ABC of palliative care: HIV infection and AIDS

Inter-generational Linkages of AIDS: Vulnerability of Orphaned Children for HIV Infection

“…However, given the paucity of health professionals in the developing world, children (especially daughters) are likely candidates for providing care for AIDSaffected adults (Nostlinger et al 2006). Risk of HIV infection to carers of AIDS patients is very low when adequate protection is used, particularly gloves (Wood et al 1997). …”

Pain Treatment in Patients Infected With Human Immunodeficiency Virus in Later Stages

“…28 With HAART, patients have an increased expectancy and quality of life. 2,4,8,29 Yet, ironically, the need for palliative care remains 2,3,9 as patients still die at a higher rate than the uninfected, 29 the virological failure rate remains high, 2,29 the adverse effects of continuous ART use are significant, 2,9,29 the results of advanced age, such as new comorbidities, became apparent (eg, end-stage liver disease secondary to hepatitis C coinfection), 9,29 the incidence of some HIV-related malignancies (eg, non-Hodgkin's lymphoma) have not declined with HAART, 9,29 and the number of late diagnosis still remains high. 9,16,29 Therefore, as mentioned previously, pain is present throughout all the course of HIV infection 5,8,11,18,29 and can profoundly reduce patient's quality of life.…”

“…2,9,10,18 However, pain is more likely to occur in later stages of HIV disease, 8,9,10,11 assuming additional importance in these stages, especially in terminally ill patients. 10,25,29 Indeed, HAART is less effective in advanced AIDS than in earlier stages, 4 and patients might benefit more from focused palliative care; 13 so decisions about treatment continuation should be taken with the patient. 4 Moreover, the dichotomy curative/palliative care is false, and palliative care should be integrated in all stages of patient's care.…”

“…[2][3][4] This change in the course of the disease led to a continuous increase in the infection prevalence, because, despite a decrease in the number of new infections, there was a decrease in mortality. [2][3][4] Nowadays, the course of HIV is similar to a progressive illness (eg, congestive heart failure) and is characterized by periodic crises, alternating with periods of return to baseline, although always slightly below the initial pre-crisis state, until death occurs. 3,4,6 Treatment of HIV has improved steadily after 1996 when HAART emerged.…”

“…[2][3][4] Nowadays, the course of HIV is similar to a progressive illness (eg, congestive heart failure) and is characterized by periodic crises, alternating with periods of return to baseline, although always slightly below the initial pre-crisis state, until death occurs. 3,4,6 Treatment of HIV has improved steadily after 1996 when HAART emerged. 2,3,7,8 There are more than 20 approved antiretroviral (ARV) drugs distributed in 6 classes: nucleoside/ nucleotide reverse transcriptase inhibitors (NRTIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), fusion inhibitors (FIs), CCR5 antagonists, and integrase strand transfer inhibitors (INSTI).…”