Much of the improved survival for patients with HIV infection in recent years owes to the prevention of PCP. Hence, the use of antipneumocystis agents such as trimethoprim-sulfamethoxazole, dapsone,…

Pneumocystis carinii Pneumonia
PCP is the most common lung disease in persons with advanced HIV infection. The presentation tends to be indolent, characterized by slowly progressive shortness of breath…

Although the differential diagnosis of lung disease in a person with HIV infection is quite broad, the probabilities of the various diagnoses can be reduced in a given patient by knowing the…

Disorders Not Necessarily Associated with Severe Immune Suppression

Bronchitis
Acute bronchitis in the PCHIS was defined by the presence of cough with sputum production for at…

Relationship of respiratory tract diseases to CD4+ Lymphocyte count, Demographic Characteristics, and Transmission Category

PCP is the most common lung disease in persons with CD4+ counts…

The conceptual relationship between the frequency and spectrum of lung diseases and CD4+ lymphocyte count is shown in Figure 412-1. The data that support this concept have…

The hallmark of the effect of HIV infection on host immune response is a progressive reduction in the number of circulating CD4+ lymphocytes or “T-helper” cells. The CD4+ lymphocyte plays…

Philip C. Hopewell

Lung disease, specifically Pneumocystis carinii pneumonia (PCP), was the first recognized mode of expression of infection with the human immunodeficiency virus (HIV). Since the original clusters of…

The disorders presenting with more general or diffuse brain dysfunction and without focal features can be further divided into those in which consciousness remains fully preserved and those accompanied by a concomitant decrease…

Several types of myopathy may complicate HIV-1 infection. Both inflammatory and noninflammatory myopathies have been described, ranging in severity from asymptomatic creatine kinase elevation to severe proximal weakness. Patients with inflammatory, polymyositis-like illnesses have improved with…

In approaching diagnosis of parenchymal brain disease, it is useful to separate the conditions that cause predominantly focal symptoms and signs from those producing more generalized brain dysfunction. Patients in the former group…

The most common spinal cord affliction in AIDS patients is the pathologically defined vacuolar myelopathy, which has been included within the broader clinical designation of the AIDS dementia complex because it is usually accompanied by evidence…

Several disorders may involve the leptomeninges in patients with advanced HIV-1 disease. The most important of these is infection by Cryptococcus neoformans. This condition may present subacutely with headache, nausea, vomiting, and confusion, just…

Effects of HIV-1 on the Nervous System
Several disorders have been suggested to relate in a more direct or fundamental way to HIV-1 infection. These include the AIDS dementia…

As with other organ systems, the spectrum of opportunistic infections of the nervous system results from the intrinsic vulnerabilities of the tissue (fertile soil) and the pattern of immunosuppression, in this case circumscribed…

The major consideration in this category is primary brain lymphoma. These B-cell lymphomas arise in the CNS, usually are multicentric (at least microscopically), and rarely metastasize systemically. Characteristically, they develop late in HIV-1 infection when…

The evolving, and eventually severe, impairment of immune defenses caused by HIV-1 renders the nervous system highly vulnerable to a broad spectrum of disorders. The following overview emphasizes general principles of pathogenesis and approach…

Although less common than in the late stages of HIV-1 infection, the nervous system may also be afflicted earlier, indeed as early as the stage of primary infection and seroconversion. Thus, individual reports have…

The neurologic complications of HIV-1 infection are both common and varied. Indeed, only rarely do the central and peripheral nervous systems of HIV-infected patients remain unaffected through the course of untreated disease.…

Following the discovery of HIV-1 as the cause of epidemic AIDS in the United States, Europe, and Asia, patients in West Africa with AIDS-like symptoms were identified whose sera reacted more strongly…

Education is the only means of HIV prevention currently available. Over the past few years significant efforts have been directed toward the development of an effective vaccine against HIV. Although substantial progress has been achieved,…

In July 1990, the first case of possible transmission of HIV from an infected health care worker (dentist) to his patients was reported. Six patients are believed to…

Transmission of HIV in the health care delivery setting has been the subject of intense investigation throughout the course of the epidemic. The percentage of health care workers with AIDS…

HIV has been transmitted via transfusion of single-donor blood and blood products, including whole blood, fresh frozen plasma, packed red blood cells, cryoprecipitate, clotting factors, and platelets. Prior to May 1985,…