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AIDS Care: Psychological and Sociomedical Aspects of AIDS/HIV Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/caic20
Advances in clinical management S. B. Squire
a
a
Research Fellow, Departments of Thoracic Medicine and Virology , Royal Free Hospital and School of Medicine , Pond Street, London, NW3 2QG, UK Published online: 25 Sep 2007.
To cite this article: S. B. Squire (1990) Advances in clinical management, AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, 2:4, 363-366, DOI: 10.1080/09540129008257754 To link to this article: http://dx.doi.org/10.1080/09540129008257754
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions
NDS CARE, VOL. 2,
363
NO.4,1990
Advances in clinical management
Downloaded by [University of Newcastle, Australia] at 23:23 30 December 2014
s. B. SQUIRE Research F e h , Departments of Thoracic Medicine and Virology, Royal Free Hospital and School of Medicine, Pond Street, London NW3 2QG, UK
The most outstanding advance in the management of HIV infected adults in the last year has been the increasing perception that medical intervention early in the infection, perhaps even in the asymptomatic phase, may improve prognosis. This perception is based on several pieces of evidence which will be discussed later in this paper. In addition to these advances in the management of patients with relatively preserved immunity, new data is now available that will lead to changes in the management of patients with more advanced disease. These changes, by contrast, can be seen more as adjustments of existing therapies rather than major new introductions. For patients with symptoms atuibutable to immunodeficiency, the first priority is to treat the presenting disease. The commonest presentation of AIDS in the developed world remains pneumocystis carinii pneumonia (PCP) (Sattler, SB17) and the choice for first line therapy still lies between intravenous co-trimoxazole or pentamidine with their recognized toxicities. The debate about the concomitant use of steroids for severe cases has not been resolved definitively by hard evidence either way, but a consensus view of chest physicians who met in San Francisco in May 1990 was that patients with certain adverse prognostic indicators at presentation (e.g. arterial p02
AIDS Care: Psychological and Sociomedical Aspects of AIDS/HIV Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/caic20
Advances in clinical management S. B. Squire
a
a
Research Fellow, Departments of Thoracic Medicine and Virology , Royal Free Hospital and School of Medicine , Pond Street, London, NW3 2QG, UK Published online: 25 Sep 2007.
To cite this article: S. B. Squire (1990) Advances in clinical management, AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, 2:4, 363-366, DOI: 10.1080/09540129008257754 To link to this article: http://dx.doi.org/10.1080/09540129008257754
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions
NDS CARE, VOL. 2,
363
NO.4,1990
Advances in clinical management
Downloaded by [University of Newcastle, Australia] at 23:23 30 December 2014
s. B. SQUIRE Research F e h , Departments of Thoracic Medicine and Virology, Royal Free Hospital and School of Medicine, Pond Street, London NW3 2QG, UK
The most outstanding advance in the management of HIV infected adults in the last year has been the increasing perception that medical intervention early in the infection, perhaps even in the asymptomatic phase, may improve prognosis. This perception is based on several pieces of evidence which will be discussed later in this paper. In addition to these advances in the management of patients with relatively preserved immunity, new data is now available that will lead to changes in the management of patients with more advanced disease. These changes, by contrast, can be seen more as adjustments of existing therapies rather than major new introductions. For patients with symptoms atuibutable to immunodeficiency, the first priority is to treat the presenting disease. The commonest presentation of AIDS in the developed world remains pneumocystis carinii pneumonia (PCP) (Sattler, SB17) and the choice for first line therapy still lies between intravenous co-trimoxazole or pentamidine with their recognized toxicities. The debate about the concomitant use of steroids for severe cases has not been resolved definitively by hard evidence either way, but a consensus view of chest physicians who met in San Francisco in May 1990 was that patients with certain adverse prognostic indicators at presentation (e.g. arterial p02
