acquired immunodeficiency syndrome (AIDS), a syndrome involving a defect in cell-mediated immunity, characterized by a susceptibility to infection with opportunistic pathogens. The U.S. Centers for Disease Control and Prevention has defined AIDS as beginning when a person with HIV infection has a CD4 cell count below 200. See also AIDS-dementia complex, AIDS-wasting syndrome. ▪ OBSERVATIONS: A patient may be diagnosed as having AIDS if he or she is infected with HIV, has a CD4+ count below 200, and exhibits one or more illnesses associated with impaired immune function. Symptoms often include extreme fatigue, intermittent fever, night sweats, chills, lymphadenopathy, enlarged spleen, anorexia and consequent weight loss, severe diarrhea, apathy, and depression. As the disease progresses, characteristics are a general failure to thrive, anergy, and any of a variety of recurring infections. ▪ INTERVENTIONS: Treatment consists primarily of chronic symptom management and combined chemotherapy to counteract the opportunistic infections. There is no known cure. Drugs used to treat AIDS include reverse transcriptase inhibitors, which interfere with the virus’s ability to synthesize DNA within host cells, and HIV protease inhibitors, which cause the production of noninfectious HIV particles. These drugs are given in combinations (often called cocktails). ▪ PATIENT CARE CONSIDERATIONS: Care of the patient with AIDS is complex and mandates a coordinated team approach that varies with the patient’s symptoms. Intervention is directed at providing education to prevent the spread of disease and infection, promoting self-care and optimal nutrition, and providing emotional support for patients and their families. Patients with tumors, hematologic abnormalities, and infections require treatment for these disorders, along with care for their HIV-related symptoms.
