1. HIV Kittima Rodgerd Rajavithi Hospital

3. HIV cytopathic retrovirus of the lentivirus family

6. Epidemiology HIV decline number in Heterosexual group

7. Age > 13 year ( Definition )

8. Laboratory Diagnosis

10. Case definition of AIDS

13. progressive quantitative and qualitative deficiency of the subset of T lymphocytes referred to as helper T cells (CD4+)

14. Acute HIV syndroms acute HIV syndrome (fever, skin rash, pharyngitis, and myalgia) occur less frequently in those infected by injection drug use versus those infected by sexual contact. The syndrome is typical of an acute viral syndrome and has been likened to acute infectious mononucleosis

15. Acute HIV syndrome ( Sign and Symptom )

18. CD4+ and Oppertunistic infection

19. CD4 decline in CD4+ T cell count of >25% *** change the ARV CD 4 + ( cells /L ) infection management > 500 same as normal host 200 – 500 Bacterial respiratory infection <350/L ***ARV therapy < 200 P.Jirovecii Prophylaxis P. jiroveci Trimethoprim/sulfamethoxazole (TMP/SMZ), 1 DS tablet qd PO C. neoforman Fluconazole 200 mg/d PO < 100 T. gondii TMP/SMZ 1 DS tablet PO qd CMV Ganciclovir, 5–6 mg/kg 5–7 d/wk IV Valganciclovir 900 mg bid PO Foscarnet 90–120 (mg/kg)/d IV < 50 MAC CMV MAC Azithromycin 1200 mg weekly PO or Clarithromycin 500 mg bid PO

22. CXR Pattern and DDx Pattern DDx in HIV patient Diffuse interstitial infiltration , CMV ,TB , Histoplasmosis , Coccidioidomycosis , MAI , Lymphoid interstitial pneumonitis Focal consolidation Bacterial pneumonia , M. mycoplasma , P. jiroveci , MTB , MAI Nodular lesion TB ,Kaposi sarcoma , fungal , Toxoplasmosis , MAI Cavity lesion P . Jiroveci , TB , Bacteria , Fungal Adenopathy Kaposi Sarcoma , TB , Lymphoma , Cryptococcosis

31. DDx

34. CT brain c contrast Toxoplasma gondii Infection showing typical multiple ring-enhancing lesions seen in T.gondii (Courtesy of Edward C. Oldfield III, MD.)

39. AIDS DEMENTIA

41. Skin

45. Seizure in HIV DDx electrolyte imbalance

49. Herpes Zoster Othalmicus