Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Human Immunodeficiency Virus Infection


Related Terms

  • HIV

Differential Diagnosis

Specialists

  • Cardiologist, Cardiovascular Physician
  • Clinical Psychologist
  • Dentist
  • Dermatologist
  • Gastroenterologist
  • Hematologist
  • Infectious Disease Internist
  • Internal Medicine Physician
  • Neurologist
  • Oncologist
  • Pathologist
  • Pulmonologist

Factors Influencing Duration

Factors that may influence the length of disability from HIV infection include the stage of the disease, the viral load, the number of CD4+ T lymphocytes present in the bloodstream, the presence of opportunistic infections during the course of the disease, and the response to drug treatment.

In addition, other diseases may increase the severity of symptoms associated with various opportunistic infections. These other diseases include infectious diseases such as hepatitis B and tuberculosis, as well as chronic infections or parasitic diseases such as malaria. Immunosuppressant drugs, pregnancy, malnutrition, genetic susceptibility, infection with other sexually transmitted diseases, and stress may also have effects. Advancing age appears to be a major determinant in how rapidly the disease progresses.

Medical Codes

ICD-9-CM:
042 - Human Immunodeficiency Virus [HIV] Disease
V08 - Asymptomatic Human Immunodeficiency Virus [HIV] Infection Status; HIV Positive NOS

Overview

Human immunodeficiency virus (HIV) is a virus of the family of human retroviruses and the subfamily of lentiviruses, known for a period of seeming inactivity (latency), persistent presence of viruses (viremia), weak host immune responses, and infection of the nervous system. Ironically, it infects certain white blood cells (WBCs) called T lymphocytes that help the body fight infections and other diseases. In particular, it is those T lymphocytes that carry a marker on its surface named the CD4+ molecule. HIV-infected CD4+ T lymphocytes are eventually destroyed because the virus binds to them and then enters the interior of the cell, where it hijacks the cell's genetic machinery. This process allows the virus to replicate, hidden from surveillance, in one of the very cell types that normally coordinate the immune response. In this way, the virus increases its number by up to 1,000 in each cell it infects before bursting out and moving into new cells to repeat the process. Consequently, after a period of time (latency period) in which HIV continues to replicate, the number of CD4+ T lymphocyte cells decreases steadily, the immune system weakens, and the individual eventually becomes highly susceptible to parasitic, fungal, bacterial, or other viral infections. About 2 months after infection, the immune system does rebound to a degree and mounts a counterattack on the virus, but eventually, the HIV-infected individual will develop acquired immune deficiency syndrome (AIDS). AIDS is characterized by normally harmless or previously uncommon infections turning deadly as a result of the individual's compromised immune system (opportunistic infections); AIDS is also characterized by previously uncommon malignant diseases. The time between initial HIV infection and the onset of AIDS is quite variable and may last from a few months to 10 years or more.

The primary way HIV is transmitted is by intimate sexual contact (either homo- or heterosexual) with an HIV-infected person. Fluids containing the virus must enter the bloodstream in order for infection to occur. HIV may enter the body through cuts or breaks in the skin, mouth, vagina, anal canal, or rectum. HIV has been found in a variety of body fluids, and the importance of these in HIV transmission varies depending upon the concentration of virus (viral load) they contain. Other methods of transmission include exposure to HIV-contaminated blood or blood products by sharing of syringes or needles, blood transfusion, or any other method of cross-contamination.

The virus may also pass from an HIV-infected mother to her fetus during development in utero or to her newborn baby during labor and delivery or when breastfeeding. Transmission rates from mother to child can be reduced by giving anti-retroviral medication to HIV-infected women during pregnancy and to their infants after birth.

Recommendations to prevent infection include the avoidance of contact with potentially contaminated body fluids. These include blood, semen, vaginal secretions, fluid from the brain or spinal cord (cerebrospinal fluid), joint fluids, chest (pleural) or heart (pericardial) fluid, and uterine (amniotic) fluid from a pregnant female. Precautions should also be employed for exposure to feces, nasal secretions, sputum, sweat, tears, urine, vomit, and breast milk that contain visible blood. There is no evidence that HIV can be transmitted through casual contact or even close nonsexual contact (such as that which occurs in families, at school, or in the workplace), or from insects or respiratory droplets.

High-risk behaviors for transmission of HIV include homo- or heterosexual practices in which condoms are not worn (unprotected sex), using condoms made of natural or non-latex membranes, sharing needles or syringes for drug self-injection, and tattooing or body piercing. Safe sex requires men to consistently and correctly use latex condoms and women to use lubricated polyurethane condoms. It is not recommended that a male and female wear condoms at the same time because friction between the two materials may cause tears or slippage of either condom. The safest form of sex is abstaining from risky behaviors for 6 months, followed by testing for HIV; a negative result would indicate safety in engaging in sexual acts with only one HIV-free partner who has undergone the same testing measures. HIV transmission through infected blood components, such as clotting factor concentrates and blood transfusions, has been reduced markedly in the US and other countries but not completely eliminated.

The Centers for Disease Control and Prevention (CDC) classify adults and adolescents infected with HIV into three clinical categories (A: asymptomatic; B: symptomatic conditions, not A or C; and C: AIDS indicator diseases); each one of these categories are subdivided into 1, 2 and 3 based on the count of CD4+ T lymphocytes (1: <= 500 cells/microlitre, 2: 200-499 cells/microlitre, and 3 < 200 cells/microlitre); the normal count is about 800 cells/microlitre.

Clinical staging of HIV/AIDS for adults and adolescents issued by WHO includes four clinical stages progressing from primary HIV infection to advanced HIV infection/AIDS (primary HIV infection, and clinical stages 1, 2 and 3). WHO clinical staging does not require a CD4+ T lymphocytes count.

Incidence and Prevalence: Since the beginning of the epidemic in the early 1980s, almost 70 million people in the world have been infected with the HIV virus. About 35 million people have died of AIDS. Worldwide, 35.3 million people were living with HIV at the end of 2012 (WHO). The Centers for Disease Control and Prevention estimates that 1,148,200 persons aged 13 years and older are living with HIV infection in the U.S, including 207,600 (18.1%) who are unaware of their infection (HIV Surveillance report).

The estimated incidence of HIV infection in the US has remained stable overall in recent years, at about 50,000 new HIV infections per year. However, some groups are affected more than others. Men who have sex with men (MSM) continue to bear the greatest burden of HIV infection, and among races/ethnicities, blacks continue to be disproportionately affected (HIV Surveillance Reports).

Source: Medical Disability Advisor



Causation and Known Risk Factors

In general, risk factors for HIV/AIDS include unprotected homosexual or heterosexual sex, intravenous drug abuse with contaminated needles, exposure to infected body fluids (e.g., needlestick), and maternal-fetal transmission during pregnancy and childbirth.

From 2008 through 2011, the rates for persons aged 20 to24 and 25 to29 increased. The rates for all other age groups either decreased or remained stable. During this same period, the rates for Asian increased. The rates for blacks/African Americans, Hispanics/Latinos, Native Hawaiians/other Pacific Islanders, and persons of multiple races decreased. The rates for American Indians/Alaska Natives and whites remained stable ("HIV Surveillance Report").

Source: Medical Disability Advisor



Diagnosis

History: An HIV-infected individual may report high-risk sexual behavior, intravenous drug use, or rarely, multiple transfusions of blood or blood products. Two to four weeks after the initial infection, individuals will experience a brief flu-like illness with a sore throat, weakness, fever, or rash. These symptoms will disappear within a few days or weeks and are followed by a long incubation (latency) period, during which there are no overt signs of infection. After this latency period, HIV-infected individuals most often progress to AIDS, reporting altered mental status that includes short-term memory loss, concentration difficulties, mood changes (usually toward depression, apathy, or suicidal ideation) or dementia; symptoms may also include cough, shortness of breath, night sweats, skin growths, easy bruising, unexpected nosebleeds, difficulty swallowing (dysphagia), chest pain, persistent fever, diarrhea, abdominal pain, vomiting, headaches, and/or weight loss.

Physical exam: The HIV-infected individual may have a fever, skin rash, and/or enlarged lymph nodes that show up 2 to 4 weeks after initial infection. This is followed by a latent phase that can last up to 10 years or more. During this phase, there are no clear physical signs, except for occasional nonthreatening infections such as chronic herpes (shingles) or oral fungal infection with Candida (thrush). HIV-infected individuals who have developed AIDS may have one or several AIDS-defining illnesses such as lesions in the digestive or respiratory tract that are characteristic of yeast infections (candidiasis), plaque-like lesions in the mouth (oral hairy leukoplakia), or raised blue or purple spots anywhere on the body (Kaposi's sarcoma). An eye examination may reveal blurry vision, spots before the eyes (floaters), or loss of vision. It may be difficult to visualize the retina during an eye examination, and the retina may have a "cottage cheese and ketchup" appearance. Wheezes or crackling (dry rales) sounds in the lungs, enlarged nodes, abdominal masses, fluid in the abdominal cavity (ascites), enlarged liver (hepatomegaly), enlarged spleen (splenomegaly), reflex abnormalities, gait problems, and cranial nerve impairment may also be noted during physical examination.

Tests: HIV infection can be determined by blood or urine tests or by home testing.

Blood tests: HIV infection can be determined by either direct detection of the virus or detection of the antibodies that the individual produces in response to HIV. Direct detection of the virus may be done at any time following infection, and the HIV polymerase chain reaction (PCR) or HIV culture tests are commonly used. However, with antibody detection tests, there is a time delay before the immune system will mount a response against HIV, and a waiting period of 6 months following infection is usually recommended to increase reliability. The most common types of antibody tests for HIV diagnosis include the enzyme-linked immunoabsorbent assay (ELISA), Western blot, immunofluorescence, radioimmune-precipitation, and hemagglutination.

Oral/Urine tests: Oral tests use oral fluid (not saliva) that is collected from the mouth using a special collection device. This is an enzyme immunoassay (EIA) antibody test similar to the standard blood EIA test. These tests require a follow-up confirmatory Western Blot using the same oral fluid sample.

The accuracy of urine tests is less than the accuracy of blood and oral fluid tests. These tests require a follow-up confirmatory Western Blot using the same urine sample.

Home tests: Home HIV tests are available over-the-counter at local drug stores. The individual collects a sample, run the test, and obtain their test results at home.

The rate of HIV disease progression is measured by the rate of increase in viral load in the bloodstream or tissue of an infected individual. Thus, repeated viral load measurement can serve as both an accurate indicator of disease progression and an indicator of the effectiveness of anti-viral drug treatment. Viral load can be determined by measuring HIV ribonucleic acid (RNA) in plasma. Commonly, three types of assays are used to measure HIV RNA: reverse transcriptase polymerase chain reaction (RT-PCR), the branched deoxyribonucleic acid (bDNA) test, or the nucleic acid sequence-based amplification (NASBA).

Other tests may be performed to monitor the extent of damage the virus has done to the immune system. The most important of these counts the number of CD4+ T lymphocytes in the bloodstream using flow cytometry. This test is also used to monitor the effectiveness of antiretroviral drug therapy, to determine the risk for opportunistic diseases and the need for preventative (prophylactic) drug administration, and to assess the prognosis for the HIV-infected individual.

Other tests may include a complete blood count (CBC) with a white blood cell differential count, blood urea nitrogen (BUN) and creatinine, liver function tests, glucose and lipid profiles, arterial blood gases (ABGs), blood chemistries, electrolytes, blood culture, stool culture, a rapid plasma reagin (RPR) test or a Venereal Disease Research Laboratory (VDRL) test for syphilis, a hepatitis B core antibody test, hepatitis C and toxoplasmosis serology, a purified protein derivative (PPD) test for tuberculosis, and a Pap smear in women. In some clinical settings, urinalysis, cytomegalovirus (CMV) serology, and a qualitative test for glucose-6-phosphate dehydrogenase (G6PD) may be advisable. Additional diagnostic tests include chest x-ray, head computed tomography (CT) scan, cerebrospinal fluid analysis, and lumbar puncture.

Source: Medical Disability Advisor



Treatment

Important advances have been made in drug treatments that can slow the progression of disease following HIV infection. Drug treatment must be individualized and take into account the disease progression and the degree of immunodeficiency as determined by the CD4+ T lymphocyte cell (T cell) count. No study has determined specifically the best time to start drug treatment, but it is believed that initiating highly active antiretroviral therapy (HAART) as early as possible offers the best chance for minimizing both viral load and disease progression. Combination therapy using two nucleoside reverse transcriptase inhibitors (NRTIs) in conjunction with a protease inhibitor (PI) or a nonnucleoside reverse-transcriptase inhibitor (NNRTI) is recommended as initial therapy for most individuals. The drug regimen may be modified if the individual cannot tolerate one or more of the drugs or if there is a rising viral load, a declining CD4+ T lymphocyte count, or progression of clinical diseases characteristic of AIDS. The drugs currently in use do not kill the virus but rather interfere with its replication.

Resistance to drug therapy is also a consideration because the high rate of HIV turnover in the body often produces drug-resistant forms of the virus. Additionally, preventative (prophylactic) drug treatment for a common opportunistic disease, Pneumocystis jirovecii (formerly carinii) pneumonia (PCP), is usually prescribed. The current drug of choice for PCP prophylaxis is trimethoprim-sulfamethoxazole (TMP-SMX). Oxygen is administered for those with difficulty breathing (dyspnea), and intravenous (IV) fluids are given for dehydration or low blood pressure (hypotension). Finally, psychosocial issues are important at all stages following viral infection because adjustment or anxiety disorders, depression, and substance abuse are common among HIV-infected individuals. Psychological testing, antidepressant therapy, and/or community support groups are important adjunctive treatment for HIV.

Tremendous effort has been put forth to develop a vaccine that will either prevent infection by HIV or boost the immune systems of infected individuals. Several vaccines have been partially successful in preventing HIV infection in nonhuman primates, but these results have not been replicated in humans. Vaccine development has proven extraordinarily difficult due to the great diversity of HIV and because HIV mutates frequently, among many other reasons. Consequently, scientists have had a difficult time producing one or a combination of vaccines that will overcome the mutated viruses that escape immune recognition.

Source: Medical Disability Advisor



Prognosis

It is not inevitable that exposure to HIV means infection. Some people seem highly resistant, even though they have been exposed repeatedly. However, once infected, there is no evidence that any HIV-infected individual has ever been cured or become noninfectious. At this time, there is no recovery, and the disease is inevitably fatal. However, individuals with recent HIV infection can remain symptom-free for 15 years or more, even without drug therapy. The time from HIV infection to the development of AIDS varies considerably for different people. Over time everyone who is infected and not taking antiretroviral medicines will eventually (some sooner than others) develop AIDS and die.

Source: Medical Disability Advisor



Rehabilitation

Individuals who test positive for the HIV virus require no specific physical rehabilitation. Individuals may wish to consult with a physical therapist to develop an exercise program and should be encouraged to begin one as early as possible following HIV infection. Aerobic exercise has been found to increase cardiopulmonary fitness, improve muscle function, enhance weight gain, and improve mood state and coping behavior. Most importantly, recent studies indicate that exercise may increase CD4+ T lymphocyte cell counts in HIV-infected individuals. Individuals should exercise with a goal of attaining 75% to 85% maximum intensity while walking, jogging, biking, swimming, performing calisthenics, and/or weight training. Exercise sessions should occur 3 to 5 times per week for 30 to 60 minutes per session.

Also important in the rehabilitation of individuals infected with the HIV virus are the disciplines of psychology and social work. Individuals infected with HIV eventually develop AIDS, a disease with no known cure. Psychological counseling may help individuals deal with fears of dying and depression that accompany the diagnosis of HIV infection. Because distress and depression have been shown to lower the immune system, counseling has a beneficial effect on an individual's physical health. Individuals who have become infected through intravenous drug use can participate in behavior modification programs at drug treatment centers. These programs may be successful in helping individuals recover from drug addiction.

Social workers can also assist individuals diagnosed with HIV. The newer treatments for HIV infection are expensive and often not covered by health insurance. Social workers can direct individuals to programs that subsidize treatment. For those individuals who have become infected through intravenous drug use, social workers can aid in placement at drug rehabilitation centers.

Source: Medical Disability Advisor



Complications

Individuals with HIV may experience a number of complications during the course of their illness, as it progresses into AIDS. Actually, AIDS can be regarded the main complication of HIV infection. Drug therapy may cause adverse side effects, including nausea, severe headache, insomnia, or anemia.

The type, number, and severity of complications as a result of the disease varies with the status of immune system functioning and progression of the disease. Typical complications include fatigue, dizziness, anorexia and weight loss, nausea and vomiting, diarrhea, cough, dysphagia, dyspnea, pain, fever, itching (pruritus), sleep disturbances, night sweats, and psychological distress. Other complications may include skin diseases (dermatophytosis, psoriasis), inflammation of hair follicles (folliculitis), arthritis (reactive arthritis), decreased hemoglobin in the blood (anemia), bleeding into the skin or other organs (idiopathic thrombocytopenic purpura [ITP]), decreased white blood cell count (leukopenia), kidney disorders (nephropathy), chronic herpes (shingles), mental disorders (dementia), a variety of cancerous tumors (Kaposi's sarcoma, Hodgkin's lymphoma, non-Hodgkin's lymphoma, and squamous cell carcinoma), mouth sores and lesions (oral hairy leukoplakia), an oral fungal infection (thrush), and a variety of tooth and gum (periodontal) diseases (linear gingival erythema, necrotizing ulcerative gingivitis).

Most complications arise as a product of opportunistic infections when the immune system is in a weakened (compromised) state. Many of the diseases associated with opportunistic infections in HIV-infected individuals arise from fungal infections (e.g., PCP, aspergillosis, candidiasis, cryptococcosis, histoplasmosis, coccidioidomycosis, penicilliosis), parasitic infections (e.g., cryptosporidiosis, isosporiasis, toxoplasmosis, microsporidiosis, strongyloidosis, cyclosporiasis), viral diseases (e.g., cytomegalovirus [CMV], herpes simplex virus types 1and II [HSV-I and HSV-II], varicella-zoster virus or VZV, Epstein-Barr virus [EBV], polyomavirus, poxvirus, parvovirus, human papillomavirus [HPV], hepatitis virus), and bacterial infections (e.g., Mycobacterium, Nocardia, Bartonella, Rhodococcus, Haemophilus influenzae, Pseudomonas aeruginosa, Staphylococcus aureus, Salmonella).

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

HIV-infected individuals may need to be transferred to a job requiring less physical activity or take a leave of absence. In the workplace, HIV is an important component of a comprehensive infectious disease policy, and universal precautions should be incorporated into all procedures, regardless of the HIV status of employees. Risk of exposure to blood-borne HIV can be modified by ongoing education, engineering controls, and the use of safety devices. Universal precautions include hand washing, protecting intact skin, caring for and appropriately covering damaged skin, properly handling and disposing of sharp objects, and carefully handling all blood and body fluids. Disposable latex gloves should be worn during all medical procedures and emergencies and when coping with industrial accidents. A plan for rapid evaluation and management should be in place in case HIV exposure occurs. Neurocognitive impairment may adversely affect work in which essential job functions require complex cognitive function.

Some individuals with this condition may lead essentially normal lives in the workplace for an extended time without restriction or accommodation. However, the nature of the disease may result in illness and disability ranging from minor to extraordinarily severe. An established policy regarding illness and disability is critical to the management of individuals with this condition.

Risk: In an immune compromised individual, working with heavy public contact, indigent or incarcerated populations, or in health care settings may place the individual at increased risk of further or recurrent infection. Some risk can be mitigated by frequent hand washing, gloves, or masks. Universal blood and body fluid precautions must be exercised in both directions to protect the individual and those he or she comes into contact with. Occupations with high risk of cuts in close proximity to other workers should be examined for safety precautions.

Capacity: In the short term, once stabilized and treated, there would not be expected to be any change in an individual’s capacity limits. However, HIV stage 3 is a progressive disease and long term fatigue, anemia, recurrent infections and pulmonary limits may reduce capacity. Testing with stress ECHO and Pulmonary Function would be useful.

Tolerance: Fatigue is a prominent symptom of untreated HIV infection as well as the accompanying opportunistic infections. Once infection is stabilized, and CD4+ T lymphocytes counts are restored to normal, most patients can return to work and will function well. Limits may be due to perceived worksite acceptance. Counseling may be of great use in newly diagnosed individuals to assist in return to work transition.

Source: Medical Disability Advisor



Maximum Medical Improvement

180 days.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Has diagnosis of HIV infection been confirmed?
  • Have conditions with similar symptoms been ruled out?
  • Which factors (stage of disease, viral load, number of CD4+ T lymphocytes present, complications, associated opportunistic infections) may complicate treatment and affect disease progression?

Regarding treatment:

  • Has drug treatment plan been individualized, taking into account the disease progression and degree of immunodeficiency?
  • Although there is not a general consensus on the best time to start drug treatment for HIV, is drug therapy appropriate for this individual at this time?
  • Is combination highly active antiretroviral therapy (HAART) available to individual?
  • Is the present combination of drugs being administered appropriate for this individual?
  • Can drug regimen be modified if individual cannot tolerate one or more of the drugs or if there is a rising viral load, a declining CD4+ T lymphocyte count, or progression of clinical diseases characteristic of AIDS?
  • What can be done to lessen adverse effects? Have alternate drug combinations been as effective?
  • Because the high rate of HIV turnover in the body often produces drug-resistant forms of the virus, what is being done to monitor the efficacy of the current drug therapy?
  • Is individual receiving prophylactic drug therapy against common opportunistic diseases?

Regarding prognosis:

  • Have the benefits of drug therapy been explained to individual?
  • Does individual understand that the period without apparent disease expression may be increased by years or perhaps decades by using combination highly active antiretroviral therapy (HAART)?
  • Is individual involved in appropriate drug therapy at this time? If not, is it available to him or her?
  • If not available, how can the individual access combination highly active antiretroviral therapy (HAART)?
  • Can individual be compliant with long-term drug therapy?
  • Has individual experienced complications, such as opportunistic infections? Are complications being effectively treated under current treatment plan?
  • Does individual have realistic expectations?
  • Because psychosocial issues are important at all stages following viral infection, has individual received psychological testing?
  • Would individual benefit from antidepressant therapy?
  • Would individual and/or family benefit from psychological counseling?
  • Is individual involved in a community support group?
  • Have issues of sexuality been adequately addressed?

Source: Medical Disability Advisor



References

Cited

Berkow, Robert, Mark H. Beers, and Andrew J. Fletcher. "Immunodeficiency Disorders." Merck Manual of Medical Information Home Edition. Simon and Schuster, 2008. 892-899.

HIV Surveillance Report. "Diagnoses of HIV Infection in the United States and Dependent Areas, 2011." Centers for Disease Control and Prevention (CDC). 24 Jul. 2013. National Center for Health Statistics. 7 Jun. 2014 <http://www.cdc.gov/hiv/library/reports/surveillance/2011/surveillance_Report_vol_23.html>.

WHO. "HIV/AIDS." Global Health Observatory. 2014. World Health Organization. 7 Jun. 2014 <http://www.who.int/gho/hiv/en/>.

Source: Medical Disability Advisor






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