You are a hospital doctor working in a high prevalence HIV area presented with a severely ill patient with haemoptysis, headache, and fever. You conduct a relevant history and examination to help focus your differential diagnoses. Prompts are provided to elicit important opportunistic infections associated with HIV infection. It is noted that there is both clinical and immunological staging of HIV. Working in a developing world rural setting, you are limited with what tests can be used. However, there are global WHO guidelines for antiretroviral therapy. The problems of HIV/TB co-infection and multi-drug resistance in these areas are illuminated. The case ends in a global summary of the AIDS epidemic and international strategies that are taking place to curtail its spread.
KeywordsHepatitis Tuberculosis Bacillus Malaria Cavitation
- 1.UNAIDS. Report on the global AIDS epidemic. Geneva: Joint United Nations Programme on HIV/AIDS; 2010. Available from: http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2010/20101123_globalreport_en.pdf. Accessed 22 Aug 2012.
- 2.Gill GV, Beeching N. HIV infection and disease in the tropics. Lecture notes on tropical medicine. 6th ed. London: Wiley-Blackwell; 2009, Chapter 13.Google Scholar
- 4.WHO. WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children. 2006. Available at: http://www.who.int/hiv/pub/guidelines/HIVstaging150307.pdf. Accessed 22 Aug 2012.
- 5.WHO. Antiretroviral therapy for HIV infection in adults and adolescents. Recommendations for a public health approach. 2010 revision. Available at: http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf. Accessed 22 Aug 2012.
- 6.HIV/TB Coinfection: Basic Facts, October 2007. Available at: http://www.eurekalert.org/HIV-TBreport/images/HIV_TB_Coinfection.pdf. Accessed 22 Aug 2012.
- 7.WHO. The global burden of disease. 2004 update. Available from: http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf. Accessed 22 Aug 2012.
- 8.UNAIDS and WHO. AIDS epidemic update. Geneva: WHO; 2009. Available from: http://data.unaids.org/pub/report/2009/jc1700_epi_update_2009_en.pdf. Accessed 22 Aug 2012.
- 9.UNAIDS. The Treatment 2.0 framework for action: catalysing the next phase of treatment, care and support. Available from: http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/20110824_JC2208_outlook_treatment2.0_en.pdf. Accessed 22 Aug 2012.