12.07.2015 Views

The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

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A <strong>Clinical</strong> <strong>Guide</strong> <strong>to</strong> <strong>Supportive</strong> <strong>and</strong> <strong>Palliative</strong> <strong>Care</strong> <strong>for</strong> <strong>HIV</strong>/<strong>AIDS</strong> • Chapter 2: Overview of <strong>Clinical</strong> IssuesFigure 2-3: Evolution of <strong>HIV</strong> Treatment Paradigms 1981 - 200126 picasToxicityResistanceCo-morbidities?CurativeBerlin <strong>AIDS</strong>ConferenceConcorde TrialIntroductionof ProteaseInhibi<strong>to</strong>rs,AdditionalNRTI’s/NNRTI’s<strong>The</strong>rapeutic ParadigmIntroduction ofAdditional NRTIs<strong>and</strong> NNRTIsIntroduction of AZT ACTG 076First <strong>AIDS</strong>Cases Reportedby CDC<strong>Palliative</strong>1981 1987 1993 1994 1996 1997 1998 1999 2000 2001patient <strong>and</strong> provider can interact in ways that emphasize the <strong>to</strong>tality of care <strong>and</strong> not merelyadherence <strong>to</strong> recommended antiretroviral regimens.Rather than the false dicho<strong>to</strong>my of either curative or palliative care, this guide is suggestingthat both approaches need <strong>to</strong> be considered throughout the course of <strong>HIV</strong> disease. This integratedapproach is represented graphically in Figures 2-4a <strong>and</strong> 2-4b. Rather than the simple <strong>and</strong>10U.S. Department of Health <strong>and</strong> Human Services • Health Resources <strong>and</strong> Services Administration • <strong>HIV</strong>/<strong>AIDS</strong> Bureau

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