Psychological issues in patients with PHI. (Wrap-Up).Individuals who learn they are infected with HIV--whether chronically or acutely--commonly experience a range of emotions including: * anger * confusion * anxiety * shame, guilt, or alienation * sadness or depression The psychological impact of such feelings can be profound, and referral to a counselor or therapist experienced with HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. disease is recommended. In particular, depression is the most common psychiatric disorder among HIV-infected patients and pharmacological intervention may be warranted. Persons diagnosed with primary HIV infection (PHI phi n. Symbol  The 21st letter of the Greek alphabet.PHI, n See health information, protected. ) are faced with psychological challenges unique to their early disease stage. A PHI patient presenting with symptoms such as fevers, rash, or diarrhea may confuse these symptoms with those of AIDS. Patients with PHI should first be assured that they do not have AIDS and that PHI is an early disease stage after which many people remain healthy for 10 years or longer, even without treatment. Additionally, treating factors that may have contributed to infection (for instance, alcohol, drug, or sexual addiction sexual addiction Sex compulsion Sexology Compulsive and ritualized sexuoerotic hyperactivity, generally under specific sexuoerotic conditions and stimuli. See Sexaholics Anonymous. ) can help reduce further transmission, especially during such an episode of high viremia viremia /vi·re·mia/ (vi-re´me-ah) the presence of viruses in the blood. vi·re·mi·a n. The presence of viruses in the bloodstream. as found in PHI. Of equal concern, especially if the clinician decides to initiate antiretroviral antiretroviral /an·ti·ret·ro·vi·ral/ (-ret´ro-vi?ral) effective against retroviruses, or an agent with this quality. an·ti·ret·ro·vi·ral adj. therapy during PHI, is that patients understand why they will be taking potent drugs to fight HIV when most chronically infected people are advised to wait until mid- or late-stage disease before starting therapy. An essential issue is whether or not patients should be enrolled into clinical study, if available. Each patient should be counseled about the pros and cons pros and cons Noun, pl the advantages and disadvantages of a situation [Latin pro for + con(tra) against] of such enrollment. Also, issues regarding potential drug side effects Side effects Effects of a proposed project on other parts of the firm. and toxicities, as well as the importance of adherence, should be explained. REFERENCES (1.) Schacker T. Primary HIV infection. Early diagnosis and treatment are critical to outcome. Postgrad Med. 1997; 102(4):143-146, 149-151. (2.) Yu K, Daar ES. Primary HIV infection. Current trends in transmission, testing, and treatment. Postgrad Med. 2000; 107(4): 114-122. (3.) Remien RH, Rabkin JG. Psychological aspects of living with HIV disease. West J Med. 2001; 175(5):332-335. Special thanks to Miles Glaspy, LMS W-A CP, for contributing to this article. |
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