1. HAEMATOLOGICAL MANIFESTATIONS OF HIV DR NEIL LITTLETON

2. SO HOW BIG IS THE PROBLEM?

3. WHAT ARE SOUTH AFRICAN DYING OF? Tuberculosis (12%) Influenza and pneumonia Intestinal infectious diseases Heart disease CVA Diabetes HIV HPT Chronic respiratory disease Other viral diseases

4. WHAT IS KILLING US IN THE EC TB Heart disease CVA Influenza & pneumonia Intestinal infections Chronic lower respiratory tract diseases Diabetes Other viral diseases HIV HPT

5. WHAT IS KILLING THE BIGGEST GROUP TUBERCULOSIS Other viral diseases HIV

6. WHAT IS KILLING THE MEN TUBERCULOSIS HIV

7. THE NEW FACE OF HIV

8. CYTOPENIAS TUMOURS BLEEDERS CLOTTERS PRESENTATION

9. CYTOPENIAS- PLATELETS ITP TTP DIC Dysplasia Drugs Hypersplenism Aplasia Infections- granulomatous eg TB- fungus etc Tumours

10. HIV INDUCED DYSPLASIA

11. WORK UP-ITP FBC with smear: true thrombocytopenia vs clumps Size of platelets, granules ( dysplasia) Other cells:malignant, infections ( bacteria, malaria) Fragments Leucoerythroblastic reaction

12. WORK UP - ITP INR & PTT CD 4 ANF BMBx Sonar - asses splenic size AND SPLENIC VEIN SIZE

13. CYTOPENIAS - ANEAMIA When to investigate: 11g/dL, 10g/dL, 9g/dL, 8g/dL Causes: production deficit or peripheral destruction or both HAEMATINIC SCREEN RPI, Haptoglobin, Coombs,LDH, +/- SPEP BMBx

14. CAUSES - ANEAMIA ACD Drugs- AZT/ Bactrim Infections - Parvovirus / HBV/ HCV/CMV/ HIV PRCA - Drugs( ARV's rare), T cell auto immunity BM displaced by tumour AIHA - cold/ warm/ both

15. TUMOURS Hodgkin's lymphoma - AIDS defining High grade B Cell NHL- AIDS defining T Cell NHL ( ALC & T Angioimmunoblastic) Low grade B Cell Other ( CML, myeloma) Karposi's - AIDS defining

16. TUMOUR PRESENTATION Often the tumour declares itself Lymph adenopathy needs to be reacted on! B symptoms Abdominal distention, jaundice Pneumonias......? Lung lesions Irrespective of CD 4 count

21. CLOTTERS & BLEEDERS HIV is a thrombotic disease- don't forget People with HIV have a higher incidence of thrombosis Research - TBH Acquired Haemophilia - RARE

22. THE NEW FACE OF HIV?

23. THE CHANGING FACE OF HIV

24. - MOTTO OF ALOE IGAZI UNIT “We live in hope.”