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Books, Journals, New Media
July 12, 2000

AIDS: The Medical Management of AIDS

Author Affiliations
 

Harriet S.MeyerMD, Contributing EditorDavid H.MorseMS, Journal Review EditorRobertHoganMD, adviser for new media

 

Not Available

JAMA. 2000;284(2):241. doi:10.1001/jama.284.2.241

This sixth edition of The Medical Management of AIDS continues the practice of assembling in print continuing education updates (now conducted twice yearly because of their continually increasing popularity and demand) presented by faculty members of the University of California, San Francisco, and the University of Utah. These programs succeed in meeting clinicians' desire to keep abreast of the latest in diagnosis and treatment of human immunodeficiency virus (HIV) infection and the opportunistic infections and neoplasms that complicate the epidemic that has now claimed more than 17 million lives throughout the world.

With a MEDLINE search of the medical literature revealing at least 2338 English-language papers published in 1999 alone, there is no shortage of information available on the subject. The challenge is to dice it and slice it and then reassemble the parts into a package of information that is clinically relevant and useful. In this task, editors Sande and Volberding and their 65 contributors have again capably risen to the challenge.

The book follows a simple organizational scheme: first some introductory material on epidemiology and pathogenesis of HIV infection, then sections on antiretroviral therapy, organ-system–specific discussions of the manifestations of HIV infection and its complications (such as gastrointestinal and neurologic), and detailed chapters on opportunistic infections and malignancies (eg, Pneumocystis carinii pneumonia, cryptococcal and other fungal infections, and nontuberculous mycobacterial disease). The book concludes with a potpourri of other matters, ranging from antiretroviral therapy for HIV exposures to AIDS in older individuals—a subject that has received scant attention up to now. In each chapter, the emphasis is on clarity and brevity, but not at the cost of omitting what is important to the reader—a guide to the diagnosis and management of HIV disease.

Although the quality of all chapters is quite high, I found those on HIV laboratory testing, pneumocystis pneumonia, and AIDS-related malignancies to be particularly informative. In revising every two years, the editors have been able to keep the book fresh through the 12 years of its existence. Chapters have been rewritten and added, and references have been updated. The usual problems associated with multiple authorship are largely absent here for there is little overlap or conflicting opinion.

Are there any faults with this book? Yes, but they are few. The chapter on adverse effects and interactions of antiretroviral medications fails to mention abacavir, amprenavir, and efavirenz, while the following chapter includes each drug in its review of antiretroviral activity, dosing, and utility. Quality of x-ray film reproduction is poor and needs to be improved in future editions. A particular peeve of this reviewer is the failure, once again, to correct the erroneous transposition of a pair of radiographs (figures 9-4 and 9-7), a problem cited in my reviews of this book dating back to the third edition some 7 years ago! Other minor points can be mentioned as well: the 20% frequency of transfusion-requiring anemia occurring with zidovudine therapy was true in the early years of the drug's use (the literature cited in support of this statement is from 1987), but significant zidovudine-associated anemia is unusual with the 600 mg/d doses currently used. Also, the dose of corticosteroids used as an adjunct to antipneumocystis therapy is not specified.

On the whole, however, my observations in reviews of earlier editions remain true. The book is extremely readable and compact, yet thorough enough to answer most questions clinicians might encounter in their daily struggle to provide optimal care to patients with HIV infections. The enormous strides that have been made and the progress that has occurred over the past 19 years of dealing with AIDS are reflected in Sande and Volberding's The Medical Management of AIDS.

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