HIV Manual for Health Care Professionals.

Muma RD, Lyons BA, Borucki MJ, Pollard RB. East Norwalk, CT 06855, Appleton & Lange, 1994, paperback, 299 pp, $24.95.

The basic premise of this multiauthored text is that health care professionals will have the knowledge and clinical tools necessary to treat the patient with human immunodeficiency virus (HIV) for the presence of symptoms or conditions that would lead to specific medical intervention. The primary objective of the book is to supply the information needed to provide appropriate drug and medical intervention for the patient with HIV. The first part of the book reviews epidemiology and immunology. The etiology and pathogenesis of HIV is then reviewed. There are a few simplistic diagrams to explain these areas. The next several chapters review pretest and posttest counseling, treatment of primary infection and vaccines, and the diagnosis and treatment of common infection and malignancies. These chapters are well written and use concise tables to coalesce the information contained in them. A few radiographs that may assist the visual learner are also included.

Following this information, two chapters on syphilis and hepatitis are presented. These chapters address co-infection of hepatitis and syphilis with HIV. Clinical manifestations are presented and well referenced. The section on the management of adverse drug reaction is very beneficial for the physical therapist in terms of differential diagnosis. The chapter on interpreting laboratory data does assist in understanding the immunological parameters of patients seen in rehabilitation settings. There is a chapter on women with HIV and a chapter on pediatric HIV infection; these are two areas of great concern that highlight this book for clinical recommendation. Several chapters are written from a nursing perspective, both inpatient as well as outpatient. The social and psychological aspects of acquired immunodeficiency syndrome are interwoven as a theme in several of these chapters and a separate chapter at the end.

The 8- X 5-in spiral-bound format of this book is similar to other pocket-size clinical assessment books for the health care professional. This informative text contains much useful data and many insightful observations about the clinical syndromes found in patients living with HIV. It does not, however, include a specific chapter on rehabilitation strategies of the patient who is HIV-positive. Exercise and nutrition are only mentioned in the prevention chapter and in a few of the nursing chapters.

Additionally, an excess amount of information is given in several chapters regarding suicidal patients. The information is repeated in subsequent chapters by the nursing authors. The index includes a very detailed outline of specific opportunistic infections and clinical concerns, and is an excellent reference tool for the clinician. Unfortunately, it does not include rehabilitation components and would be a poor guide for assisting the physical therapist or occupational therapist in rehabilitation strategies. It does, however, establish the backdrop of information necessary to solve problems when treating a patient who is HIV-positive.

Overall, the book is uniformally referenced, and tables supplement the text very well, but illustrations are not extensive. The radiographs in the diagnosis and treatment chapter are noteworthy. Although, a cohesive writing style is usually difficult to attain with different contributing authors, this clinical text demonstrates a consistent, smooth, comprehensive, and readable style. The tables are excellent for brief reviews of symptomatology and clinical manifestation. Overall, a theme of compassion and concern for the patient who is HIV-positive is exhibited.

Physical therapists, physical therapist assistants, health profession students, and course instructors will find this clinical manual to be a good companion for courses in rehabilitation strategies. Clinical practitioners will find the text provides an easily accessible review of the multifaceted HIV disease process.