HIV

• Co-morbid factors
  • Advanced AIDS dementia complex
  • Age greater than 50
  • CHF symptomatic at rest
  • Chronic diarrhea for 1 year
  • Concomitant substance abuse
  • Refused antiretroviral therapy
  • Refused chemotherapy
  • Refused prophalactic drug treatment
• Laboratory findings
  • Abnormal immune labs
    •  CD4+ count <25 cells/mcL
      • measured when pt relatively free of acute illness
      • Viral load > 100000 copies/ml
  • Persistent Serum albumin <2.5 gm/dl
• Life-threatening complications
  • CNS Lymphoma
  • Cryptosporidium infection
  • Mycobacterium avium complex
    • untreated
    • unresponsive to treatment
    • refused treatment
  • Progressive multifocal leukoencephalopathy
  • Renal failure without dialysis
  • Systemic lymphoma with advanced HIV disease and partial response to chemotherapy
  • Toxoplasmosis unresponsive to therapy
  • Visceral Kaposi's Sarcoma unresponsive to therapy
  • Wasting (loss of 33% lean body mass)