At the completion of this chapter, the learner will be able to:

Section 1: Introduction
1.0 Give the incidence of HIV in Canada. Section 2: Basic Principles of HIV Infection
2.0 Describe the etiology of HIV infection.
2.1 Discuss the process to determine if patients are of high risk for
      acquiring HIV infection, including sexual orientation, sexual practices,
      history of other sexually transmitted diseases and intravenous drug use.
2.2 Describe how to diagnose HIV infection.
2.3 List the common antiretroviral drugs used in the treatment of HIV infection.
Section 3: Gastrointestinal Involvement in HIV Infection
3.1 General Considerations
      3.1.0 Discuss the issues that must be considered in the evaluation of
      HIV-positive patients with gastrointestinal symptoms.
3.2 Bacterial Infections
      3.2.0 Describe the principles of treatment for acute bacterial enteritis
      or colitis in HIV-infected patients.
      3.2.1 Explain the treatment regimens for HIV-related gastrointestinal
      infections.
3.3 Mycobacterial Infections
      3.3.1 Describe Mycobacterium avium-intracellulare (MAI) as related to
      immunocompromised HIV-infected patients.
3.4 Fungal Infections
      3.4.1 Explain the clinical presentation, diagnosis, and treatment protocol for
      candidal esophagitis.
      3.4.2 List other fungal infections seen in HIV infection.
3.5 Intestinal Parasitic Infections
      3.5.0 Describe the following intestinal parasitic infections, including
      symptoms, diagnosis, and treatment as related to HIV-infected patients.
      3.5.1 Giardiasis
      3.5.2 Entamoeba histolytica
      3.5.3 Cryptosporidium
      3.5.4 Microsporidium
      3.5.5 Isospora belli
      3.5.6 Strongyloides stercoralis
3.6 Viral Infections
      3.6.0 Describe the following viral infections, including presentation,
      diagnosis, and treatment as related to HIV-infected patients.
      3.6.1 Cytomegalovirus
      3.6.2 Herpes simplex virus
3.7 Neoplasms
      3.7.0 Describe the following neoplasms, including presentation,
      diagnosis, and treatment as related to HIV-infected patients.
      3.7.1 Kaposi's sarcoma
      3.7.2 Lymphoma
      3.7.3 Anal carcinoma
Section 4: Hepatobiliary and Pancreatic Involvement in HIV Infection
4.0 Discuss the involvement of the liver in HIV infection, including
      hepatitis B and C.
4.1 Discuss biliary involvement in HIV infection.
4.2 Discuss symptomatic pancreatic involvement in HIV infection.
Section 5: Nutritional Considerations and the Wasting Syndrome
5.0 Describe the cause of weight loss in HIV-infected patients.
5.1 Discuss treatment protocols for wasting.

LEARNER WORKBOOK

EXERCISE 1
1.1 What is HIV?

      1.1.1 Briefly describe the etiology of HIV infection.

      Answer (section 2, p288-289) 2.1 Explain the process to determine if a patient is at high risk of acquiring HIV
      infection.

      Answer (section 2, p289) 2.2 How is AIDS diagnosed?

      Answer (section 2, p289) 2.3 List five common antiretroviral drugs used in the treatment of HIV infection.

      Answer (section 2, p289)

EXERCISE 2
3.1 Briefly discuss the issues that must be considered in the evaluation of
      HIV-positive patients with gastrointestinal symptoms.

      Answer (section 3.1, p290) 3.2 What is Mycobacterium avium-intracellulare (MAI)?

       3.2.1 What are the presenting symptoms?

      Answer (section 3.3.1, p291)

3.3 Fill in the following chart:

Treatment regimens for HIV-related gastrointestinal infections:

Organism              Drug of First Choice     Alternative Treatments      Salmonella      Shigella      Mycobacterium         tuberculosis      Candida albicans         (esophageal)      Histoplasmosis      Cryptosporidium      Herpes simplex virus      Cytomegalovirus

      Answer ( table 1, p292-293) 3.4 How is candidal esophagitis diagnosed?

      Answer (section 3.4.1, p294) 3.5 Briefly describe Giardia lamblia and Entamoeba histolytica infection in
      HIV-infected patients.

      Answer (section 3.5, p296) 3.6 How does cytomegalovirus infection present in patients with HIV infection?
      3.6.1 How is CMV treated?

      Answer (section 3.6.1, p299) 3.7 What is the most common neoplasm seen in HIV-infected patients?

      Answer (section 3.7.1, p301) 4.1 How is the liver affected in HIV-infected patients?

      Answer (section 4, p302-303) 5.1 What are the causes of weight loss in HIV-infected patients?

      Answer (section 5, p304, paragraph 1) 5.2 What are the treatments for HIV-associated wasting?

      Answer (section 5, p304, paragraph 2)