency Virus Patients in an Emergency Department in Hong Kong: A Report of Four Cases

2005 ◽  
Vol 12 (3) ◽  
pp. 168-177
Author(s):  
KL Mok ◽  
PG Kan
Keyword(s):  
Emergency Department ◽  
Human Immunodeficiency Virus ◽  
Hong Kong ◽  
Hiv Infection ◽  
Opportunistic Infections ◽  
Hiv Patients ◽  
Accident And Emergency ◽  
Immunodeficiency Virus ◽  
High Index Of Suspicion ◽  
Immunodeficiency Syndrome

Human immunodeficiency virus (HIV) causes breakdown of the immune system and predisposes patients to various opportunistic infections and neoplasms. However, many patients may not be aware of the HIV infection before the development of their first HIV related complications. We reported four unrecognised HIV patients presenting to our accident and emergency department with common complications of HIV infection and the acquired immunodeficiency syndrome (AIDS). Although not as common as in America, emergency physicians in Hong Kong still have to take care of patients with unknown HIV status. The common presentations of HIV patients will be discussed. A high index of suspicion and knowledge of common HIV/AIDS complications are required for managing these patients.

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