Medical management of human immunodeficiency virus infection

The human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) pandemic has pervasive effects on culture, economics, policy, and human development. All organs can be affected by complications of HIV/AIDS, including the eye. When sufficient resources are available and widespread a...

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Main Author: Kempen John
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2008-01-01
Series:Indian Journal of Ophthalmology
Subjects:
Online Access:http://www.ijo.in/article.asp?issn=0301-4738;year=2008;volume=56;issue=5;spage=385;epage=390;aulast=Kempen
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author Kempen John
author_facet Kempen John
author_sort Kempen John
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description The human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) pandemic has pervasive effects on culture, economics, policy, and human development. All organs can be affected by complications of HIV/AIDS, including the eye. When sufficient resources are available and widespread antiretroviral resistance does not exist, the four available classes of antiretroviral agents - nucleoside/nucleotide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, and fusion inhibitors - can be combined to provide highly active antiretroviral therapy (HAART). For many (not all) patients, HAART converts an inexorably fatal disease into a chronic disease with a fairly good prognosis. Use of HAART often induces partial immune recovery, which has predominantly beneficial effects on ocular complications of AIDS. However, HAART-induced immune recovery sometimes results in immune recovery inflammatory syndromes, such as immune recovery uveitis. Use of HAART is the single most useful intervention for most patients with ocular complications of AIDS. However, specific ocular therapy is also critical to avoid blindness in the early months before immune recovery can occur, or if HAART is unavailable. Increasing availability of HAART worldwide shows great promise to alleviate one of the world′s greatest plagues. However, predictable secular trends in the AIDS epidemic make it likely that the number of cases of ocular complications of AIDS will increase substantially before they decrease. Ophthalmologists worldwide should be familiar with the diagnosis and management of cytomegalovirus retinitis - the most common ocular complication of AIDS - and should establish partnerships with physicians who are able to provide HAART. Research is needed to determine the optimal approach for managing cytomegalovirus retinitis in resource-constrained settings.
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spelling doaj.art-b046d65e7bc3403eb458240531fe30652022-12-21T19:52:03ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892008-01-01565385390Medical management of human immunodeficiency virus infectionKempen JohnThe human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) pandemic has pervasive effects on culture, economics, policy, and human development. All organs can be affected by complications of HIV/AIDS, including the eye. When sufficient resources are available and widespread antiretroviral resistance does not exist, the four available classes of antiretroviral agents - nucleoside/nucleotide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, and fusion inhibitors - can be combined to provide highly active antiretroviral therapy (HAART). For many (not all) patients, HAART converts an inexorably fatal disease into a chronic disease with a fairly good prognosis. Use of HAART often induces partial immune recovery, which has predominantly beneficial effects on ocular complications of AIDS. However, HAART-induced immune recovery sometimes results in immune recovery inflammatory syndromes, such as immune recovery uveitis. Use of HAART is the single most useful intervention for most patients with ocular complications of AIDS. However, specific ocular therapy is also critical to avoid blindness in the early months before immune recovery can occur, or if HAART is unavailable. Increasing availability of HAART worldwide shows great promise to alleviate one of the world′s greatest plagues. However, predictable secular trends in the AIDS epidemic make it likely that the number of cases of ocular complications of AIDS will increase substantially before they decrease. Ophthalmologists worldwide should be familiar with the diagnosis and management of cytomegalovirus retinitis - the most common ocular complication of AIDS - and should establish partnerships with physicians who are able to provide HAART. Research is needed to determine the optimal approach for managing cytomegalovirus retinitis in resource-constrained settings.http://www.ijo.in/article.asp?issn=0301-4738;year=2008;volume=56;issue=5;spage=385;epage=390;aulast=KempenAcquired immune deficiency syndromeantiretroviral therapycytomegalovirus retinitishighly active antiretroviral therapyhuman immunodeficiency virusimmune recovery
spellingShingle Kempen John
Medical management of human immunodeficiency virus infection
Indian Journal of Ophthalmology
Acquired immune deficiency syndrome
antiretroviral therapy
cytomegalovirus retinitis
highly active antiretroviral therapy
human immunodeficiency virus
immune recovery
title Medical management of human immunodeficiency virus infection
title_full Medical management of human immunodeficiency virus infection
title_fullStr Medical management of human immunodeficiency virus infection
title_full_unstemmed Medical management of human immunodeficiency virus infection
title_short Medical management of human immunodeficiency virus infection
title_sort medical management of human immunodeficiency virus infection
topic Acquired immune deficiency syndrome
antiretroviral therapy
cytomegalovirus retinitis
highly active antiretroviral therapy
human immunodeficiency virus
immune recovery
url http://www.ijo.in/article.asp?issn=0301-4738;year=2008;volume=56;issue=5;spage=385;epage=390;aulast=Kempen
work_keys_str_mv AT kempenjohn medicalmanagementofhumanimmunodeficiencyvirusinfection