English Version
As part of a routine examination for insurance coverage, a 25 year old previously healthy woman is found to have a positive test for human immunodeficiency virus type 1 (HIV-1) antibody. Heterosexual contact is her only risk factor for HIV acquisition. She is asymptomatic and has a normal physical examination. The results of hematologic and other routine laboratory tests are normal. Her CD4 cell count is 325 cells per cubic millimeter, and her plasma HIV-1 RNA level is 60,000 copies per milliliter (both confirmed on repeated testing). How should her case be managed?
The Clinical Problem
In the United States, it is estimated that 900,000 to 1 million persons are infected with HIV-1. One quarter to one third of these persons do not know their infection status, thus jeopardizing their own care and putting others at risk through transmission that might be prevented with counseling, behavior modification, and potentially, antiretroviral therapy. The number of new cases of acquired immuno deficiency syndrome (AIDS) reported each year in the United States has been stable, at approximately 40,000, but the incidence of HIV-1 infection and other sexually transmitted infections has increased in certain at risk populations, such as men who have sex with men. Blacks, Hispanics, and women are disproportionately represented among persons with HIV-1 infection, AIDS, or both.
The era of potent antiretroviral therapy, which began in 1996, has resulted in marked reductions in the rates of illness and death due to HIV-1 infection in the developed
world and has led to the management of HIV-1 infection as a chronic disease, with life expectancies after diagnosis now measured in decades.
Journals for full download on the link below
In the United States, it is estimated that 900,000 to 1 million persons are infected with HIV-1. One quarter to one third of these persons do not know their infection status, thus jeopardizing their own care and putting others at risk through transmission that might be prevented with counseling, behavior modification, and potentially, antiretroviral therapy. The number of new cases of acquired immuno deficiency syndrome (AIDS) reported each year in the United States has been stable, at approximately 40,000, but the incidence of HIV-1 infection and other sexually transmitted infections has increased in certain at risk populations, such as men who have sex with men. Blacks, Hispanics, and women are disproportionately represented among persons with HIV-1 infection, AIDS, or both.
The era of potent antiretroviral therapy, which began in 1996, has resulted in marked reductions in the rates of illness and death due to HIV-1 infection in the developed
world and has led to the management of HIV-1 infection as a chronic disease, with life expectancies after diagnosis now measured in decades.
Journals for full download on the link below
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