Personal Views

Another deadly Zairian disease

BMJ 1996; 313 doi: (Published 06 July 1996) Cite this as: BMJ 1996;313:58
  1. J Burdon

    I first saw him on a Thursday afternoon, newly admitted from the clinic that morning. He was 22 and looked as if the was about to die. He weighed 40 kg and had lost 33% of his body weight over the previous 12 months. He was suffering from severe chronic diarrhoea, and when I examined him he had oral candida. The nurse who had admitted him from the outpatient department had written “Bangui” as the likely diagnosis in the notes. Bangui is a local euphemism for HIV infection, so named after the capital city of the Central African republic where one of the early international meetings on HIV was held. I sighed at seeing another life ending prematurely and at the prospect of having to spend time in an already busy day counselling him before and after performing the HIV test that would undoubtedly show him to be infected.

    Each week we see about 10 new adult patients with HIV admitted to the ward. They present in a variety of ways but mostly with weight loss, fever, cough, or diarrhoea. Some, particularly those with tuberculosis, respond well to treatment and it is satisfying to follow them in the clinic as their weight increases, their cough diminishes, and their confidence is restored. But it is unrewarding work on the whole, and you feel that you are scratching the surface of the problem–indeed, …

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