Dr. Daar received his undergraduate degree from UCLA and medical degree from Georgetown University School of Medicine. He completed an internship and residency in internal medicine at Cedars-Sinai Medical Center and his clinical and research fellowship in infectious diseases at Cedars-Sinai Medical Center and UCLA.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Should patients with the flu- or mono-like illness of primary HIV infection be treated?
There are theoretical reasons why patients identified with HIV around the time they are first infected (primary, acute infection) may benefit from the immediate initiation of potent antiviral therapy. Preliminary evidence suggests that unique aspects of the body's immune response to the virus may be preserved by this strategy. It is thought that treatment during the primary infection may be an opportunity to help the body's natural defense system to work against HIV. Thus, patients may gain improved control of their infection while on therapy and perhaps even after therapy is stopped. At one time, the hope was that if therapy was started very early in the course of the infection HIV could be eradicated. Most evidence today however suggests that this is not the case. Consequently, early treatment is not likely to result in a cure, although other benefits may still exist. The current recommendation is that patients with primary infection should be referred to clinical studies where the potential role of therapy can be discussed and further explored. If emotional or social situations make adherence to such treatment questionable, however, the patients are clearly better off delaying therapy.
What about treatment for HIV during pregnancy?
One of the greatest advances in the management of HIV
infection has been in pregnant women. Prior to antiviral therapy, the risk of
HIV transmission from an infected mother to her newborn was approximately 25%-35%. The first major advance
in this area came with studies giving ZDV after the first trimester of
pregnancy, then intravenously during the delivery process, and then after
delivery to the newborn for six weeks. This treatment showed a reduction in the
risk of transmission to less than 10%. Although less data are available with
more potent drug combinations, clinical experience suggests that the risk of
transmission may be reduced to less than 5%. Current recommendations are to
advise HIV-infected pregnant women regarding both the unknown side effects of
antiviral therapy on the fetus and the
promising clinical experience with potent therapy in preventing transmission. In
the final analysis, however,
pregnant women with HIV should be treated essentially the same as nonpregnant
women with HIV. Exceptions would be during the first trimester, where therapy
remains controversial, and avoiding certain drugs that may cause greater concern
for fetal toxicity, such as EFV.
All HIV-infected pregnant women should be managed by an obstetrician with
experience in dealing with HIV-infected women. Maximal obstetric precautions to
minimize transmission of the HIV virus, such as avoiding scalp monitors and
minimizing labor after rupture of the uterine membranes, should be observed. In addition, the
potential use of an elective Caesarean section (C-section) should be discussed,
particularly in those women without good viral control of their HIV infection
where the risk of transmission may be increased. Breastfeeding should be avoided
if alternative nutrition for the infant is available since HIV
transmission can occur by this route. Updated guidelines for managing HIV-infected women
are updated on a regular basis and can be found at http://www.aidsinfo.nih.gov.
Most sore throats are caused by viruses or mechanical causes (such as mouth breathing) and can be treated successfully at home. However, a person should be seen by a health care professional if they have a sore throat that has a rapid onset, and is associated with a fever or tenderness of the front of the neck; a sore throat that causes the person to have difficulty swallowing (not just pain swallowing) or breathing; or if a sore throat lasts for more than a week.
Pneumonia is inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Low testosterone can affect both men and women. Causes of low testosterone in males include undescended testicles and injury to the scrotum. Low testosterone in females includes ovary conditions. Treatment for low testosterone in men includes testosterone replacement therapy. Currently there is no FDA approved testosterone treatment for women.
Cellulitis is an acute spreading bacterial infection below the surface of the skin characterized by redness, warmth, inflammation, and pain. The most common cause of cellulitis is the bacteria Staph (Staphylococcus aureus).
Athlete's foot (tinea pedis) is a skin infection caused by the ringworm fungus. Symptoms include itching, burning, cracking, peeling, and bleeding feet. Treatment involves keeping the feet dry and clean, wearing shoes that can breathe, and using medicated powders to keep your feet dry.
Thrush is an infection of the mouth caused by the candida fungus. Symptoms of Thrush include pain or difficulty swallowing, a feeling that food gets stuck in the throat, and fever.
Sexually transmitted diseases, or STDs,
are infections that are transmitted during any type of sexual exposure,
including intercourse (vaginal or anal), oral sex, and the sharing of sexual
devices, such as vibrators. Women can contract all of the STDs, but may have no symptoms, or have different symptoms than men do.
Dementia is a significant loss of intellectual abilities such as memory capacity, severe enough to interfere with social or occupational functioning. There are different criteria classification schemes for dementias such as cortical, subcortical, progressive, primary, and secondary dementias. Other conditions and medication reactions can also cause dementia. Dementia is diagnosed based on a certain set of criteria. Treatment for dementia is generally focused on the symptoms of the disease.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Hodgkin's disease is a cancer of the lymphatic system with symptoms that include unexplained, recurring fevers, unexplained weight loss, itchy skin, and painless swelling of the lymph nodes in the neck, underarm, and groin. Treatment for adult Hodgkin's disease depends on the staging of the disease, the lymph nodes' size, and the health of the patient.
Non-Hodgkin's lymphoma is cancer of the lymphatic system, a vital part of the body's immune system. Symptoms include swollen lymph nodes, fever, night sweats, coughing, weakness, chest pain, unexplained weight loss, and abdominal pain. Treatment depends on which type of non-Hodgkin's lymphoma you have, the stage of the cancer, your age, how fast the cancer is growing, and whether you have other health problems.
The spleen enlarges if it is asked to do excessive work in filtering or manufacturing blood cells, if there is abnormal blood flow to it, or if it is invaded with abnormal cells or deposits. Symptoms of an enlarged spleen may include weakness and fatigue, easy bleeding, and poor white blood cell function. Treatment of an enlarged spleen is focused toward the cause of the splenomegaly. Surgery may be required to remove the spleen.
Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
Sexually transmitted diseases, or STDs, are infections that are transmitted during any
type of sexual exposure, including intercourse (vaginal or anal), oral sex, and
the sharing of sexual devices, such as vibrators. Although treatment exists for many STDs, others currently are
usually incurable, such as those caused by HIV, HPV, hepatitis B and C, and HHV-8.
Grief is the feeling one experiences after a loss (of a friendship, death of loved one, job). Complicated grief refers to grief that lasts for more than a year. Mourning describes the customs and rituals that help a bereaved individual make sense of their loss.
Neuropathic pain is chronic pain resulting from injury to the nervous system. The injury can be to the central nervous system (brain and spinal cord) or the peripheral nervous system (nerves outside the brain and spinal cord).
Toxoplasmosis (toxo) is a parasitic infection that causes flulike symptoms, swollen lymph nodes, and muscle aches and pains that may last from a few days to several weeks. Toxoplasmosis can be contracted by touching the hands to the mouth after gardening, cleaning a cat's litter box, or anything that came into contact with cat feces. Toxoplasmosis can also be contracted by eating raw or partly cooked meat, especially pork or lamb, or touching the hands to the mouth after contact with raw or undercooked meat.
Optic neuritis is inflammation of the optic nerve, the structure that connects the eye to the brain. The precise cause of optic neuritis is unknown, but it is thought to be a type of autoimmune disorder. Optic neuritis most commonly develops due to an autoimmune disorder that may be triggered by a viral infection.
Gum disease is caused by plaque and may result in tooth loss without proper treatment. Symptoms and signs of gum disease (gingivitis or periodontal disease) include receding gums, bad breath and pocket formation between the teeth and gums. Treatment depends upon the stage of the gum disease, how you responded to earlier treatments, and your overall health.
Fatigue can be described in various ways. Sometimes fatigue is described as feeling a lack of energy and motivation (both mental and physical). The causes of fatigue are generally related to a variety of conditions or diseases for example, anemia, mono, medications, sleep problems, cancer, anxiety, heart disease, drug abuse, and more. Treatment of fatigue is generally directed toward the condition or disease that is causing the fatigue.
Drugs commonly abused by teens include tobacco products, marijuana, cold medications, inhalants, depressants, stimulants, narcotics, hallucinogens, PCP, ketamine, Ecstasy, and anabolic steroids. Some of the symptoms and warning signs of teen drug abuse include reddened whites of eyes, paranoia, sleepiness, excessive happiness, seizures, memory loss, increased appetite, discolored fingertips, lips or teeth, and irritability. Treatment of drug addiction may involve a combination of medication, individual, and familial interventions.
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.
Cocaine is an addictive stimulant that is smoked, snorted, and injected. Crack is cocaine that comes in a rock crystal that is heated to form vapors, which are then smoked. Cocaine has various effects on the body, including dilating pupils, constricting blood vessels, increasing body temperature, heart rate, and blood pressure.
AIDS is the advanced stage of HIV infection. Symptoms and signs of AIDS include pneumonia due to Pneumocystis jiroveci, tuberculosis, toxoplasmosis, seizures, weakness, meningitis, yeast infection of the esophagus, and Kaposi's sarcoma. Anti-retroviral therapy (HAART) is used in the treatment of AIDS.
Anabolic steroids are synthetic substances that are related to testosterone and promote skeletal muscle growth and the development of male sexual characteristics in both men and women. In the 1930s, it was discovered that anabolic steroids could promote skeletal muscle growth in lab animals, which lead to anabolic steroid abuse by bodybuilders and weight lifters.
HIV / AIDS RSS
Healthy Living Tips
This site complies with the