RESUMO
This review is intended as an update on modern trends in the global impact and epidemiology of human immunodeficiency virus infection for physicians who are not acquired immunodeficiency syndrome experts. Africa has been the most affected, but epidemics are spreading in Asia and Russia. Therefore, physicians should be informed about seroconversion disease and human immunodeficiency virus diagnosis as well as the impact of sexually transmitted infections on many stages of human immunodeficiency virus. International treatment guidelines are available. Highly active antiretroviral therapy has been the mainstream therapy since 1996, but all drugs--regardless of class used--have potent side effects, many of which are dermatologic. Others affect the neurologic, hematopoietic, cerebral, and abdominal systems, and drug interactions are common. Lipodystrophy is a common, long-term side effect that is still not well understood. Broader use of highly active antiretroviral therapy has highlighted viral resistance. This is reviewed, and a simple explanation of therapeutic monitoring is provided.
Assuntos
Infecções por HIV , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , HumanosAssuntos
Etnicidade , Infecções por HIV/diagnóstico , Infecções por HIV/etnologia , HIV/isolamento & purificação , Vigilância da População/métodos , Infecções Sexualmente Transmissíveis/epidemiologia , Feminino , Infecções por HIV/transmissão , Humanos , Masculino , Programas de Rastreamento , Infecções Sexualmente Transmissíveis/diagnóstico , Reino Unido/epidemiologiaRESUMO
Pelvic inflammatory disease (PID) is a common condition presenting to Genitourinary Medicine clinics in the UK. It is unclear what is the best therapeutic option in the outpatient setting. A clinical audit of current standard of care in women presenting with PID was conducted. A total of 150 women were diagnosed clinically during a six-month period. Chlamydia and gonorrhoea were identified in 30% and 4% of patients respectively. The clinical and microbiological cure rates of oral doxycycline and metronidazole were assessed. In 57% of patients their symptoms resolved, but 18% had persistent signs and symptoms; 25% did not attend for follow up visit. Partner notification was discussed in 87% of patients. With a treatment failure rate of 18% we felt it appropriate to change the antibiotic regimen of PID in our department.