58 - Complications of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS)

Summary

This chapter discusses the diagnosis, evaluation and management of acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV). Enzyme-linked immunoassay (ELISA) or rapid HIV test followed by Western blot analysis for confirmation is the current gold standard for diagnosis of the condition. In the deteriorating patient with HIV/AIDS, the usual considerations of airway, breathing, and circulation (ABC) should be made. Patients with decreased level of consciousness and concern for airway compromise should be intubated. The reported complications for AIDS include HIV nephropathy, and acute renal failure. HIV nephropathy is an indication for the initiation of antiretroviral therapy (ART). Some antiretroviral drugs are associated with nephrolithiasis and should be avoided. Patients with AIDS who are presenting with hypotension and evidence of shock are likely to be in septic shock. Norepinephrine is currently the initial vasopressor of choice in this situation.