AIDS2009.pdf - PATHOLOGY OF AIDS Version 20 by Edward C....

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PATHOLOGYOFAIDSVersion 20byEdward C. Klatt, MDMercer UniversitySchool of MedicineSavannahMay 28, 2009Copyrightby Edward C. Klatt, MDAll rights reserved worldwide
Page 2TABLE OF CONTENTSCHAPTER 1 - HUMAN IMMUNODEFICIENCY VIRUS5INTRODUCTION5BIOLOGY OF HUMAN IMMUNODEFICIENCY VIRUS7OTHER HUMAN RETROVIRUSES18EPIDEMIOLOGY OF AIDS20RISK GROUPS FOR HUMAN IMMUNODEFICIENCY VIRUS INFECTION27NATURAL HISTORY OF HIV INFECTION28PROGRESSION OF HIV INFECTION32IDIOPATHIC CD4+ T-LYMPHOCYTOPENIA36PREVENTION OF HIV TRANSMISSION37TREATMENT FOR AIDS39CHAPTER 2 - DIAGNOSIS OF AIDS50DIAGNOSTIC TESTS FOR HUMAN IMMUNODEFICIENCY VIRUS50PEDIATRIC HIV INFECTION AND AIDS69CRITERIA FOR AIDS-RELATED COMPLEX73OTHER CAUSES OF IMMUNOSUPPRESSION74CHAPTER 3 - OPPORTUNISTIC INFECTIONS IN AIDS75PNEUMOCYSTIS JIROVECI (CARINII) INFECTIONS75CYTOMEGALOVIRUS INFECTIONS79MYCOBACTERIAL INFECTIONS81CRYPTOCOCCUS NEOFORMANS INFECTIONS87HERPESVIRUS INFECTIONS89CANDIDA INFECTIONS92
Page 3TOXOPLASMA GONDII INFECTIONS94HISTOPLASMA CAPSULATUM INFECTIONS96COCCIDIOIDES IMMITIS INFECTIONS98GASTROINTESTINAL PROTOZOAL INFECTIONS99BACTERIAL INFECTIONS SEEN WITH AIDS102CHAPTER 4 - NEOPLASMS ASSOCIATED WITH AIDS109KAPOSI’S SARCOMA109MALIGNANT LYMPHOMAS112OTHER NEOPLASMS117CHAPTER 5 - ORGAN SYSTEM PATHOLOGY IN AIDS119RESPIRATORY TRACT PATHOLOGY IN AIDS119GASTROINTESTINAL TRACT PATHOLOGY IN AIDS137CENTRAL NERVOUS SYSTEM PATHOLOGY IN AIDS151PERIPHERAL NERVE AND MUSCLE PATHOLOGY IN AIDS166OPHTHALMIC PATHOLOGY IN AIDS173LYMPH NODE PATHOLOGY IN AIDS176BONE MARROW AND PERIPHERAL BLOOD IN AIDS183THYMUS IN AIDS187ENDOCRINE ORGAN PATHOLOGY IN AIDS188HEPATOBILIARY SYSTEM PATHOLOGY IN AIDS191CARDIOVASCULAR PATHOLOGY IN AIDS196GENITOURINARY PATHOLOGY IN AIDS201DERMATOPATHOLOGY IN AIDS206PANCREAS IN AIDS217PREGNANCY AND THE PLACENTA IN AIDS219
Page 4HEAD AND NECK PATHOLOGY IN AIDS220BONE, JOINT, AND SOFT TISSUE PATHOLOGY IN AIDS222CYTOPATHOLOGY IN AIDS225PEDIATRIC AIDS226CHAPTER 6 - SAFETY PROCEDURES WITH AIDS232EDUCATIONAL GOALS232UNIVERSAL PRECAUTIONS233OSHA REGULATIONS234DISINFECTION PROCEDURES238ACCIDENTAL EXPOSURES239INVASIVE AND SURGICAL PROCEDURES242THE SURGICAL PATHOLOGY LABORATORY244THE AIDS AUTOPSY245MORTUARY AND FORENSIC LABORATORY PROCEDURES246ATHLETICS AND HIV INFECTION248CHAPTER 7 - MEDICOLEGAL ISSUES AND AIDS251DEATH INVESTIGATION AND CERTIFICATION IN AIDS251DETERMINATION OF CAUSE AND MODE OF DEATH WITH HIV INFECTION 251ETHICAL ISSUES ARISING FROM THE AIDS EPIDEMIC253HIV TESTING AND COUNSELING255BLOOD AND TISSUE BANKING AND AIDS257TABLES 1 - 10259
Page 5CHAPTER 1 - HUMAN IMMUNODEFICIENCY VIRUSINTRODUCTIONThe human immunodeficiency virus (HIV) was unknown until the early 1980's but sincethat time has infected millions of persons in a worldwide pandemic.The result of HIV infectionis relentless destruction of the immune system leading to onset of the acquiredimmunodeficiency syndrome (AIDS).The AIDS epidemic has already resulted in the deaths ofover half its victims.All HIV-infected persons are at risk for illness and death from

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