Letter from the Editor

Dear HEPP News Readers,

This month, HEPP is addressing opportunistic infections and fevers of unknown origins. As the treatment of HIV has improved over the years, what we consider opportunistic infections has shifted considerably. Dr. Bick has done his usual excellent job in presenting our current and past thoughts on OIs. Although previous issues have discussed it, hepatitis is rapidly becoming our most lethal coinfection. More and more authors are including hepatitis as an opportunistic infection. Likewise, more and more correctional systems are having to face the reality of hepatitis C in their populations. All of us will be significantly relieved when we have better treatment regimens for this disease complex, especially the genotype 1 series that is so prevalent in our environment.

We all hope that with better and better control of HIV disease, with mechanisms to make sure our patients get every dose every time, with newer and easier regimens, and with more potent antivirals, that opportunistic infections that plagued us just five years ago and destroyed our patients' lives and quality of life, will be a distant medical memory. In some significant sized systems, there has not been a case of CMV retinitis in over two years. Although it will be unlikely because of late diagnoses in some of our patients, hopefully PCP pneumonia and Mycobacterium avium complex will become important only in the history of medicine textbooks.

Fevers of unknown origin (FUO) is a very complex subject that is addressed very succinctly in this issue. The challenges presented by a patient with an FUO are enough to make the hardiest diagnostician quake, especially when other signs and symptoms, laboratory analyses, and radiography are not helpful.

After reading this issue, health care providers should understand the steps involved in working up a fever of unknown origin and the various treatment regimens recommended for opportunistic infections.

Please enjoy this issue. Not only is it another intellectually stimulating and challenging presentation, but this journal touches us all right where we live. It is so relevant to our daily lives. The authors and editors have done a great job in making this journal the top of the line in its field.

Sincerely,

David Thomas, M.D.

Back to the HEPP News December 2001 contents page.