A: HIV wasting syndrome. The rates of AIDS‐defining conditions have dropped substantially in many parts of the world with the widespread use of combination antiretroviral therapy (ART). Risk factors for presentation with an AIDS‐defining condition in the developed and developing world include undiagnosed advanced HIV infection and/or lack of uptake or access to ART. Access to primary prophylaxis has also contributed to the decline in morbidity and mortality in many parts of the world. HIV wasting is an extremely common manifestation of untreated advanced HIV infection. The etiology is poorly understood but includes metabolic disturbance and malabsorption. In one study, malnourished (body mass index of < 17) patients with AIDS at the introduction of ART was associated with a significantly increased risk of death. The condition is usually reversible with the use of ART, treatment of underlying opportunistic infections, and nutritional supplementation (including parenteral nutrition) until immune competence is restored.
The spots of this patient’s back are likely Kaposi’s Sarcoma, a condition caused by human herpes virus- 8 (HHV-8) and closely related to AIDS. Kaposi’s Sarcoma occurs was one of the opportunistic infectious conditions that brought attention to the first cases of HIV/AIDS in the United States in 1981.
A: HIV wasting syndrome. The rates of AIDS‐defining conditions have dropped substantially in many parts of the world with the widespread use of combination antiretroviral therapy (ART). Risk factors for presentation with an AIDS‐defining condition in the developed and developing world include undiagnosed advanced HIV infection and/or lack of uptake or access to ART. Access to primary prophylaxis has also contributed to the decline in morbidity and mortality in many parts of the world. HIV wasting is an extremely common manifestation of untreated advanced HIV infection. The etiology is poorly understood but includes metabolic disturbance and malabsorption. In one study, malnourished (body mass index of < 17) patients with AIDS at the introduction of ART was associated with a significantly increased risk of death. The condition is usually reversible with the use of ART, treatment of underlying opportunistic infections, and nutritional supplementation (including parenteral nutrition) until immune competence is restored.
ReplyDeleteThe spots of this patient’s back are likely Kaposi’s Sarcoma, a condition caused by human herpes virus- 8 (HHV-8) and closely related to AIDS. Kaposi’s Sarcoma occurs was one of the opportunistic infectious conditions that brought attention to the first cases of HIV/AIDS in the United States in 1981.
Sources:
http://www.springerimages.com.ezp-prod1.hul.harvard.edu/Images/MedicineAndPublicHealth/2-AID0104-04-016A
http://www.nejm.org/doi/full/10.1056/NEJM198112103052401