Malignancies have been detected in approximately 40% of all patients with acquired immunodeficiency syndrome (AIDS) sometime during the course of their illness. These cancers have been both a primary cause of death in some patients and also a source of considerable morbidity. In the current era of highly active antiretroviral therapy (HAART), patients infected with the human immunodeficiency virus (HIV) are surviving longer than ever. HAART appears to have substantially reduced the incidence of... More »

A 50-year-old African American man with HIV infection had a CD4+ T-cell count of 18/μL (1%), CD8+ cell count of 1035/μL (69%), and CD4:CD8 ratio of 0.01 at the time of diagnosis. He had multiple erythematosquamous skin lesions over his forehead, face, chest, back, and extremities More »

In 2006, the CDC recommended “opt-out” routine HIV testing in all health care encounters for persons 13 to 64 years of age. While this recommendation has garnered some support, concerns about the feasibility of such routine testing in a busy office without disrupting patient care has persisted. We report the results of a pilot study to determine the feasibility of routine testing in a busy urban clinic. More »

A 33-year-old man from the Ivory Coast (who had been living in the United States for the past 8 years) received a diagnosis of AIDS when he presented with Pneumocystis jiroveci pneumonia. His CD4+ cell count was 6/µL, and his HIV RNA level was 575,000 copies/mL. He also presented with altered sensorium and seizure activity and was found to have obstructive hydrocephalus and... More »

Bilateral retrobulbar optic neuritis developed in a 38-year-old woman with advanced HIV infection. This was secondary to varicella-zoster virus (VZV) infection, confirmed by polymerase chain reaction detection of VZV in the patient's cerebrospinal fluid. There was no evidence of retinitis, and the ocular symptoms preceded the rash. This case illustrates that a new onset of unexplained visual loss resulting from optic neuritis in an HIV-positive patient may be caused by VZV infection. Clinicians... More »

Neurosarcoidosis has not been reported in patients with HIV infection. We present the case of a patient with AIDS in whom spinal cord sarcoidosis developed years after highly active antiretroviral therapy was initiated and her immune system was reconstituted. Treatment with prednisone resulted in resolution of MRI lesions and symptoms. Since patients with HIV-1 infection who are receiving antiretroviral therapy can survive for many years, physicians should be aware of chronic immune restoration... More »

We report 4 cases of bladder cancer in an ethnically diverse population of about 2500 HIV-infected patients. These patients were younger than the median age at diagnosis of bladder cancer in the United States. More »

In a recent editorial in The AIDS Reader, the “burden of responsibility for routine HIV testing” was accurately described as now falling on all clinicians, including those in emergency departments (EDs). Routine HIV testing in the ED seems logical because patients who seek health care in the ED are often underinsured and have low incomes, the very populations with a higher prevalence of undiagnosed HIV. More »

Routine surgery to remove the primary tumor in patients with unresectable colon metastases is no longer necessary, according to a group at New York’s Memorial Sloan-Kettering Cancer Center. They based their decision on six years of clinical experience at their institution and reported on them at ASCO 2009. More »

ORLANDO—Ginger has been used for years to treat gastrointestinal upset, but for the first time, a large double-blind multicenter randomized study has shown ginger supplements can successfully stem chemotherapy-related nausea, University of Rochester in New York investigators reported at ASCO 2009 (abstract 9511). Some 70% of patients experience nausea and vomiting related to chemotherapy. While vomiting can largely be prevented with anti-emetics, nausea is typically more difficult to prevent and... More »