INTRODUCTION

1. HIV causes a chronic infection that leads to profound immuno-suppression. This process ultimately leads to the depletion of CD4+ lymphocytes which eventually predisposes the patient to develop a variety of opportunistic infections and certain new abnormal growth of tissue (neoplasm).
2. Most patients with CD4+ counts of 350-800 appear well.
3. Susceptibility to opportunistic infections increases as HIV induced immunodeficiency becomes more severe. As the CD4+ cell count falls, certain marker infections may occur (e.g. oral candidiasis, diarrhoea and TB).
4.  In managing OIs, it is important to bear in mind the following principles:

• Do no harm
• Do the simple things well (e.g. hydration, pain relief, proper nutrition, etc) in accordance with the relevant guidelines

COMMONLY OCCURING OPPORTUNISTIC INFECTIONS

Diseases of the skin

• Fungal rashes
• Itchy rashes
• Skin lumps/swellings
• Ulcerations/wounds
• Warts, herpes zoster lesions

Diseases of the respiratory system

• TB
• Pneumonia

Diseases of the mouth, stomach, intestine

• Oral thrush
• Painful oral ulcers
• Lumps in the mouth
• Diarrhoea and vomiting
• TB of the abdomen

Diseases of the brain

• Mental disturbance
• Meningitis (severe headaches/stiff neck)

Diseases of the Nerves

• Numbness, pain, tingling sensation, etc.

TUBERCULOSIS

TB is a life-threatening infection that often occurs concurrently

in patients with HIV and AIDS and as such requires that every counsellor knows about it. This infection is:

• caused by an organism called Mycobacterium tuberculosis
• is more common in patients with HIV infection than in HIV-negative individuals
• is seen at any stage of the HIV disease
• is known to enhance the progression of HIV disease
• is seen more commonly in the lungs (pulmonary) but could also be seen in other tissues (extra-pulmonary) and its symptoms include cough, weight loss, fever and night sweats
• curable provided the client adheres to treatment regime and instructions given by the health worker
• Directly observed Therapy (DOTS) is the nationally accepted treatment modality for TB

              This will assist in the correct treatment of both infections that may be fatal if not attended to.

IF A CLIENT HAS COUGH, REMEMBER TO REFER FOR TB SCREENING