SCHIZOPHRENIA AND HIV

There is very little published information regarding the co-occurrence of human immunodeficiency virus (HIV)-spectrum illness and psychotic illnesses, including schizophrenia, even though their coexistence in t he same patient may severely affect the course of both illnesses. Esti mates of the frequency of HIV infection in patients with preexisting m ental illness range between 5 and 7 percent. Estimates of new-onset ps ychosis in patients with HIV-spectrum illness range between 0.2 and 15 percent and may increase as the stage of HIV illness progresses. Rega rdless of which illness came first, their occurrence together appears to be associated with more morbidity and mortality than would be expec ted with either illness alone. Patients with new-onset psychosis respo nd to and tolerate relatively low doses of antipsychotic medication. W hether the presence of HIV decreases the effective daily dose of neuro leptic medication in patients with preexisting psychosis is not yet kn own. A clearly superior neuroleptic medication for patients with both psychosis and HIV infection has not yet been identified. Further syste matic exploration is needed.