HIV Manual 2001 replaces the AIDS Manual for Doctors and Dentists published in 1995. (formerly Information on AIDS for Doctors and Dentists, 1987 and 1992) More than a simple update, the new manual has been extensively rewritten, based on a series of clinical protocols of the Integrated Treatment Centre of the Special Preventive Programmes, Department of Health. The changes between the two editions attest to the dramatic turn of events since 1996 when the very potent protease inhibitor was made available in Hong Kong. Highly active antiretroviral therapy as we know it today controls HIV and transforms it into a manageable disease. The outlook of HIV medicine thus took on a most positive note with decreased mortality and morbidity. Attention since then has become focussed on long term management issues.
This manual makes no pretensions to a textbook on the subject but does aim at giving medical practitioners in Hong Kong a synopsis of HIV medicine as it is today and in the local context. Algorithms of management are included wherever appropriate to assure convenience of use. As such, this manual should serve as a handy reference in that unexpected encounter with problems related to HIV, which are becoming less uncommon nowadays. To this end, a palm version of the manual is under preparation.(watch out: www.aids.gov.hk)
In the new manual, a shift towards HIV-specific treatment issues should be evident, commensurate with the modern paradigm of HIV management in which the proper use of antiretrovirals cannot be overemphasized. However, for various reasons, opportunistic infections and malignancies continue to be important, especially in the newly diagnosed and in the way effective antiretrovirals have impacted on their manifestations and management.
Until a cure of HIV is found, the pace of HIV medicine will continue to be rapid. Although this manual covers mainly the basic tenets of HIV medicine rather than its more controversial aspects, part if not all of the material will easily become outdated as new developments unearth. For this reason, a 'soft copy' of this manual is also housed in the web, which is updated on an as-needed basis. Regardless, all physicians are advised to keep abreast with the more significant developments in this area. We owe it to our patients.
We acknowledge the input of all clinicians currently working or have worked with us at the Integrated Treatment Centre (and the HIV clinics before it), the encouragement of the high-spirited nursing team of Special Preventive Programmes, without which, this Manual would remain an unfulfilled dream.
The editors