Diagnostic and Management Strategies for Altered Sensorium in HIV/AIDS Patients
0Diagnostic and Management Strategies for Altered Sensorium in HIV/AIDS Patients: A Syndromic Approach
Layman Abstract : Managing changes in awareness, thinking, and perception (altered sensorium) in people with HIV and AIDS is crucial because these issues can have multiple causes. These changes may result from infections, cancer, metabolic imbalances, or the direct effect of HIV on the brain.
Early detection is key, and doctors rely on medical history, physical exams, and tests like brain scans, spinal fluid analysis, and blood work to identify the cause. Common infections such as cryptococcal meningitis, toxoplasmosis, and cytomegalovirus encephalitis must be considered, along with non-infectious conditions like HIV-associated neurocognitive disorders (HAND), brain lymphoma, and progressive multifocal leukoencephalopathy (PML).
Treatment depends on the specific cause and may include antiretroviral therapy (ART) to control HIV, medications to fight infections, and supportive care. A team of specialists, including neurologists and infectious disease experts, is often needed to provide well-rounded care. Addressing emotional and social factors, ensuring patients take their HIV medications properly, and regularly monitoring brain function are all essential for long-term management.
As people with HIV live longer due to medical advancements, ongoing research is important to improve treatment strategies and enhance their quality of life while reducing the impact of cognitive problems.
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Original Abstract : Managing altered sensorium in individuals with HIV and AIDS is a vital aspect of clinical practice, given the multifaceted factors contributing to cognitive changes in this group. Altered sensorium, which involves disruptions in consciousness, cognition, and perception, can arise from diverse causes such as opportunistic infections, malignancies, metabolic imbalances, or the direct impact of HIV on the central nervous system. Early detection and a thorough evaluation are critical for effective management. The initial workup should include a detailed medical history, comprehensive physical examination, and focused diagnostic tests such as neuroimaging, lumbar puncture, and pertinent laboratory assessments. Common infectious etiologies like cryptococcal meningitis, toxoplasmosis, and cytomegalovirus encephalitis should be considered, as well as non-infectious conditions such as HIV-associated neurocognitive disorders (HAND), primary CNS lymphoma, and progressive multifocal leukoencephalopathy (PML). Treatment plans must be customized based on the underlying cause, incorporating optimized antiretroviral therapy (ART), targeted antimicrobial regimens, and supportive interventions.
A multidisciplinary approach, involving neurologists, infectious disease specialists, and other healthcare providers, is essential for comprehensive care. Moreover, addressing psychosocial factors, ensuring adherence to ART, and regularly monitoring for neurocognitive changes are integral to long-term management.
With advancements in HIV treatment and the increasing age of individuals living with HIV, continued research into the mechanisms, prevention, and management of altered sensorium is vital. Such efforts aim to improve clinical outcomes, enhance quality of life, and mitigate the neurocognitive burden associated with HIV and AIDS.
View Book: https://doi.org/10.9734/bpi/mono/978-93-49238-92-3/CH7
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