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Index

abacavir 72 ablation 28 abscesses 77 accuracy, testing 8, 9 aciclovir 20, 40, 50 addictive drug users see injection drug use adenoviruses 39 adrianycin 27 advice, to patients 22

Africa

epidemiology 3 prevention strategies 103

AIDS

case definitions 1—2, 62 personal account 108—10 albendazole 39 allopurinol 27 alpha interferon 44 amikacin 53 amphetamines 72 amphotericin B 36, 52 anaemia 20—1 anal disease

herpes simplex 40

tumours 29

anal sex, unprotected 101 analgesics 20, 90 anorexia 39

antenatal testing 74—5 anthracyclines 26 antiangiogenics 26 antibiotics 20 antibodies

beneficial effects 14 development of 13 harmful effects 14 positivity to see seroconversion tests

accuracy 8 pre-test discussions 82—3 pregnant women 104 understanding of prevalence 4 anticonvulsants 52, 90 antidepressants, tricyclic 90 antidiarrhoeal agents 49 antiemetics 49, P7, 92 antifungals 19, 20 antigens

tests for 8, 9-10

see also specific antigens

antiretrovirals

children 78-9 clinical effectiveness 53—4 counselling 85 developing countries 63—4 drug interactions 35, 72 drug users 71—2 malignancies 28 mitochondrial dysfunction 75

MTCT 75

new agents 58

plasma viral load 55—6 primary infection 56—7 resistance 10, 57 survival 21

toxicides 57—8

types 46 anus see anal disease anxiety see fear appetite stimulants 39 ART see antiretrovirals arterial blood gases 31 Asperfillusfumigatus 36 asymptomatic infection 18 atovaquone 32, 33, 47, 48 azithromycin 48, 53 AZT see zidovudine

B lymphocytes 13, 26 bacterial infections

children 77

developing countries 60 diarrhoea 38

IDU 69

lung 31, 34

treatment 52—3

see also specific bacteria/diseases

Barre-Sinoussi 7

basic fibroblast growth factor 24, 26 behaviours, risk of infection 100, 101 benzodiazepines 68, 69, 71, 90 biopsies

lymph nodes 13, 18

open lung 31—2

transbronchial 34, 37, 46 bisexual men 101—2 bleomycin 25, 27, 28, 34 blood, for testing 11 blood donors

testing of 10

transmission to and from 59 blood gases, arterial 31 blood products 2, 105 blood transfusion 2, 105 bone marrow 26, 27, 28 “boredom”, risk behaviour 101 brain see central nervous system breastfeeding, MTCT 74 breath, shortness of 69 bronchoscopy

fibroeptic 31, 34 precautions 95

Campylobacter 38, 53 cancer see tumours Candida albicans 52 candidiasis

oesophageal 20

oral 19, 20, 38, 52, 77

vulvovaginal 52

cannabis 69 carbamazepine 9 0 carriers

in community 97

hospital care 96

WHO estimates 6

case definitions 1—2, 62

CCR5 12

CD4 T cells

activation of 16

counts

AIDS definition 1

anal cancer 29

asymptomatic infection 18 children 76, 81 classification of HIV 17 cryptosporidiosis 39, 48, 49 cytomegalovirus 37, 50 dementia 45

diarrhoea 38

monitoring infection 14—15 neurological manifestations 42 non-Hodgkin’s lymphoma 26 P.

carinii 33, 47

primary cerebral lymphoma 27 primary infection 56 prognostic indication 21 toxoplasmosis 43, 48 tuberculosis 35

fall in, after infection 13

HIV replication in 6

HIV target 12

treatment with cytokines 58

CD8 T cells

beneficial effects 14, 15

responses to CMV 51

responses to HIV 56

rise in, after infection 13 cellulitis 78

Centers for Disease Control (CDC)

AIDS-defining malignancies 23

case definition of AIDS 1—2, 62 classification of HIV 17, 76

Central Africa 3

central nervous system

lymphoma 27-8, 44-5

toxoplasmosis 43, 48, 61

see also neurological manifestations cerebral disease see central nervous system cervical cancer 21, 28 chemokines 12, 14 chemoprophylaxis 36 chemotherapy

cervical cancer 28

Hodgkin’s lymphoma 28—9

KS 25, 34

non-Hodgkin’s lymphoma 27 chest radiology 30

fungal pneumonia 36

KS 24, 34

lobar pneumonia 34

lymphocyte interstitial pneumonitis 37

P carinii 31, 32, 33, 46

ρleurally based lymphoma 36

tuberculosis 35, 60

children antenatal testing 74—5 clinical manifestations 76-8 diagnosis 76—7 epidemiology 2, 5, 75—6 management 78—81 mother-to-child transmission 74—5 natural history 76—8 prognostic markers 78 seropositivity, KS 24 see also infants

chimpanzees 6

Chlamydia trachomatis 40 chlordiazepoxide 67 chlorhexidine 20 choice, facilitating 93 cholangitis, sclerosing 40 cholestasis 40

CHOP chemotherapy 27 cidofovir 44, 50-1 Ciprofloxacillin 53 clarithromycin 48, 53 classification

of HIV 17-18

HIV infection in children 76 lymphoma 26 of pain 89

clindamycin 32, 46, 47, 48 clinical aspects 12

children 76-8 developing countries 60-2 clinical waste 97 clofazimine 53 clonazepam 90 clonidine 90

Clostridium difficile 39 clotrimazole 20 clotted blood, for testing 11 CMV see cytomegalovirus co-codamol 89 co-dydramol 89 co-receρtors 12 co-trimoxazole 21, 32, 33, 43, 46, 47, 48, 53, 63, 81 cocaine 72

colitis 39 colposcopy 28 combination therapy 106—7

counselling 85 directly observed 71 community agencies 85 community aspects 97 complementary therapies 81 compound pains 91—3 computed tomography 43, 44—5, 48 condoms 101 confidentiality 21-2, 84 confirmatory tests 8—9 confrontation, drug user patients 67 consent 87 constitutional symptoms 19 contact, with drug users 66.

67 control policies 95—8 controlled drugs, prescriptions 68 coping strategies 83, 84, 85 core protein see ρ24
corticosteroids 47, 48 costs, of AIDS 5 cough 69 counselling

being HIV positive 106 defined 82 inoculation injuries 98 linking agencies 85 need for 82—3 psychological issues 83 responses to results 84 skills 83 therapy 85 voluntary 104-5 worried well 85

Cryptococcal meningitis 42, 43, 52, 61 Cryptococcus neoformans 36, 42, 43 cryptosporidiosis 48—9, 7 7 Cryptosporidium sρρ. 39

CSF abnormalities 42, 43 cutaneous disorders see skin disorders CXCR4 12 cyclophosphamide 27

Cyclospora sp. 39

cytokines

growth of KS cells 24 treatment with 58 cytomegalovirus

brain 44 children 77 colitis 39 lungs 37 treatment 50, 51 cytosine arabinoside 44 cytoxic cells see CD8 cells

dexamethasone 27

diamorphine 71

diarrhoea 38—9

cryptosporidiosis 49 developing countries 61

IDU 69

diazepam 68, 90

diclazuril 49

didanosine 72

direcdy observed therapy 35, 72 discriminating tests 8 disinfection 97

DNA, tests for 9-10, 76 doxorubicin 25, 27, 28, 34 drug abusers see injection drug use DSPN 45

dying patients 92—4

education, health 99—100 efavirenz 57, 72

ELISA 77

emotional support 22 encephalitis 44, 70 Encephalitozoon Intestinalis 39 encephalopathies

children 78

drug users 70

see also central nervous system

Entamoeba hystolytica 39

enteral nutrition 39

Enterocytozoon bienusi 39 epidemiology 1—5

children 74—5

developing countries 59 epidurals 90 epilepsy 69

dacarbazine 28 dapsone 32, 35, 47, 48, 52 daunorubicin 25, 34 death

children 77, 78 drug users 72 managing 86—7

pre-AIDS, drug users 69 decision-making, with patients 87 decontamination 97 definitions, AIDS 1-2, 62 delavirdine 35, 72 dementia 45, 69, 70 dendritic cells 12-13 dentists, transmission by 96 deoxyguanosine 50 dependency, IDU-related HIV 66 dermatitis

ρruriginous 59, 60

Seborrhoeic 19, 20 developing countries 59—64

ART 76

case definitions of AIDS 62 clinical aspects 60—2 control of STIs 105 epidemiology 3, 59 natural history 59—60 public health authorities 64 staging of HIV 62, 63 developmental needs, children 81

Epstein-Barr virus 20, 26, 27, 77 erythromycin 49 ethambutol 53

ethnic minorities, prevention strategies 103 Europe, epidemiology 4 evaluation, pain 88—89, 91

excision 28 exposure-prone procedures 96 eye, CMV infection 44, 50

false results, tests 8, 13 famciclovir 20, 50 families

care of children 81 counselling for 84 dying patients 93 impact on 3 fatigue 69 fear

of infection 85

of pain 67—8

fever 69

fire hazards, IDU 66, 67

first aid 98

first aid kits 105

Aecainide 9 0

Auconazole 20, 36, 52

Aucytosine 52

Aumazenil 68—9

folinic acid 32, 47

folliculitis 20

follow-up tests 8—9 foscarnet 39, 40, 50, 51 fungal infections

lungs 31, 36

skin 60

treatment 51, 52

see also specific fungi/diseases

furosemide 92

herpes zoster see varicella zoster virus heterosexual transmission 4, 59, 99, 103 highly active antiretroviral therapy see HAART Histoplasma capsulation 36

HIV

AIDS-defining conditions 1

origin 6

related viruses 7

tests see tests

vaccine development 15-16

gabapentin 90

Gallo 7

ganciclovir 39, 40, 50, 51

gastrointestinal manifestations 38—41

KS 25

gay community 100—1

genome sequences, tests for 9—10

genotypic mutations 54, 57

germ cell tumours, testicular 29

glandular fever, differential diagnosis 18

global epidemiology 2—5

glucocorticoids 33

glycoρyrronium 92

gp41 15

gpl20 12, 15

granulocyte colony-stimulating factor 24, 50

Guidelines on Clinical Management, DrugMisuse and Dependence 65, 68 GUM clinics 101, 104, 105

gut see gastrointestinal disorders

Guthrie cards 73

HIV infection

care and pain control 86-94

children 73-81

clinical aspects 12 control policies 95—8 counselling 82—5 developing countries 59-64 development of epidemic 2-5 gastrointestinal and hepatic manifestations 38-44 history and management of 17-22 immune responses 12-13, 14 injection drug use 65-72

lungs 30-7 monitoring 14—15 neurological manifestations 42-5 personal account 106-7 prevention strategies 99-106 transmission see transmission treatment see management tumours in 23—9

see also specific diseases and (types of) pathogens

HAART

dementia 45

fungal infections 52 immunotherapy 16

infants 79

KS 25, 26

life expectancy 4

lung disease 32

MTCT 75

PML 44

risk behaviour 100

tumours 23, 29

viral infections 51 haematological problems 20—1 Haemophilus influenzae 34, 69, 7 7 hairy leukoplakia 19, 20 health care workers

carriers 96

transmission of HIV 2

health education 99-100 helper T cells see CD4 T cells hepatitis B

disinfection 97

drug use 65

drug users 69—70

hospital care 96

response to vaccination 40 hepatitis C

drug use 65

drug users 40, 69—70

heroin 72

herpes simplex

anogenital disease 20, 40

treatment 38, 50

herpes virus-8, human 23M, 25, 29

HIV-I

developing countries 59-60 origin 6

tests 8

transmission 7

HIV-2

developing countries 59-60

origin 6

prevalence 7 progression 60 tests 8

transmission 7

West African connection 1

Hodgkin’s disease 28-9 home testing 9, 10 homosexual transmission 59 horizontal transmission 7 hospital care

drug users 67

infection control 95—6

HP∖ζ cervical carcinoma 28

HTLV viruses 7

human herpes virus-8 23^4, 25, 29 human immunodeficiency virus see HIV human papilloma virus 28, 29, 40 hydrocortisone 19, 20 hyoscine 92

Iiypergammaglobulinaemia 7 7 hyperimmune bovine colostrum 49 hypertonic saline test 31 Iiypogammaglobulinaemia 75 hypoxaemia 47

IDU see injection drug use illegal drug use, on wards 67

imidazole 52 immunisation 15—16, 80 immunoglobulin infusions 80 response to HIV 8 (IgG) transfer to infants 75-6 immunopathology 12—13 immunotherapy 16 impetigo 20 indinavir 72, 98 infants

CD4 counts 76

HAART 79

P. carinii 61

transfer of IgG 75—6 infection see HIV infection information, for patients 11, 22, 83 injection drug use 65—72

malignancies 28 management strategies 66—8 medical care systems 65—6 medical problems 69—72 prevention strategies 102—3 transmission by 59 inoculation injuries 96, 98 interferon 40, 44 interleukin 2 16, 58 interleukin 6 24, 26 intracranial hypertension 43 invasive tests, lung disease 31—2 isoniazid 35, 36, 52, 63 Isospora belli 39, 61 isosρoriasis 49 Italy, malignancies 28 itraconazole 36, 52 izoniazid 80

IDU 69

investigations 30—2

KS 34-5

lymphocyte interstitial pneumonia 37 lymphoma 36

non-specific pneumonia 37 opiates 68

Pneumocystis carinii pneumonia 32M tuberculosis 35—6

lung function tests 31 lung secretions 92 lymph nodes

in KS 24

Persistentgeneralisedlymphadenopathy 13, 18 Iymphadenopathy

IDU 69

Persistentgeneralised 13, 18 Iymphangioma-Iike KS 24 lymphocyte interstitial pneumonia 37, 77 lymphocytes

replication of virus 7

see also specific types

Iymphokines 12 lymphoma

children 78

gastrointestinal tract 41 Hodgkin’s 28-9 lung disease 30, 36 non-Hodgkin’s 26—7 primary cerebral 27—8, 44—5 lymphopenia 74, 20

macrolides 48 macrophages 12—13, 26 magnetic resonance imaging 43, 44—5, 78 malaria 61

malignancies see tumours

jaundice 69

JC virus 43M

management/treatment bacterial infections 52—3 children 78—81
Kaposi’s sarcoma 1, 23—6, 29, 63

children 78

developing countries 61

drug users 70

gastrointestinal tract 41

lung disease 30, 34—5 ketoconazole 20, 52 KS see Kaposi’s syndrome KSHV see human herpes virus-8

developing countries 63—4 early HIV infection 17-22 fungal infections 51, 52

IDU-related HIV 66-8

IDU-related problems 67-70 protozoal infections 46—9 types of 46

viral infections 49, 50—1

see also specific disorders and methods

medazolam 71

Iamivudine 57, 75, 98 lesions

KS 24,25,41

PCNSL 44

Ietrazuril 49

leucopenia 32 lidocaine 90

life expectancy 3, 4 liposomes 25 liquid disinfectants 97 lung disease 30—7

bacterial infections 34 cancer 29, 37 children 77 cytomegalovirus 37 fungal pneumonia 36

medical care, drug users 65—6 megestrol acetate 39 memory 69 meningitis, Cryptococcal 42, 43, 52, 61 methadone 68, 71, 72, 102 methotrexate 27 methylprednisolone 33 metronidazole 20 microsporidia 39, 49 monocytes 13 Montagnier 7 morphine 71, 89, 90 mortality see death; dying patients mother-to-child transmission 59, 64, 74—5 mouth problems 19, 20 movement-related pain 92

MTCT see mother-to-child transmission

multi-drug resistant tuberculosis 36, 53 multidisciplinary teams, care of children 81 Mycobacterium spp.

avium complex/avium Intracellulare 52. 53, 60, 61 children 77, 80

diarrhoea 38

neurological manifestations 42

tuberculosis see tuberculosis

p24

in diagnostic tests 9, 76 disease progression 14 paclitaxel 26 paediatric AIDS see children pain

classification 88

compound 90—2 fear of, drug users 67—8

naloxone 68

natural history 17—22

children 76-8

in developing world 59—60

nausea 91—2

needles

exchange programmes 102

sterile packs 105

transmission by 2

Neisseria gonorrhoea 40 nelfinavir 72, 79 neonates

seropositive 73—1

testing 74—5

neoplasms see tumours neurological manifestations 42—5

children 77

clinical approach 42 developing countries 61 opportunistic infections 43-4 neuropathic pain 90 neutropenia 20—1, 50 nevirapine 57, 72, 75 nociceptive pain 90 non-Hodgkin’s lymphoma 26-7, 29 non-invasive tests 8—9

lung disease 30—1

non-medical symptom control 88

non-nucleoside RT inhibitors 35, 52, 54, 55, 57, 72, 75 non-steroidal anti-inflammatory drugs 89, 92 nucleoside RT inhibitors 54, 55, 58, 72 nystatin 20

management 88—90

children 81

IDU-related HIV 71 in the last few days 93 movement-related 92 neuropathic 90 therapeutic approach to 9 0 palliative care 86—94 paracetamol 89 partners, counselling for 84 patients

consent 87

counselling 82—5 decision-making 87 discussing prognosis 87 general management 21—2 partnership with 87 testing of 10—11 see also dying patients peer support 106 penicilliosis 61 Penicillium marneffei 61 pentamidine 32, 33, 46, 47 peripheral nerve disorders 45 Persistentgeneralisedlymphadenopathy 13, 18 personal accounts

having AIDS 108-9

HIV antibody positive 106—7 phenotypic resistance 57 phenytoin Pf 90 PHI see primary HIV infection plasma viral load

ART 55-6

occult bacteraemia 77 octreotide 90 oesophageal disease 25, 38

Oncostatin M 24 open lung biopsy 31—2 opiates

lung disease 69 nociceptive pain 89 pain management 71

side effects 68, 89

toxicity 89 withdrawal from 68 withdrawal symptoms 67 opportunistic infections

children 77 drug users 70

neurological manifestations 43M ρroρhylaxis 21 treatment 63

oral conditions 19, 20, 25, 38, 52, 77 orphans 3

osteomyelitis 77 oximetry 31

non-breast-fed infants 78 platelet-derived growth factor 24 pleural effusions 35 pneumococcal infections 60, 63, 77 pneumococcal polysaccharide vaccine 80 Pneumocystis carinii 1

African infants 61 bacterial cause 31 chest radiograph 31 grading of severity 32 IDU-related HIV 69 pneumonitis 37 prophylaxis 27, 30, 33-4, 35 treatment 32-3, 46-8 pneumonia see lung disease pneumonitis 37 policies, control of infection 95—8 poliomyelitis 80 polymerase chain reaction, in tests 9, 10, 11, 43^1, 76 polyradiculopathy, CMV 44

Popovic 7 post-test counselling 83—1 pre-AIDS deaths 69

ρre-terminal restlessness 93 pre-test discussions 82—3 prednisolone 27, 33 pregnancy

antibody testing 104

terminations 82

prescribing

controlled drugs 68

IDU 66-7

pain management 89—90

prevention/risk reduction children 80, 81 counselling 83 strategies 99—106 primaquine 32, 46, 47 primary CNS lymphoma 27-8, 44-5 primary HIV infection 17—18

treatment 56—7

prognosis, discussing 87 prognostic markers 21, 78 progression

HIV-2 60

IDU-related HIV 71

risk of 21

progressive multifocal Ieucoencephalopathy 43M protease inhibitors 35, 52, 54, 55, 58, 72, 79 protozoal infections 46—9

diarrhoea 39

ρruriginous dermatitis 59, 60

Pseudomonas aeruginosa 34

psychological responses, positive results 84 psychological support 22

psychosocial management, patients 82-5 public health programmes 64 pulmonary disease/function see lung ρyrazinamide 52 pyrimethamine 33, 48

safe sex 7, 83, 85, 99 saline induced sputum 31, 46 saliva, in testing 9

Salmonella spp.

38, 53, 60, 77 sarcoma see Kaposi’s sarcoma Schistosoma mansoni 61 screening kits 8 screening tests see tests Seborrhoeic dermatitis 19, 20 sedative drugs, IDU 68 seizures 69, 78 self-test kits 10 septic arthritis 77 septicaemia, bacterial 60, 69 seroconversion 17—18 development of 1 7 KS 24 neurological symptoms 42 seropositive persons counselling 83M potentially infectious 7 prevention interventions 103—4 psychological responses 84 sexual transmission 2 control and testing 105 counselling 104 preventing 100—1 young persons 99 sharps disposal 96—7 Shigella 38 shingles see varicella zoster virus SIV 7, 15 skin disorders 19-20, 60

KS 24, 25

skin punctures 98

“slim” disease 59, 61 smoking policies, IDU 67 social effects, HIV infection 65, 66

quantity/quality equation 86-7 sodium valproate 72

sooty mangabey monkeys 6

radiotherapy

cervical cancer 28

KS 25

lymphoma 27

re-socialisation, IDU 67 recombinant human growth factor 39 recreational drug use

anti-viral therapy 71

medical care 65, 66

medical effects 68

referrals 106

regional variation, developing countries 61 religious beliefs 94

rescue services 97

resistance, to drugs 10, 57 respiratory disease see lung retinitis, CMV 44, 50 retirement 106

retroviruses 6, 7

reverse transcriptase 6

reverse transcriptase inhibitors 54 rifabutin 35, 52, 53 rifampicin 35, 36, 52, 53, 72, 80 risk behaviour 103

ritonavir 35, 72

RNA, tests for 9-10, 76

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