Explain that very effective therapies are now available for HIV/AIDS treatment.Assess patient’s support system and coping mechanism.Provide basic information about HIV, AIDS and transmission.If risk activity within last 6 months, inform patient of window period and advise re-testing 3 months later.PCR) is not recommended as a diagnostic test (except in infants and children < 18 months of age) but utilized as a management tool to guide and monitor treatment. The implications of positive and negative test results and the patient’s potential risk factors should be discussed, and the patient educated on HIV infection and safer sex practices. because he has engaged in high-risk sexual behaviours, pre-HIV test counselling should be carried out for the patient. If a patient voluntarily requests HIV testing, e.g.Reasons for refusal should also be documented. You may want to document that patient is agreeable for HIV testing. However, just like in any diagnostic investigation, it is prudent to inform patients that you are doing this test and offer to answer any queries. When HIV testing is medically indicated and carried out as part of the overall medical management of the patient, extensive pre-HIV test counselling is not required. A signed consent is not needed for HIV testing.fourth generation antibody-P24 antigen combination test, rapid test kits) followed by confirmatory test (e.g. Others: wasting dementia progressive multi-focal leucoencepholopathy).non-Hodgkin’s lymphoma, CNS lymphoma, Kaposi’s sarcoma, cervical cancer) Protozoa: cerebral toxoplasmosis cryptosporidial diarrhoea.Fungi: oesophageal candidiasis cryptococcal meningitis histoplasmosis (extra-pulmonary) Pneumocystis jiroveci pneumonia.extrapulmonary) atypical mycobacteria infections recurrent bacterial pneumonia (2 or more episodes in one year) recurrent non-typhoid-salmonella septicaemia. Median duration of illness is 20 days (range 1 month) CMV retinitis or disease other than liver, spleen, lymph node involvement. Some have oral and genital ulcerations and neurological illnesses (e.g. Combination of more than one of the following symptoms: fever, adenopathy, rash, sore throat, myalgia, diarrhoea, nausea, vomiting, headache, weight loss or oral thrush. Seroconversion illness/Acute retroviral syndrome.Progression through 4 stages individuals with higher viral loads generally progress faster. There have been 29 children infected through mother-to-child transmission locally. Most cases (90%) are males with the highest proportion (32%) in the 30-39 years age group. The majority (94%) were infected via the sexual route: heterosexual sex (66%), homosexual (21%) and bisexual (7%). Epidemiologyīy the end of 2009, there were a total of 4404 cases reported in Singapore (2009 notification rate: 124 per million population). Infectious for whole duration of infection most infectious during the period of seroconversion and untreated late-stage disease when the viral load (measured as number of HIV copies/ml plasma) is very high. Transmission after contact with saliva, tears, urine, stool and bronchial secretions has not been reported. Via sexual route (most common), transfusion of infected blood (or blood products) and contaminated needles from mother-to-child during in-utero, intrapartum and perinatal period and via breastfeeding. Without treatment, about half of infected adults will develop AIDS within 10 years after infection. The time from infection to development of detectable antibodies is generally 1- 3months.īetween 1 and 6 weeks (median 3 weeks) after exposure to HIV, one half to two thirds of recently infected individuals develop a mononucleosis-like illness referred to as the acute retroviral syndrome. The median incubation period is shorter in infants than in adults. Human immunodeficiency virus I and II Incubation Period
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