The American Academy of HIV Medicine's "Recommendations for the Triage of HIV+ Patients" target physicians in areas with large numbers of Hurricane Katrina evacuees who may have had little experience treating HIV patients. The document recommends the following steps:
- Treating active opportunistic infections or other infections with antibiotics or other appropriate medication is first priority.
- Try to determine the patient's CD4-cell count. Varying CD-4 counts put patients at risk of opportunistic infections for which they should be screened, such as HIV-related pneumonia for those with counts below 200; histoplasmosis, toxoplasmosis, and cryptococcal meningitis for those with counts below 100; and mycobacterium avium complex and systemic fungal disease for those with counts below 50.
- While both prophylactic and antiretroviral treatment courses should be continued if possible, doctors should place a priority on the administration of anti-HIV drugs to avoid treatment interruption.
- If patients cannot access all their antiretrovirals, every drug should be stopped, rather than continuing only one or two.
- Tetanus shots should be administered to HIV patients.
- While live-virus vaccines should be used with caution in HIV patients, they should be safe for patients with CD-4 counts above 350.
The guidelines include information on which drug combinations to use and which to avoid; treating pregnant women; HIV post-exposure prophylaxis; and rapid HIV testing.
More information, including help accessing HIV specialists and clinics, is available at www.aahivm.org. Also visit www.aidsinfo.nih.gov/guidelines.
Back to other news for September 15, 2005