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Typically, stage 4B develops in patients with a CD4 count 1 mo; Cytomegalovirus infection (with damage to organs other than the liver, spleen, lymph nodes) in a patient older than one month; Cytomegalovirus retinitis with loss of vision; HIV-associated encephalopathy (HIV encephalitis); Herpes simplex infection: chronic ulcers that last longer 1 month, or bronchitis, pneumonia, esophagitis in a patient older than one month; Histoplasmosis disseminated or extrapulmonary; Intestinal isosporosis (with diarrhea lasting more than 1 month); Kaposi's sarcoma; Interstitial lymphoid pneumonia in a child under the age of 13; Burkitt's lymphoma (or other B-cell non-Hodgkin's lymphoma); immunoblastic lymphoma; Lymphoma of the brain primary; Mycobacteriosis caused by M. avium-intracellulare , disseminated or extrapulmonary; Pulmonary tuberculosis in an adult or adolescent over 13 years of age, in the presence of severe immunodeficiency: CD4 1% of the total population) HIV prevalence.
unprotected sex, with a partner whose HIV status is unknown (last examination more than 3 months before sexual contact), lack of practice of using a condom for every sexual contact, taking psychoactive substances, non-medical parenteral interventions 1. Complaints and anamnesis In order to assess the risk of HIV infection and choose the tactics of diagnosing the disease, when collecting anamnesis, it is recommended to obtain information on [14-22] (2A): forms of behavior associated with the risk of HIV infection ; time and route of HIV infection (probable or known) ; HIV testing (date of first positive HIV test, reason for testing, last negative HIV test) ; the presence of diseases that have the same mechanism of transmission as HIV infection (viral hepatitis B and C, sexually transmitted diseases) or contribute to HIV infection ; sexual and reproductive health (current methods of contraception, data on pregnancies) ; smoking, drinking alcohol and other psychoactive substances .
When collecting anamnesis of the disease, it is recommended to pay attention to the presence in the anamnesis of diseases that may be the result of HIV infection (viral, fungal, bacterial lesions of the skin and mucous membranes, repeated pneumonia, tuberculosis, swollen lymph nodes, "mononucleosis-like syndrome", changes in body weight, physique) [16,17,23,24] (2A).
When taking anamnesis of the disease in a patient with suspected HIV, it Buy Female Cialis (Tadalafil) 10mg, 20mg online - Women's Health is recommended to pay special attention to possible Buy Cycrin (Medroxyprogesterone ) 5mg, manifestations 10mg online - Women's Health of tuberculosis (fever, cough, weight loss, night sweats) [3,5] [25] (1B). Physical examination As part of the physical examination, it is necessary to pay attention to the clinical manifestations characteristic of HIV infection and signs indicating past or existing secondary diseases. When conducting a physical examination of all patients in order to diagnose HIV infection, determine its stage, the presence of secondary diseases, opportunistic infections, and identify complications [3,5, 25] (1C): assess the general condition, paying attention to changes in body weight, physique (presence of signs of lipodystrophy); a complete examination of the skin and mucous membranes of the whole body, including the perianal and inguinal regions, pay attention to the presence of jaundice of the skin and mucous membranes, elements of a rash of herpes zoster (fresh or traces of previously transferred episodes), seborrheic dermatitis, fungal lesions, elements of Kaposi's sarcoma, chancriform elements, papillomas, warts, traces of injections in injecting drug users.