0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:13
Human Herpes 6 Human Immunodeficiency Virus Type 1 (HIV-1) 729■respiratory symptoms
■inflamed tympanic membranes
Immunocompromised pt – can be associated with encephalitis, pneu-
monitis, graft rejection
tests
■PCR HHV6 available research settings
■Viral antigen isolation from blood and tissue
Paired serology can be helpful.
differential diagnosis
n/a
management
■Supportive
specific therapy
■For immunocompromised pt (limited data); ganciclovir or foscarnet
follow-up
n/a
complications and prognosis
■HHV6 can reactivate and cause fever, hepatitis, bone marrow sup-
pression, pneumonia and encephalitis.Human Immunodeficiency Virus Type 1 (HIV-1).............
MALCOLM D.V. JOHN, MD, MPH
history & physical
History
■High-risk sexual practices, esp. unprotected receptive anal/vaginal
sex (average risk 0.1–0.3%, as high as 3% in highest-risk situations);
cofactors for sexual transmission include STDs, esp. ulcerative gen-
ital diseases, traumatic intercourse, and uncircumcised males
■IV drug use esp. sharing uncleaned needles
■Blood transfusion between 1978–1985; current risk from blood trans-
fusion 1:450,000–1:660,000 units of blood
■Perinatal from HIV+mother to infant; risk varies from 15% to 60%
(about 25% in the U.S.)
■Occupational exposure esp. deep parenteral injection with a hollow-
bore needle with blood from HIV+patient with high viremia; average