Description

HIV infected patients may present “on take” with acute medical problems which are complications of HIV disease, or its treatment, or with unrelated general medical problems. Some patients will declare their HIV status, others will fail to declare or deny it, and others will be unaware of their infection. A careful history and examination may reveal evidence of occult immunosuppression. Complex drug-drug interactions may occur between antiretroviral drugs and drugs given to treat acute medical problems such as cardiac dysrythmias, fits, or acute psychosis/anxiety states.

Patients with known or suspected HIV infection presenting with community acquired pneumonia should be treated in the same way as the general population. Tuberculosis should be considered in the differential diagnosis of any known/suspected HIV infected patient with respiratory symptoms. Immunosuppressed patients presenting with acute neurological problems, e.g. fits, meningitis or sub-acute dementia should always have a cranial CT or MRI performed before lumbar puncture even if papilloedema or focal signs are absent.