Editor
David H. Spach, MD
Professor of Medicine
Clinical Director, Northwest AETC
Division of Infectious Diseases
University of Washington
Associate Editor
Joel E. Gallant, MD, MPH
Professor of Medicine and Epidemiology
Associate Director, AIDS Service
Division of Infectious Diseases
Johns Hopkins University
New Cases
A
27-Year-Old with Disseminated Histoplasmosis
Disseminated histoplasmosis in HIV-infected persons is a potentially
life-threatening infection. Clinical manifestations are often non-specific.
Diagnostic testing often involves using a combination of tests, including
antigen tests and culture. Preferred initial treatment of progressive
disseminated infection consists of liposomal amphotericin B (AmBisome),
followed by maintenance therapy with oral itraconazole (Sporanox).
A
43-Year-Old with New Visual Symptoms
Cytomegalovirus retinitis
remains an important clinical problem with patients with advance
immunosuppression. Symptoms of cytomegalovirus retinitis usually
include one or more of the four āFāsā: floaters, flashes, field deficits,
or failing vision. Oral valganciclovir (Valcyte), with or without
a ganciclovir intraocular implant, is generally recommended for initial
therapy.
African
Americans with HIV: Epidemiology and Risk Factors
The HIV epidemic has disproportionately affected African Americans
and in recent years more new diagnoses of HIV (with or without AIDS)
involve African Americans than any other racial/ethnic population.
This case includes a review of the epidemiology and factors related
to the explosion of the HIV epidemic in African Americans.
Protease Inhibitor-Associated Hyperbilirubinemia
Isolated unconjugated hyperbilirubinemia is a known adverse effect
that can develop while taking atazanavir. This case includes a
review of the natural history, mechanism, genetic predisposition,
and management of protease-inhibitor associated hyperbilirubinemia.
Homelessness
and HIV
The HIV epidemic in the United States involves a substantial number
of marginally housed and homeless individuals. The optimal management
of homeless HIV-infected persons requires an in-depth understanding
of many of the unique aspects of clinical care for this patient population.
A
37-Year-Old Migrant Worker with Diarrhea
In evaluating this AIDS patient with severe diarrhea, challenge
your skills in identifying gastrointestinal parasitic pathogens as
seen on a modified acid-fast smear of a stool sample. Differentiating
these pathogens is paramount for optimal management.
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