Home page  |  Help  |  Clear
English  |  French
 Search  |  Categories  |  Titles A-Z  |  Countries  |  Compare countries  |  Index  
Full TOC
Expand Document
Expand Chapter
Preferences

close this bookNational Guidelines for the Clinical Management of HIV/AIDS - Tanzania (NACP; 2005; 131 pages)
View the documentLIST OF ABBREVIATIONS
View the documentACKNOWLEDGEMENTS
View the documentFOREWORD
Open this folder and view contentsCHAPTER 1: INTRODUCTION
Open this folder and view contentsCHAPTER 2: ORGANIZATION OF HIV/AIDS CARE AND TREATMENT
Open this folder and view contentsCHAPTER 3: HIV/AIDS PREVENTION
Open this folder and view contentsCHAPTER 4: PROTECTIVE MEASURES AGAINST HIV TRANSMISSION
Open this folder and view contentsCHAPTER 5: LABORATORY TESTS IN HIV/AIDS
Open this folder and view contentsCHAPTER 6: HIV/AIDS AND PREGNANCY
Open this folder and view contentsCHAPTER 7: PEDIATRIC HIV/AIDS AND RELATED CONDITIONS
Open this folder and view contentsCHAPTER 8: COMMUNITY AND HOME BASED CARE FOR PEOPLE LIVING WITH HIV/AIDS (PLHA)
Open this folder and view contentsCHAPTER 9: COUNSELLING RELATED TO HIV-TESTING AND TREATMENT ADHERENCE
close this folderCHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
View the document10.1 Introduction
Open this folder and view contents10.2 Clinical features commonly encountered in patients with HIV/AIDS
Open this folder and view contents10.3 Prophylactic treatment of common opportunistic infections in HIV/AIDS
close this folder10.4 Treatment of Opportunistic Infections:
View the document10.4.1 Viral infections
View the document10.4.2 Bacterial infections
View the document10.4.3 Fungal infections
View the document10.4.4 Protozoa
Open this folder and view contentsCHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS
Open this folder and view contentsCHAPTER 12: MANAGEMENT OF HIV INFECTED PATIENTS USING ANTIRETROVIRAL DRUGS
Open this folder and view contentsCHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
Open this folder and view contentsCHAPTER 14: USE OF ARVS IN SPECIAL CIRCUMSTANCES
Open this folder and view contentsCHAPTER 15: HIV/AIDS AND NUTRITION
Open this folder and view contentsCHAPTER 16: MANAGEMENT OF ANTIRETROVIRAL MEDICINES
Open this folder and view contentsCHAPTER 17: CERTIFICATION OF HEALTHCARE FACILITIES AS CARE AND TREATMENT SITES
 

10.4.1 Viral infections

Viruses that are commonly associated with HIV/AIDS include:

Herpes simplex virus

Varicella zoster virus

Human papilloma virus

Herpes simplex virus infection (HSV)

Clinical features

Classical presentation of primary HSV infection includes

Fever

Lymph node enlargement

Small painful vesicles

Painful ulcers on the mucosa and skin

Pain along gluteal and upper thigh muscles (Sacral radiculomyelitis) may occur with genital/rectal HSV

Lesions usually resolve within 10-21 days after primary infection. The HSV then becomes latent in trigeminal and sacral nuclei and may reactivate.

Clinical features common in those with HIV/AIDS include:

Persistent/erosive genital/peri-rectal ulcerations which are mainly associated with HSV-2

More recurrent herpetic lesions.

Diagnosis

The diagnosis is usually based on clinical history and physical findings. Laboratory tests include serology, culture, immunoflorescence or immunoassay

Treatment

For mild and moderate cases of HSV, give Acyclovir 400mg orally three times daily for 7 days and for severe and recurrent HSV give Acyclovir 800mg orally, five (5) times daily for 5 days.

Varicella-zoster virus (Herpes zoster or shingles)

Clinical features

Early symptoms include pain (often severe and radicular) and fever followed 2-4 days later by vesicular rash over involved dermatomes. Primary varicella-zoster virus (VZV) infection usually results in chicken pox. However primary VZV infection in immuno-compromised persons may be associated with the following;-

More numerous lesions

Disseminated disease associated with pneumonitis, hepatitis and hemorrhagic skin lesions.

CNS manifestations including encephalitis and cerebellar ataxia

Prolonged healing time

Bacterial super-infection

Herpes zoster in HIV infected individuals may be more severe, with more recurrences and may involve more dermatomes

Diagnosis

Diagnosis of herpes zoster is usually based on findings of characteristic painful skin lesions at different stages of evolution (erythema, papule, vesicles, crusts).

Treatment

Analgesics are indicated, but the pain may be refractory even to potent analgesics.

Acyclovir 800mg 5 times per day for 7days.

With disseminated VZV or ophthalmic nerve involvement give IV/Oral Acyclovir 10 mg/kg/day 8 hourly, for 7 days

Erythromycin or Cloxacillin 500mg three times daily for 7 days for bacterial super-infection.

Post-herpetic pain: give Paracetamol/Aspirin or Diclofenac, also Amitriptylin 25-50mg nocte

Use of steroids (prednisolone) in herpes zoster is not recommended in this set up

to previous sectionto next section

Please provide your feedback English  |  French