HIV infection and AIDS in the developing world. ABC of AIDS.

This clinical review focuses on HIV infection and AIDS in the developing world. It is noted that in most developing countries heterosexual transmission is the dominant mode of transmission and mother-to-child transmission of HIV is much more common than in industrialized countries. As in industrialized countries the clinical manifestations associated with HIV infection are wide-ranging from an asymptomatic state to symptomatic disease to fatal illness characterized by opportunistic infections malignancies neurological disease and wasting. Symptoms include weight loss fever night sweats diarrhea tuberculosis bacterial septicemia cerebral toxoplasmosis and other endemic tropical diseases. The WHO has introduced a clinical case definition that could be used in settings where laboratory facilities are inaccessible. The WHO has also proposed a staging system for HIV infection and disease using clinical and laboratory data. Although the general approach to treatment in developing countries should ideally be no different from that in industrialized countries the lack of infrastructure and resources for diagnosis and treatment has hampered successful management of HIV-infected people.