ABSTRACT
A variety of medical complaints are commonly voiced by HIV-infected individuals, especially those at advanced stages of immune deficiency. A challenge for the clinician is to recognize how the presence of HIV infection may change the significance and implications of a specific complaint or physical finding. Among patients with advanced HIV infection, relatively minor complaints such as a headache, fever, or cough may signify life-threatening opportunistic infections or malignancies, which would not be considerations in the normal host. Even at earlier stages in the natural history of HIV infection, such common problems as diarrhea, chest pain, and fatigue must be viewed from the unique perspective of the complex, multisystem disorder that the virus causes. Furthermore, antiretroviral therapy (ART) has brought with it new disorders, such as the lipodystrophy syndrome, lactic acidosis/hepatic steatosis associated with several of the nucleoside reverse transcriptase inhibitors, severe hypersensitivity reactions to abacavir, acute hepatitis associated with nevirapine, and renal disorders associated with tenofovir among others. Finally, of course, the presence of HIV infection does not preclude other unrelated disorders.
