The urological management of the patient with acquired immunodeficiency syndrome

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dc.contributor.authorHeyns C.F.
dc.contributor.authorFisher M.
dc.date.accessioned2011-05-15T16:15:43Z
dc.date.available2011-05-15T16:15:43Z
dc.date.issued2005
dc.description.abstractIn people infected with the human immunodeficiency virus (HIV) both the CD4 T-cell count and the viral load are used to monitor disease progression to acquired immunodeficiency syndrome (AIDS). CD4 counts of &lt
dc.description.abstract500/mm3 are associated with opportunistic infections and certain malignancies, so-called 'AIDS-defining' conditions. Highly active antiretroviral therapy, using combinations of reverse transcriptase inhibitors and/or protease inhibitors, can improve considerably the prognosis of people who are HIV-positive, but such therapy is not yet widely available in many developing countries. People with AIDS are predisposed to urinary tract infection (UTI) by uncommon bacteria and pathogens, e.g. fungi, parasites and viruses, which may affect any urogenital organ
dc.description.abstracttreatment should be culture-specific and long-term, because there is a tendency to recurrence, infection with multiple organisms and resistant isolates. Voiding dysfunction in patients with AIDS is usually a result of neurological complications caused by opportunistic infections, and has a poor prognosis. Of patients with AIDS, 30-50% develop a cancer, especially Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL). KS may involve any urogenital organ, but is usually part of systemic disease. Small lesions on the external genitalia can be treated with laser, cryotherapy or surgical excision, larger lesions with radiotherapy, and disseminated or visceral KS with multidrug chemotherapy. NHL may involve the kidneys, testes and retroperitoneal lymph nodes, thus obstructing the ureters, which may require ureteric stenting or percutaneous nephrostomy. NHL can be treated with radiotherapy and combination chemotherapy. Urolithiasis in patients with AIDS may be caused by indinavir, a protease inhibitor, but the more common types of stones may also occur. Fluid-electrolyte and acid-base disturbances are common in patients with advanced AIDS, secondary to vomiting, diarrhoea, malnutrition or septicaemia. HIV-associated nephropathy occurs in 10-30% of patients, and often leads to renal failure. Testicular atrophy is common, leading to infertility, erectile dysfunction (ED) and decreased libido. Treatment for ED must include counselling about strategies to reduce the transmission of HIV. The risk of HIV transmission after parenteral exposure to blood from an HIV-positive patient is relatively low (0.2-0.4%)
dc.description.abstractthe urologist can reduce the risk of transmission during surgery by adopting certain precautions. After occupational exposure to HIV, chemoprophylaxis with antiretroviral medication can significantly reduce the probability of HIV transmission. © 2005 BJU INTERNATIONAL.
dc.description.versionReview
dc.identifier.citationBJU International, Supplement
dc.identifier.citation95
dc.identifier.citation5
dc.identifier.issn14655101
dc.identifier.other10.1111/j.1464-410X.2005.05435.x
dc.identifier.urihttp://hdl.handle.net/10019.1/13459
dc.subjectabacavir
dc.subjectaciclovir
dc.subjectalpha interferon
dc.subjectaminoglycoside antibiotic agent
dc.subjectamphotericin B
dc.subjectamprenavir
dc.subjectanalgesic agent
dc.subjectantifungal agent
dc.subjectantivirus agent
dc.subjectazithromycin
dc.subjectbleomycin
dc.subjectcefixime
dc.subjectcholinergic receptor blocking agent
dc.subjectcidofovir
dc.subjectciprofloxacin
dc.subjectclotrimazole
dc.subjectcontrast medium
dc.subjectcotrimoxazole
dc.subjectdapsone
dc.subjectdelavirdine
dc.subjectdidanosine
dc.subjectdoxorubicin
dc.subjectdoxycycline
dc.subjectefavirenz
dc.subjectethambutol
dc.subjectfamciclovir
dc.subjectfluconazole
dc.subjectfluorouracil
dc.subjectfoscarnet
dc.subjectganciclovir
dc.subjectimiquimod
dc.subjectindinavir
dc.subjectinterferon
dc.subjectisoniazid
dc.subjectlamivudine
dc.subjectmiconazole
dc.subjectnelfinavir
dc.subjectnevirapine
dc.subjectnorfloxacin
dc.subjectofloxacin
dc.subjectpentamidine
dc.subjectpodophyllotoxin
dc.subjectprostaglandin
dc.subjectproteinase inhibitor
dc.subjectpyrazinamide
dc.subjectquinolone derivative
dc.subjectretinoic acid
dc.subjectretinoid
dc.subjectrifampicin
dc.subjectritonavir
dc.subjectRNA directed DNA polymerase inhibitor
dc.subjectsaquinavir
dc.subjectsildenafil
dc.subjectstavudine
dc.subjectsulfadiazine
dc.subjecttestosterone
dc.subjecttioconazole
dc.subjecttrichloroacetic acid
dc.subjectvincristine
dc.subjectzalcitabine
dc.subjectzidovudine
dc.subjectantibiotic agent
dc.subjectantiretrovirus agent
dc.subjectphenazopyridine
dc.subjectunindexed drug
dc.subjectacquired immune deficiency syndrome
dc.subjectcandidiasis
dc.subjectcondyloma acuminatum
dc.subjectcryotherapy
dc.subjectcystostomy
dc.subjectdisease classification
dc.subjectdisease course
dc.subjectelectrolyte disturbance
dc.subjectepididymitis
dc.subjecterectile dysfunction
dc.subjectgenital ulcer
dc.subjectgerm cell tumor
dc.subjecthematuria
dc.subjecthighly active antiretroviral therapy
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectinfection prevention
dc.subjectKaposi sarcoma
dc.subjectkidney carcinoma
dc.subjectkidney failure
dc.subjectkidney infection
dc.subjectlaser surgery
dc.subjectlibido disorder
dc.subjectlymphocyte count
dc.subjectmale infertility
dc.subjectmicturition disorder
dc.subjectmolluscum contagiosum
dc.subjectnephrolithiasis
dc.subjectnonhodgkin lymphoma
dc.subjectopportunistic infection
dc.subjectpathogenesis
dc.subjectpatient counseling
dc.subjectpenis cancer
dc.subjectpercutaneous nephrostomy
dc.subjectpriority journal
dc.subjectprostate cancer
dc.subjectprostatitis
dc.subjectrectovaginal fistula
dc.subjectreview
dc.subjectsingle drug dose
dc.subjecttestis atrophy
dc.subjectureter obstruction
dc.subjectureter stent
dc.subjecturethritis
dc.subjecturinary tract infection
dc.subjecturolithiasis
dc.subjectvirus load
dc.subjectvirus transmission
dc.subjectabnormally high substrate concentration in blood
dc.subjectabscess
dc.subjectagitation
dc.subjectanemia
dc.subjectaphthous ulcer
dc.subjectbloating
dc.subjectcancer combination chemotherapy
dc.subjectchemoprophylaxis
dc.subjectdiarrhea
dc.subjectdisease predisposition
dc.subjectdizziness
dc.subjectfatigue
dc.subjectfistula
dc.subjectheadache
dc.subjecthyperbilirubinemia
dc.subjectinfertility
dc.subjectkidney disease
dc.subjectlactic acidosis
dc.subjectmyopathy
dc.subjectnausea
dc.subjectneutropenia
dc.subjectpancreatitis
dc.subjectparesthesia
dc.subjectperipheral neuropathy
dc.subjectprognosis
dc.subjectprostate abscess
dc.subjectrash
dc.subjectside effect
dc.subjectAcquired Immunodeficiency Syndrome
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectUrologic Diseases
dc.titleThe urological management of the patient with acquired immunodeficiency syndrome
dc.typeReview
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