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Part 2 book “Dental management of the medically compromised patient” has contents: Rheumatologic disorders, organ transplantation, acquired bleeding and hypercoagulable disorders, congenital bleeding and hypercoagulable disorders, neurologic disorders, psychiatric disorders, drug and alcohol abuse,… and other contents.
PA R T VII Immunologic Disease 308 18 AIDS, HIV Infection, and Related Conditions DEFINITION On June 5, 1981, when the Centers for Disease Control and Prevention (CDC) reported five cases of Pneumocystis carinii (now jiroveci) pneumonia in young homosexual men in Los Angeles, few suspected that it heralded a pandemic of acquired immunodeficiency syndrome (AIDS) In 1983, a retrovirus (later named the human immunodeficiency virus [HIV]) was isolated from a patient with AIDS Since that first report, more than 70 million persons have been infected with HIV, and more than 30 million have died of AIDS.1 The total number of deaths has exceeded those caused by the Black Death of 14th-century Europe and the influenza pandemic of 1918 and 1919 About 95% of HIV-infected persons live in low- to middleincome regions and countries and in sub-Saharan Africa More than 40% of new infections (excluding those in infants) occur in young people 15 to 24 years of age.1,2 AIDS is an infectious disease caused by HIV, which is transmitted predominantly through intimate sexual contact and by parenteral means In view of the nature of this bloodborne pathogen, HIV infection and AIDS have important implications for dental practitioners Although HIV has rarely been transmitted from patients to health care workers, this may occur, and patients with HIV infection or AIDS may be medically compromised and may need special dental management considerations On the basis of current statistics, the average dental practice is predicted to encounter at least two patients infected with HIV per year The definition of AIDS provided by the CDC has been revised several times over the years, and in 2008, it was revised to be laboratory-confirmed evidence of HIV infection in a person who has stage HIV infection (i.e., a CD4+ lymphocyte count 1 month in duration) Cytomegalovirus disease (other than liver, spleen, or nodes), onset at age >1 month Cytomegalovirus retinitis (with loss of vision)† Encephalopathy, HIV related Herpes simplex: chronic ulcers (>1 month’s duration) or bronchitis, pneumonitis, or esophagitis (onset at age >1 month) Histoplasmosis, disseminated or extrapulmonary Isosporiasis, chronic intestinal (>1 month’s duration) Kaposi sarcoma† Lymphoid interstitial pneumonia or pulmonary lymphoid hyperplasia complex*† Lymphoma, Burkitt (or equivalent term) Lymphoma, immunoblastic (or equivalent term) Lymphoma, primary, of brain Mycobacterium avium complex or Mycobacterium kansasii infection, disseminated or extrapulmonary† Mycobacterium tuberculosis infection of any site, pulmonary,†‡ disseminated,† or extrapulmonary† Mycobacterium infection, other species or unidentified species, disseminated† or extrapulmonary† Pneumocystis jiroveci pneumonia† Pneumonia, recurrent†‡ Progressive multifocal leukoencephalopathy Salmonella septicemia, recurrent Toxoplasmosis of brain, onset at age >1 month† Wasting syndrome attributed to HIV *Only among children younger than 13 years of age (Data from Centers for Disease Control and Prevention: 1994 revised classification system for human immunodeficiency virus infection in children less than 13 years of age, MMWR Recomm Rep 43:1, 1994 and Centers for Disease Control and Prevention: 2008 revised surveillance case definitions for HIV infection among adults, adolescents, and children aged