Prevention and Management of Opportunistic Infections
People with advanced HIV infection are vulnerable to infections or malignancies that are called because they take advantage of the opportunity offered by a weakened immune system. Even though there are currently no drugs for the cure of HIV infection, there is treatment for some opportunistic infections resulting from HIV induced immune deterioration.
It should be recognized that only opportunistic infections are treated and cured not HIV itself. In most cases patients dont die from HIV infection but succumb to the complications that the HIV induced immune deterioration cannot handle. Opportunistic infections depend on the level and kind of infections that are common in a given area and so these diseases may also be common diseases that are fond among HIV uninfected population e.g. Tuberculosis, pneumonia, etc. Their management therefore occurs within the normal health care setting.
However, because of the high frequency of certain diseases in HIV infected people, special attention may be provided to AIDS patients or HIV infected patients in terms of prevention and treatment. E.g. the use of fluconazole in the prevention and treatment of fungal infection (The Diflucan Initiative), Isoniazid Preventive Therapy against Tuberculosis. Commonly encountered clinical features in patients with HIV and AIDS include:
- Cough and difficulty in breathing (dyspnoea).
- Oropharyngeal and oesophageal Candidiasis.
- Vaginal Candidiasis.
- Weight Loss.
- Persistent Generalized Lymphadenopathy (PGL).
- Skin rashes, sores and generalized pruritis.
- Altered mental status.
In resource constrained countries the main challenges is the choice between interventions that alleviate the morbidity and suffering of those in need while not exceeding the financial and technical capabilities of the health system. Effective intervention against opportunistic diseases requires the following strategies:
- Prevention of exposure to sources of infection where possible.
- Prevention of active disease using drugs with aim of eradicating existing infection prior to development of active disease or preventing new infection
- Early treatment of active disease aimed at reducing the source of infection. In addition there is a need to ensure that there is necessary infrastructure to diagnose the condition, monitor the intervention and counsel the patients.