HIV

HIV

Abstract

Although progress has been in treating HIV infection and AIDS , the epidemic remains a critical public health issue in all communities across the country and around the world . Prevention , early detection and ongoing treatment remain important aspects of care for people with HIV infections and AIDS . Nurses in all settings encounter people with this disease thus , nurses need an understanding of the dis knowledge of the physical and psychological consequences associated with the diagnosis , and expert assessment and clinical management skills to provide optimal care for people with

HIV infection and AIDS

In 1987 , just 6 years after the first cases of AIDS were reported , the U .S . Food and Drug Administration (FDA ) approved the first antiretroviral agent in 1988nthe first randomized controlled trial of primary prophylaxis of Pneumocystis carinii pneumonia appeared in the literature and in 1995 protease inhibitors joined the growing number of antiretroviral agents . Improved treatment of HIV and AIDS has resulted in increased survival times in 1996 , 1997 , and 1998 , age-adjusted death rates fell 29 , 48 , and 21 , respectively

This intent to

describe the modes of transmission of HIV infection

describe the pathophysiology of HIV infection

explain the physiology underlying the clinical manifestations of HIV infection

Describe the management of patients with HIV infection

Discuss the interventions appropriate for patients with HIV infection and AIDS

I . Introduction

Since acquired immunodeficiency syndrome (AIDS ) was first recognized more than 20 years ago , remarkable progress has been made in improving the quality and duration of life of persons with HIV infection . During the first decade , this progress was associated with recognition of opportunistic disease processes , more effective therapy for complications , and introduction of prophylaxis against common opportunistic infections (OIs . The second decade has witnessed progress in developing highly active antiretroviral therapies (HAART ) as well as continuing progress in treating OIs (Masur , Kaplan Holmes , 1999 . Since the HIV serologic test (enzyme immunoassay [EIA] , formerly enzyme-linked immunosorbent assay [ALISHA] , became available in 1984 , allowing early diagnosis of the infection before onset of symptoms , HIV infection has been best managed as a chronic disease and most appropriately managed in an outpatient care setting (Gallant , 2001

II . Background

A . Epidemiology

In fall 1982 , the Centers for Disease Control and Prevention (CDC issued a case definition of AIDS after the first 100 cases were reported . Since then , the CDC has revised the case definition a number of times (1985 , 1987 , and 1993 All 50 states , the District of Columbia , U .S . dependencies and possessions , and independent nations in free association with the United States report AIDS cases to the CDC using a uniform surveillance case definition and case report from (CDC 2000 . Starting in the late 1990s , more states started to implement HIV case reporting in response to the changing epidemic and the need for information on persons with HIV infection who have not developed AIDS As of December 2001 , there were 816 ,149 reported cases of HIV /AIDS and 506 , 154 adults , adolescents , and children in the United States (including...