Palliative care in HIV/AIDS – considerations on two study cases

Ana-Iulia Vintilă (a), Odette Chirilă (b), Mariana Mărdărescu (c)

(a): medical nurse
(b): senior clinical psychologist
(c): MD, PhD, infectious diseases
(a), (b), (c): HIV/AIDS Paediatric Department, National Institute of Infectious Diseases „Prof. Dr. Matei Balş”, Bucharest, Romania

Corresponding author:
Mariana Mărdărescu MD: e-mail: mardarescum@yahoo.com

Abstract

Palliative care is holistic care, provided to patients who are not responding to curative treatment.

HIV/AIDS is an incurable chronic disease that affects the patient and his family. In HIV/AIDS infection, good condition alternates with acute periods of illness. Disease regression is often evident, but it is uncertain when death arrives. These alternations of good condition with acute periods of illness cause mental stress to both patient and his family. The family is always expecting the unavoidable death, which is unforeseeable.

AIDS patients in a terminal phase need special care which should be given in the hospital in order to respect and implement universal precautions. This requires personal care and only single-use materials which are expensive.

Two cases are presented of patients with AIDS, clinical and immunological stage C3. First case – Diagnosis: Disseminated Tuberculosis, Pancytopenia, Chronic Pancreatitis. Second case – Diagnosis: Decompensate HBV Cirrhosis, Upper and Lower Digestive Haemorrhage, Thrombocytopenia.

The two patients had epitasis with large quantity blood and upper digestive haemorrhage. Bleeding represents a risk for those attending to HIV (+) patients. Therefore it is preferable for patients to be cared for in the hospital where a multidisciplinary team takes care for the patient.

Key words: palliative care, HIV/AIDS, epitasis, haemorrhage, death

(Full text in Romanian)