FOCUSED REVIEW - PHYSIATRIC MANAGEMENT OF HIV-RELATED DISABILITY

Since 1981, the epidemic of acquired immunodeficiency syndrome (AIDS), due to infection with human immunodeficiency virus (HIV), has grown a nd challenged health care providers in the United States, Although the total number of AIDS cases diagnosed each year appears to be reaching a plateau, cases attributable to heterosexual transmission are rising , With improved treatment, survival of persons with HIV infection is e xpected to increase; this change suggests that the prevalence of HIV-r elated physical disability will also increase, This article outlines t he pathophysiology and systemic manifestations of HIV infection, The m ore common neuromuscular and neurological complications at each stage of the disease are presented, and appropriate rehabilitation intervent ions are discussed, The indications for aerobic exercise in persons wi th HIV infection and the approach to disability management in pediatri c HIV infection are presented, Psychosocial considerations related to access to rehabilitations services, discrimination on the basis of HIV infection or membership in HIV risk behavior groups, and vocational r ehabilitation are discussed, The review concludes that rehabilitation interventions in persons with HIV infection are based on functional de ficits, rather than disease processes, suggesting that a general physi atric fund of knowledge should be adequate to manage most HIV disabili ty. (C) 1996 by the American Academy of Physical Medicine and Rehabili tation