Academy of HIV Medicine has issued recommendations for the
treatment and care of HIV-positive people forced to relocate
due to Hurricane Katrina. The guidelines, released in
a document titled "Recommendations for the
Triage of HIV+ Patients," are intended for
physicians who may not have extensive experience in treating
HIV patients and who practice in areas with large
numbers of evacuees.
According to the
document, the following steps are recommended:
first priority is to treat active opportunistic infections
or any other infection with antibiotics or other
* Physicians should try to determine each
patient's CD4-cell count, as varying counts put
them at risk for different opportunistic infections
the patient should be screened for, like HIV-related
pneumonia for those with counts under 200;
histoplasmosis, toxoplasmosis, and cryptococcal
meningitis for those with counts under 100; and
mycobacterium avium complex and systemic fungal disease for
those with counts under 50.
there's a choice between getting antiretroviral
medications or prophylactic drugs to prevent
opportunistic infections, doctors should get the
anti-HIV drugs first to avoid treatment interruptions. But
both courses of medication should be continued if
patients cannot obtain all their antiretroviral drugs, every
drug should be stopped, rather than continuing just one or
* HIV-positive people should receive tetanus
* Live-virus vaccines should be used with
caution in HIV patients, but those with CD4-cell
counts above 350 should experience no problems.
also include sections on which anti-HIV drugs to consider
and which combinations to avoid; treating pregnant women;
using anti-HIV drugs to prevent HIV disease after
possible exposure to the virus; and rapid HIV antibody
people displaced by Hurricane Katrina, AAHIVM recommends
locating a local HIV specialist or treatment clinic by going
online to www.aahivma.org.
information on treating HIV patients, go online to www.aahivma.org or to
the National Institutes of Health's Web site at www.aidsinfo.nih.gov/guidelines.