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Palliative care for HIV disease in the era of highly active antiretroviral therapy

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References

  1. Centers for Disease Control and Prevention.HIV/AIDS Surveillance Report. US HIV and AIDS Cases Reported Through December 1998. Atlanta, GA: Centers for Disease Control and Prevention; 1998:10(2):1–43.

    Google Scholar 

  2. Centers for Disease Control and Prevention.Update: Trends in AIDS Incidence, Deaths and Prevalence—United States, 1996. Atlanta, GA: Centers for Disease Control and Prevention; 1997:46(8):165–173.

    Google Scholar 

  3. Wong T, Reggy A, Chiasson MA, Simonds R, Loo V, Heffes J. Protease inhibitors are associated with declining AIDS deaths in NYC.Int Conf AIDS. 1998:12:68 Abstract 12280.

    Google Scholar 

  4. Carpenter, CCJ, Fischl MA, Hammer SM et al. Antiretroviral therapy for HIV infection in 1998.JAMA. 1998;280:78–86.

    Article  CAS  PubMed  Google Scholar 

  5. Centers for Disease Control and Prevention. Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents.MMWR Morb Mortal Wkly Rep 1998; 47(RR-5):43–82.

    Google Scholar 

  6. Delta Coordinating Committee. Delta: a randomized double-blind controlled trial comparting combinations of zidovudine plus didanosine or zalcitabine with zidovudine alone in HIV-infected individuals.Lancet. 1996;348:283–291.

    Google Scholar 

  7. Hammer, S, Katzenstein DA, Hughes MD, et al. A trial comparing nucleoside monotherapy with combination therapy in HIV-infected adults with CD4 cell counts from 200 to 500 per cubic millimeter.N Engl J Med. 1996;335:1081–1090.

    Article  CAS  PubMed  Google Scholar 

  8. Raffi F, Reliquet V, Auger S, et al. Efficacy and safety of stavudine and didanosine combination therapy in antiretroviral-experienced patients.AIDS. 1998;12:1999–2005.

    CAS  PubMed  Google Scholar 

  9. Gulick RM, Mellors JW, Havlir D, et al. Treatment with indinavir, zidovudine, and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy.N. Engl J Med. 1997;337:734–739.

    Article  CAS  PubMed  Google Scholar 

  10. Hammer SM, Squires KE, Hughes MD, et al., for the AIDS Clinical Trial Group 320 Study Team. A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4+ cell counts of 200 per cubic millimeter or less.N Engl J Med. 1997;337:725–733.

    Article  CAS  PubMed  Google Scholar 

  11. Cameron DW, Heath-Chiozzi M, Cohen C, et al., for the Advanced HIV Disease ritonavir Study Group. Randomized placebo-controlled trial of ritonavir in advanced HIV-1 disease.Lancet. 1998;351:543–549.

    Article  CAS  PubMed  Google Scholar 

  12. Montaner JSG, Reiss P, Cooper D, et al., for the INCAS Study Group. A randomized, double-blind trial comparing combinations of nevaripine, didanosine, and zidovudine for HIV-infected patients.JAMA. 1998;279:930–937.

    Article  CAS  PubMed  Google Scholar 

  13. Brettle, RP, Wilson A, Povey S, et al. Combination therapy for HIV: the effect on inpatient activity, morbidity and mortality of a cohort of patients.Int J STD AIDS. 1998;9:80–87.

    Article  CAS  PubMed  Google Scholar 

  14. Hogg RS, Heath KC, Yip B, et al. Improved survival among HIV-infected individuals following initiation of antiretroviral therapy.JAMA. 1998;11:450–454.

    Google Scholar 

  15. Palella FJ, Delaney KM, Moorman AC, et al., and the HIV Outpatient Study Investigators. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection.N Engl J Med. 1998;338:853–860.

    Article  PubMed  Google Scholar 

  16. Egger M, Hirschel B, Franciolo P, et al., and the Swiss HIV Cohort Study. Impact of new antiretroviral combination therapies in HIV-infected patients in Switzerland: prospective multicentre study.BMJ. 1997;315:1194–1199.

    CAS  PubMed  Google Scholar 

  17. Phillips AN, Katlama C, Barton S, et al., for the EuroSIDA Study Group. Survival in 2367 zidovudine-treated patients according to use of other nucleoside analogue drugs.J Acquir Immune Defic Syndr Hum Retrovirol. 1998;17:239–244.

    CAS  PubMed  Google Scholar 

  18. Chiasson MA, Berenson L, Li W, et al. Declining AIDS mortality in New York City.J Acquir Immune Defic Syndr Hum Retrovirol. 1999;21:59–64.

    CAS  Google Scholar 

  19. Centers for Disease Controls and Prevention. Update: trends in AIDS incidence, deaths and prevalence-United States, 1996.MMWR Morb Mortal Wkly Rep. 1997;17:239–244.

    Google Scholar 

  20. Centers for Disease Control: estimated incidence of AIDS and deaths of person with AIDS, adjusted for delays in reporting, by quarter-year of diagnosis/death. United States. January 1985–June 1997. HIV/AIDS Surveillance Reports 1997;9:1–44.

    Google Scholar 

  21. Fantoni M, Ricci F, del Borgio C, et al. Multicentre study on the prevalence of symptoms and symptomatic treatment of HIV infection.J. Palliat Care. 1997;13:9–13.

    CAS  PubMed  Google Scholar 

  22. Kelleher P, Cox S, McKeogh M. HIV infection: the spectrum of symptoms and disease in male and female patients attending a London hospice.Palliat Med. 1997;11:152–158.

    CAS  PubMed  Google Scholar 

  23. O'Neill JF, Alexander CS. Palliative medicine and HIV/AIDS.Prim Care. 1997;24:607–615.

    PubMed  Google Scholar 

  24. Selwyn PA, Arnold R. From fate to tragedy: the changing meanings of life, death and AIDS.Ann Intern Med. 1998;129:899–902.

    CAS  PubMed  Google Scholar 

  25. Newshan G, Witt Sherman D. Palliative care. Pain and symptom management in persons with HIV/AIDS.Nurs Clin North Am. 1999;43:131–145.

    Google Scholar 

  26. Institute of Medicine Report.Approaching Death: Improving Care at the End of Life. Washington, DC: National Academy Press; 1997.

    Google Scholar 

  27. Robinson V, George R, Butters E, Howes G, Edwards D, Higginson I. Symptom profile in late HIV disease.Int Conf AIDS. 1991;7:338. Abstract M.C.3160.

    Google Scholar 

  28. Fantoni M, Ricci F, del Borgo C, et al.. Symptom profile in terminally ill AIDS patients.AIDS Patient Care STDS. 1996;10:171–173.

    CAS  PubMed  Google Scholar 

  29. Bradley WG, Verma A. HIV associated peripheral neuropathy. In:Fifth Conference Retrovirology Opportunistic Infections. Chicago, IL. February 1–5, 1998;234. Abstract S23).

  30. Lebovits AH, Smith G, Maignan M, Lefkowitz M Pain in hospitalized patients with AIDS: analgesic and psychotropic medications.Clin J Pain. 1994;10:156–161.

    CAS  PubMed  Google Scholar 

  31. Singer EJ, Zorilla C, Fahy-Chandon B, Chi S, Syndulko K, Tourelotte WW. Painful symptoms reported by ambulatory HIV infected men in a longitudinal study.Pain. 1993;54:15–19.

    Article  CAS  PubMed  Google Scholar 

  32. McCormack JP, Li R, Zarowny D, Singer J. Inadequate treatment of pain in ambulatory HIV patients.Clin J Oncol. 1993;9:279–283.

    CAS  Google Scholar 

  33. Dixon P, Higinson A. AIDS and cancer pain treated with slow release morphine.Postgrad Med J. 1991;67:S92-S94.

    PubMed  Google Scholar 

  34. Shofferman J. Pain: diagnosis and management in the palliative care of AIDS.J Palliat Care. 1988;4:46–49.

    Google Scholar 

  35. Larue F, Fontaine A, Colleau SM Underestimation and treatment of pain in HIV disease: multicentre study.BMJ. 1997;314:23–28.

    CAS  PubMed  Google Scholar 

  36. O'Neill WM, Sheppard JS. Pain in immunodeficiency virus disease: a review.Pain. 1993;54:3–14.

    Article  PubMed  Google Scholar 

  37. Breitbart W, Rosenfeld BD, Passik SD, McDonald MV, Thaler H, Portenoy RK. The undertreatment of pain in ambulatory AIDS patients.Pain. 1996;65:243–249.

    Article  CAS  PubMed  Google Scholar 

  38. Rosenfeld B, Breitbart W, McDonald MV, Passik SD, Thaler H, Portenoy RK. Pain in ambulatory AIDS patients. II: Impact of pain on psychological functioning and quality of life.Pain. 1996;68:323–328.

    Article  CAS  PubMed  Google Scholar 

  39. Breitbart W, McDonald MV, Rosenfeld B, Monkman ND, Passik S. Fatigue in ambulatory AIDS patients.J Pain Symptom Manage. 1988;15:159–167.

    Google Scholar 

  40. Librach SL. The pain manual: principles and issues in cancer pain management. Toronto, Canada: Pegasus Healthcare; 1991.

    Google Scholar 

  41. Expert Advisory Committee on the Management of Sever and Chronic Pain in Cancer Patients.Cancer Pain: a Monograph on the Management of Cancer Pain. A Report of the Expert Advisory Committee on the Management of Severe Chronic Pain in Cancer Patients. Ottawa, Canada: Health and Welfare Canada; 1984.

    Google Scholar 

  42. World Health Organization. Expert Committee.Cancer Pain and Palliative Care. A Report of the WHO Expert Committee. Geneva, Switzerland: World Health Organization; 1990. Technical Report Series 804.

    Google Scholar 

  43. Ventafridda V, Tamburini M, Caraceni A, DeConno F, Naldi F. Validation study of the WHO method for cancer pain relief.Cancer. 1987;59:850–856.

    CAS  PubMed  Google Scholar 

  44. Walker VA, Hoskin PJ, Hanks GW, White ID. Evaluation of WHO guidelines for cancer pain in a hospital-based palliative care unit.J Pain Symptom Manage. 1988;3:145–149.

    Article  CAS  PubMed  Google Scholar 

  45. Grond S, Zech D, Schrug S, Lynch J, Lehmann KA. Validation of World Health Organization guidelines for cancer pain relief during the last days and hours of life.J Pain Symptom Manage. 1991;6:1411–1422.

    Article  Google Scholar 

  46. Librach SL. Special issues in pain control during terminal illness.Can Fam Physician. 1995;44:415–419.

    Google Scholar 

  47. Singh S, Fermie P, Peters W. Symptom control for individuals with advanced HIV infection in subacute residential unit: which symptoms need palliating? Paper presented at: VII International Conference on AIDS. July 19–24, 1992; Amsterdam, The Netherlands. Abstract 5248.

  48. Newshan GT, Wainapel SF. Pain characteristics and their management in persons with AIDS.J Assoc Nurses AIDS Care. 1993;4:53–59.

    CAS  PubMed  Google Scholar 

  49. Breitbart W. Pharmacotherapy of pain in AIDS. In: Wormser GP, ed.A Clinical Guide to AIDS and HIV. Philadelphia, PA: Lippincott Raven; 1996:359–361.

    Google Scholar 

  50. Walsh TD. Adjuvant analgesic therapy in cancer pain. In: Foley KM, Bonica JJ, Ventafridda V, Callaway MV, eds.Proceedings of the Second International Congress on Pain. Vol. 16.Advances in Pain Research and Therapy. New York, NY: Raven Press; 1990:155–169.

    Google Scholar 

  51. Foley KM. The role of adjuvant drugs and anesthetic blocks in the management of patients with cancer and pain. In: Stanley TH, Ashburn MA, Fine PG, eds.Anesthesiology and Pain Management. Dordrecht, The Netherlands: Kluwer Academic; 1991.

    Google Scholar 

  52. Maddox JF, Desmond DP. Reliability and validity of information from chronic heroin users.J Psychiatric Res. 1975;12:87–95.

    Google Scholar 

  53. Goldstein MF, Friedman SR, Neaigus A, Jose B, Ildefonso G, Curtis R. Self-reports of HIV risk behavior by injecting drug users: are they reliable?Addiction. 1995;90:1097–1104.

    Article  CAS  PubMed  Google Scholar 

  54. Ward SE, Goldberg N, Miller-McCauley V, ei al. Pain-related barriers to management of cancer patients.Pain. 1993;52:319–324.

    Article  CAS  PubMed  Google Scholar 

  55. Von Roen JH, Cleeland CS, Gonin R, Hatfield AK, Pandya KJ. Physician attitudes and practices in cancer management: a survey from the Eastern Cooperative Oncology Group.Ann Intern Med. 1993;119:121–126.

    Google Scholar 

  56. Berger AM, Portenoy RK, Weissman DE.Principles and Practice of Supportive Oncology. Philadelphia: Lippincott, Williams, and Wilkins; 1998:513–530.

    Google Scholar 

  57. Cleeland CS, Gonin R, Hatfield AK. Pain and its treatment in outpatients with metastatic cancer. The Eastern Cooperative Oncology Group's outpatient study.N Engl J Med. 1994;330:592–596.

    Article  CAS  PubMed  Google Scholar 

  58. Jacox A, Carr DB, Payne R, ei al.Management of Cancer Pain. Clinical Practice Guideline. Number 9. Rockville, MD: US Department of Health and Human Services, Public Health Service; Agency for Health Care Policy and Research; 1994:14. AHCPR publication 94-0593.

    Google Scholar 

  59. Zerwekh J. Supportive care of the dying patient. In: Baird SB, McCorkle R, Grant M, eds.Cancer Nursing: a Comprehensive Textbook. Philadelphia, PA: W. B. Saunders; 1991:875–884.

    Google Scholar 

  60. Grant M. Nausea, vomiting, and anorexia.Semin Oncol Nurs. 1987;3:277–286.

    CAS  PubMed  Google Scholar 

  61. Reuben DB, Mor V. Nausea and vomiting in terminal cancer patients.Arch Intern Med. 1986;146:2021.

    Article  CAS  PubMed  Google Scholar 

  62. Rousseau PC. Antiemetic therapy in adults with terminal disease. A brief review.Am J Hospice Palliat Care. 1995;12:13.

    CAS  Google Scholar 

  63. Von Gunten CF, Von Roenn JH. Supportive care of patients with AIDS. In: Berger AM, Portenoy RK, Weissman DE, eds.Principles and Practice of Supportive Oncology. Philadelphia: Lippincott, Williams, and Wilkins; 1998:861–875.

    Google Scholar 

  64. Ferris FD, Flannery JS, McNeal HB, ei al.A Comprehensive Guide for the Care of Persons with HIV Disease. Module 4: Palliative Care. Toronto, Canada: Kirkpatrick and Associates Printing; 1995.

    Google Scholar 

  65. Bruera E, Neumann CM. Management of specific symptom complexes in patients receiving palliative care.CMAJ.. 1998;158:1717–1726.

    CAS  PubMed  Google Scholar 

  66. Billings JA. The management of common symptoms. In: Billings JA, ed.Outpatient Management of Advanced Cancer. Philadelphia, PA: J. B. Lippincott; 1985:40–139.

    Google Scholar 

  67. Grant M. Nausea, vomiting, and anorexia.Semin Oncol Nurs. 1987;3:277–286.

    CAS  PubMed  Google Scholar 

  68. Revicki DA, Wu AW, Murray M. Change in clinical status, health status, and health utility outcomes in HIV-infected patients.Med Care. 1995;33:AS173-AS182.

    CAS  PubMed  Google Scholar 

  69. Lubeck DP, Fries JF. Changes in quality of life among persons with HIV infection.Qual Life Res. 1992;1:359–366.

    Article  CAS  PubMed  Google Scholar 

  70. Lubeck DP, Fries JF. Health status among persons infected with human immunodeficiency virus: a community-based study.Med Care. 1993;31:269–276.

    CAS  PubMed  Google Scholar 

  71. Gelber RD, Lenderking WR, Cotton D, ei al. Quality-of-life evaluation in a clinical trial of zidovudine therapy in patients with mildly symptomatic (HIV) infection.Ann Intern Med. 1992;116(12 pt 1):961–966.

    CAS  PubMed  Google Scholar 

  72. Lenderking WR, Gelber RD, Cotton DJ, et al., for the AIDS Clinical Trial Group. Evaluation of the quality of life associated with zidovudine treatment in asymptomatic human immunodeficiency virus infection.N Engl J Med. 1994;330:738–743.

    Article  CAS  PubMed  Google Scholar 

  73. O'Brien WA, Hartigan PM, Martin D, Esinhart J. Changes in plasma HIV-1 RNA and CD4 lymphocyte counts and risk of progression to AIDS.N Engl J Med. 1996;334:426–431.

    Article  PubMed  Google Scholar 

  74. Testa MA, Lenderking WR, Fischer L, Revicki DA, Collier AC. Effects of combination therapy with saquinavir, zidovudine, and zalcitabine on quality of life. [abstract TuB543]XI Int Conf on AIDS. Vancouver July 7–12 1996.

  75. Cohen C, Revicki DA, Nabulsi A, Sarocco P, Jiang P, and the Advanced HIV Disease Ritonavir Study Group. A randomized trial of the effect of ritonavir in maintaining quality of life in advanced HIV disease.AIDS. 1998;12:1495–1502.

    Article  CAS  PubMed  Google Scholar 

  76. Lenderking WR, Testa MA, Katzenstein D, Hammer S. Measuring quality of life in early HIV disease: the modular approach.Qual Life Res. 1997;6:515–530.

    Article  CAS  PubMed  Google Scholar 

  77. Ezzy D, De Visser R, Grubb I, McConachy D. Employment, accommodation, finances and combination therapy: the social consequences of living with HIV/AIDS in Australia.AIDS Care, Supplement. 1988;2:S189-S199.

    Google Scholar 

  78. Kunches L, Mazzullo JM, Miller-Mack E, Russell M, Ortega Z. Educational and support needs of people living with HIV (PLWH) to improve adherence to highly active antiretroviral therapy (HAART).Int Conf AIDS. 1998;12:587.

    Google Scholar 

  79. Holzemer WL. Post-Vancouver: implications for nursing practice and nursing research.J Assoc Nurses AIDS Care. 1997;8:62–66.

    CAS  PubMed  Google Scholar 

  80. Ward D, Brown MA. Labor and cost in AIDS family caregiving.West J Nurs Res. 1994; 16:10–22.

    CAS  PubMed  Google Scholar 

  81. Brown MA, Powell-Cope G. Themes of loss and dying in caring for a family member with AIDS.Res Nurs Health. 1993;16:179–191.

    CAS  PubMed  Google Scholar 

  82. Brown MA, Powell-Cope GM. AIDS family caregiving: transitions through uncertainty.Nurs Res. 1991;40:338–345.

    CAS  PubMed  Google Scholar 

  83. Lawless S, Kippax S, Crawford J. Dirty, diseased and undeserving: the positioning of HIV positive women.Soc Sci Med. 1996;43:1371–1377.

    Article  CAS  PubMed  Google Scholar 

  84. Powell-Cope GM, Brown MA. Going public as an AIDS family caregiver.Soc Sci Med. 1992;34:571–580.

    Article  CAS  PubMed  Google Scholar 

  85. Rabkin JG, Ferrando SA. “Second life” agenda. Psychiatric research issues raised by protease inhibitor treatments for people with the human immunodeficiency virus or the acquired immunodeficiency syndrome.Arch Gen Psychiatry. 1997;54:1049–1053.

    CAS  PubMed  Google Scholar 

  86. Hackl KL, Somlai AM, Kelly JA, Kalichman SC. Women living with HIV/AIDS: the dual challenge of being a patient and caregiver.Health Soc Work. 1997;22:53–62.

    CAS  PubMed  Google Scholar 

  87. Stevens PE. Struggles with symptoms: women's narratives of managing HIV illness.J Holistic Nurs. 1996;14:142–160.

    CAS  Google Scholar 

  88. Dunbar HT, Mueller CW, Medina C, Wolf T. Psychological and spiritual growth in women living with HIV.Soc Work. 1998;43:144–154.

    CAS  PubMed  Google Scholar 

  89. Palella FJ, Delaney KM, Moorman AC, et al., and the HIV Outpatient Study Investigators. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection.N Engl J Med. 1998;338:853–860.

    Article  PubMed  Google Scholar 

  90. Stein M, O'Sullivan P, Wachtel T, et al. Causes of death in persons with human immunodeficiency virus infection.Am J Med. 1992;93:387–390.

    Article  CAS  PubMed  Google Scholar 

  91. Seik RM, Chu SY, Ward JW. Trends in infectious diseases and cancers among persons dying of HIV infection in the United States from 1998–1992.Ann Intern Med. 1995; 123:933–936.

    Google Scholar 

  92. Metz SA, Hutchins GM, Bacellar H, Besley D, Kingsley LA, Chmiel JS. A comparison of autopsy and death certificate findings among AIDS-related deaths in the Multicenter AIDS Cohort Study.Int Conf AIDS. 1993;9:659.

    Google Scholar 

  93. Kravcik S, Gilbert L, Hawley-Foss N, Cameron DW. The accuracy of death certificates in HIV infection. Paper presented at: Third National Conference on Human Retroviruses. January 28-February 2, 1996; Washington, DC.

  94. Ron E, Carter R, Jablon S, Mabuchi K. Agreement between death certificates and autopsy diagnoses among atomic bomb survivors.Epidemiology. 1994;5:48–56.

    CAS  PubMed  Google Scholar 

  95. Kravcik S, Hawley-Foss N, Victor G, et al. Causes of death of HIV-infected persons in Ottawa, Ontario, 1984–1995.Arch Intern Med. 1997;157:2069–2073.

    Article  CAS  PubMed  Google Scholar 

  96. Fisher M. Should we be stopping opportunistic infection prophylaxis in the era of HAART?J Infect. 1998;36(3):iv.

    CAS  PubMed  Google Scholar 

  97. Ravaux I, Chadapavd S, Quinson AN, Dahan V, Gallais H. Discontinue primary prophylaxis regimens in selected HIV-infected patients treated with HAART.Int Conf AIDS. 1998;12:340. Abstract 31225.

    Google Scholar 

  98. Furrer H, Opravil M, Bernasconi E, et al. Is it safe to stop primary prophylaxis in patients treated with antiretroviral combination regimens? Swiss HIV Cohort Study (SHCS).Int Conf AIDS. 1998;12:298. Abstract 22180.

    Google Scholar 

  99. Schneider MM, Borleffs JC, Stolk RP, Jaspers CA, Hoepelman AI. Discontinuation of prophylaxis for pneumocystis carinii pneumonia in HIV-1-infected patients treated with highly active antiretroviral therapy.Lancet. 1999;353:201–203.

    Article  CAS  PubMed  Google Scholar 

  100. Miller V, Sabin C, Nisius G, et al. Prognostic value of virus load levels in patients receiving HAART in the Frankfurt HIV-cohort.Int Conf AIDS. 1998;12:37. Abstract 12129.

    Google Scholar 

  101. Easterbrook PJ, Emami K, Gazzard B. The rate of CD4 cell decline and prediction of survival in zidovudine-treated patients.AIDS. 1993;7:959–967.

    CAS  PubMed  Google Scholar 

  102. Selwyn PA, Goulet JL, Molde S, et al. HIV as a chronic disease: implications for longterm, care at an AIDS-dedicated skilled nursing facility.J Urban Health. 2000;77:186–202.

    Google Scholar 

  103. Goulet JL, Molde S, Constantino J, Gaughan D, Selwyn PA. Psychiatric comorbidity and the long-term care of people with AIDS.J Urban Health. 2000;77:212–220.

    Article  Google Scholar 

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Greenberg, B., Mccorkle, R., Vlahov, D. et al. Palliative care for HIV disease in the era of highly active antiretroviral therapy. J Urban Health 77, 150–165 (2000). https://doi.org/10.1007/BF02390527

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