AIDS & HIV

It's not normally associated with the feet, but it's an important part of podiatric practice to know how to manage the various manifestations of the disease on the feet. 

In order to understand the disease, you should know that the term 'AIDS' refers to the full-blown disease cause by an infection.  

For some basic background, the virus that causes AIDS, HIV, is a member of a family of viruses known as 'RNA retroviruses'.  The HIV virus attaches to certain human cells, (macrophages, monocytes and T4 lymphocytes),  that help us fight off infections.  The virus then incorporates itself into the host cell, changing our body's ability to fight off infections. 

The result is that an individual infected with the virus is more susceptible to a host of other infections, including bacterial, mycobacterial, viral, fungal and other pathogens.  Each of these can become manifest in the feet.

HIV may cause fatigue, weight loss, fever and sweats, cough, shortness of breath, sore throat, discoloration of the tongue and mouth, headaches and behavioural changes.  Specific to the foot, HIV may affect the nervous system, the skin, and predispose the patient to various forms of cancer (e.g., Kaposi's Sarcoma and non-Hodgkins Lympoma) that may be seen in the feet.

The ELISA (enzyme-linked immunosorbant Assay) test is the primary screening test to detect the antibody to HIV-1.  The Western Blot Test is used to confirm the validity of the ELISA test.  A newer test, the Polymerase Chain Reaction (PCR) test may identify the virus at an earlier stage than either the ELISA or Western Blot Test.     

There is no cure for this disease, but treatment exists--usually in the form of combination drug therapy--which attempts to attack the virus in a variety of ways at once, thereby better keeping its effects at bay. 

In addition to immunotherapy, wound care and treatment with antibiotics may be necessary for treatment of HIV-related foot complaints. 

 

 

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S. A. Schumacher, D.P.M., F.A.C.F.A.S., F.A.C.F.A.O.M.  
Dr. S. A. Schumacher, Podiatric Corporation  

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