Brief Encounters
TREAT THE SYMPTOMS AS WELL AS THE CAUSE
HIV related symptoms, for example nausea, anorexia, or pain, may occur at any stage of HIV disease. They may be due to HIV itself, to the use of highly active antiretroviral therapy (HAART), to comorbidity, such as liver disease from hepatitis C, or to HIV associated malignancy such as non-Hodgkin lymphoma. Harding et al (see p 5) performed a systematic review to identify the effects of different models of palliative care on patient outcomes. They found that home palliative care and inpatient hospice models of care improved outcomes (pain, symptom control, anxiety, insight, and spiritual wellbeing). The authors suggest that palliative care should be offered as an integral part of HIV clinical care throughout the course of a patient’s HIV disease. However, they also point to the weakness of the evidence base for this recommendation; studies on the benefits of palliative care are often limited by poor experimental methods and few standardised outcome measures. …
