<h1>HIV</h1>

The initial asymptomatic period is called as "window period" .This is important as all tests will be -ve but patient can transmit disease to others

Opportunistic infections

are really a cause of concern & multidrug resistant tuberculosis(MDR TB) is creating a lot of problems

Various Opportunistic infections are

1. TB- Pulmonary & extrapulmonary

2. Fungal infections of skin

3. Skin infections

Main objectives of Rx at present are- to keep patient alive & free of opportunistic infections as far as possible.The patient should have very good nutrition.

Cost of Rx is very high.Many drugs are to be taken in combination.This is called as "HAART-Highly Active Anti-Retroviral Therapy" .With this therapy, it is now possible to have a longer life

There is still no effective vaccine to prevent HIV.Scientists are doing research for developing antiHIV- vaccine

HIV is rapidly spreading & is very common in
1 Africa
2 developing countries like- India
3 In India- It is seen commonly in Maharashtra,Manipur,Mizoram,etc
Its common in cities like Mumbai

Diagnosis Of CMV Retinitis

Its based on clinical findings & high degree of suspicion. Supportive measures are FFA ( Fundus fluorescein angiography).

Fundus fluorescein angiography

- This is is a simple test in which a dye is injected in vein which passes through eye circulation & serial retinal photographs are taken.

Treatment For CMV Retinitis

1. Local Treatment

1. Intravitreal Ganciclovir -

This is an antiviral drug which prevents progression of disease. The drug has to be injected inside the eye- in the vitreous cavity in operation theatre.

Advantages of Local Rx

1. It avoids side effects of oral or intravenous drugs

Disadvantages of Local Rx

1. Risk of endophthalmitis.

Endophthalmitis is a very serious eye infection which can lead to vision loss.

How much is the risk ?

Endophthalmitis can occur in 1 out of 1000- 5000 injection cases ( This is according to recent research reports). So one need not worry much.

2. Short Term Effects of Intravitreal Ganciclovir.

This is one more problem & the drug injection has to be repeated after 2-3 months or in some cases later. This depends on following factors

a. Eye's response to the 1st injection
b. General improvement in patient's immunity which is judged by CD4/CD8 counts. Immunity means body's ability to fight against diseases. It depends upon various factors like -
Nutrition
Vaccination, etc.