AIDS management | |
AIDS. A pocket book of diagnosis and management, 2nd ed. |
Any text dealing with HIV infection is rapidly outdated by the
(seemingly) daily changes in anti-retroviral availability. The
management of the infectious and oncological complications of HIV
infection is less subject to dramatic revision, and it is in this area
that this book is most successful.
A chapter on the international apects of HIV/AIDS is a welcome addition; it deals with common presentations in populations that are, numerically, most affected by HIV but who are the least able to deal with the medical and social consequences of the disease. One sobering recommendation is to consider carefully the treatment with anti-retrovirals of those who may be returning to their home, where the expense of such medication would preclude its use. The text draws on the British experience of HIV treatment, although one of the authors, Professor Mindel, is now Head of the Academic Unit of Sexual Health Medicine, universities of Sydney and New South Wales, based at Sydney Hospital. Indeed, the final section on therapeutics is derived from the guidelines of the Middlesex Hospital in London. There are a few noticeable differences from Australian practice (eg, rifampin is recommended for the treatment of Mycobacterium avium- complex infection -- whereas rifabutin is recommended in Australia) and ethambutol is not routinely used in tuberculosis (TB) therapy (while the TB Working Party of the National Health and Medical Research Council recommends its routine use in Australia), but overall there is a concordance with local recommendations and drug availability. I road-tested the book in our clinic and the staff found it useful immediately. The index is comprehensive, although the ordering of the chapters is a little unusual -- a common problem in HIV medicine -- where the boundaries of organ-specific and disease-specific approaches merge. Several chapters stand out -- the one on oral manifestations is comprehensive and instructive. The chapter on palliative care nicely distils the authors' experience and provides practical, and otherwise hard-to-find, advice on pain and symptom management in patients with advanced disease. The section dealing with the last days of life will be especially useful to anyone dealing with the terminally ill and, by itself, probably justifies the purchase. Who else should buy this book? Local HIV specialists may be interested in reading about the British approach, and medical students would benefit from the breadth of subjects covered -- including virology, epidemiology and social aspects -- but, dare I say, resident medical officers, general practitioners and specialists who only occasionally treat patients with HIV infection would be better served by a number of locally produced publications. F J Bowden
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