01. When someone has HIV, all their health issues are due to the disease. “There is a misconception [among physicians] that once a person is HIV positive, everything they have is related to the disease,” says internist M. Keith Rawlings, MD. However, people with HIV may also have diabetes, hypertension (blacks have higher risks of both) and other conditions that require a specialist’s care.
02.Once my patients get on meds, they’re goodto go. HIV drugs can cause side effects—most commonly, nausea, fatigue and diarrhea. Symptoms may be further complicated by high blood sugar, diabetes or high cholesterol. And significant drug interactions can occur between HIV meds and some antacids, antifungals, antibiotics, anticonvulsants, antihistamines, calcium channel blockers, vaso-dilators, gastrointestinal and lipid-lowering agents and oral contraceptives. Make sure your patients know that they may experience side effects with HIV meds, especially in the first weeks of treatment. And encourage them to speak openly about everything they may be putting in their body.
03. Surgeons shouldn’t operate on someone who has HIV. As long as your patient’s T-cell count is above 200, the risk of post-operative complications is lower. Below 200, patients may be refused for surgery because wounds won’t heal as well. Elective surgery is usually deferred until the immune system is improved. But if a patient needs surgery, you should assess their need independent of the fact that they’re positive.