Rehabilitation of HIV/AIDS infected patients

According to the documents of the World Health Organization (WHO), HIV infects the cells of the immune system, destroying them or changing its functions. The viral infection results in progressive degradation of the immune system and, as a result of it, the "immunodeficiency". Infections related to severe immunodeficiency, known as "opportunistic infections", for the "avail the opportunity" due the weakened immune system. AIDS is a term applied to the ultimate stages of HIV-infection. It is characterized by developing more than 20 opportunistic infections or HIV-related types of cancer. According WHO estimation, at the end of 2015 around the world there were 36.7 million HIV-infected people. In the same year approximately 2.1 million people were newly diagnosed, while 1.1 million people died because of HIV.

The development and implementation of new modern antiretroviral medications used for the treatment of and prevention of HIV-infection allowed to significantly prolong the lifetime of the patients. As of the middle of 2016, 18.2 million people were undergoing antiretroviral therapy around the world, which is about 46% of the patients that require therapy. It has been shown that, in the settings of proper and continuous following the recommendations for antiretroviral therapy, the progression of HIV in the organism can be slowed almost to complete cessation. More and more HIV-patients, even in the countries with low-income level, may maintain proper well-being and productiveness for a long time. The increase in the number of people having HIV/AIDS but maintaining the ability to actively perform in the society for a long time, shows an important role of the necessity of developing the rehabilitation program for such a group of patients.

The most frequent disorders of structure and functions (according to the International Classification of Functions – ICF) seen in HIV/AIDS patients are the following:

  • Pain
  • Muscular weakness
  • Sensory disorders
  • Limitation of the range of motions in various joints
  • High fatigability
  • Sleep disorders
  • Weight loss
  • Depressed mood, depression symptoms and other psychological abnormalities
  • Decreased “tone” and motivation
  • Attention disorders, deviations of mental and other cognitive functions
  • Disorders of balance, stance and increased risk of falling
  • Decreased self-esteem and self-confidence
  • Impaired sexual functions

Activity limitations according to ICF, specific for HIV/AIDS patients:

  • Impaired ability of self-maintaining
  • impossibility of doing household duties
  • impaired ability to walk with decreased speed, distance and balance
  • impairment of proper bimanual operating activity
  • impairment of interpersonal communication

Disorders of involvement as per the ICF, specific for HIV/AIDS patients:

  • impaired involvement in family life
  • impaired involvement into social activities, including the limitations due to developing stigma
  • impaired involvement into previous recreational activities
  • decreased possibilities of employment

Indications for undergoing the program of Rehabilitation for HIV/AIDS patients:

  1. The presence of diagnosed HIV/AIDS (any stage)
  2. Decreased quality of life as a result of HIV/AIDS
  3. The presence of rehabilitation potential (a possibility of improving in any ICF category). In case of uncertain potential the patient can enter the program of functional evaluation for defining the potential (2 weeks)
  4. Agreement from the patient and eagerness to participate in the program and a possibility of regular visiting the Center

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