Global HIV/AIDS Medicine

Editors: Paul A. Volberding, Merle A. Sande, Joep Lange and Warner Greene

Associate Editor: Joel Gallant

Saunders Elsevier, New York (2008)

Paperback, 830 pages, including index

ISBN 978–1–4160–2882–6

This comprehensive text is the reincarnation of a book to which many of us have referred, ‘The Medical Management of AIDS’. This first edition of Global HIV/AIDS Medicine extends the focus, as its title suggests, by addressing not only state of the art medical care for those with HIV infection in the developed world but also the global challenges of the HIV epidemic.

The editors are from what I would describe as the top shelf of experts in the field and are all well known to all those taking care of patients with HIV infection. Sadly, Merle Sande, one of the editors, died in November 2007 aged 68 years, as a result of multiple myeloma. An infectious diseases physician, a friend and a colleague, he has been described as ‘an impatient visionary’ and an ‘AIDS pioneer’. He was Chief of Medical Services at San Francisco General Hospital from the early 1980s when the HIV epidemic took hold and among many other contributions established with his colleagues the principles of ‘universal precautions’ that were published in the New England Journal of Medicine in 1983.

Global HIV/AIDS Medicine comprises 71 chapters and ~800 pages, and is divided into six sections, covering the epidemiology and biology of HIV infection, prevention, diagnosis and treatment, management of diseases associated with HIV infection, prevention and management in both resource-rich as well as resource-limited settings, and the economic and social consequences of the HIV epidemic. There is a section of ~20 chapters dealing solely with prevention and management of HIV infection in resource limited settings, which addresses problems associated with malnutrition, challenges and logistics of making antiretroviral therapy affordable and available, the impact of malaria and HIV co-infection and pharmacoeconomics of providing treatment in these settings. I would have liked to see a chapter dealing with algorithms for clinical management of patients with HIV infection in resource limited settings who present with e.g. neurologic symptoms and signs, or respiratory infections or diarrhoea. Although there was a chapter on diarrhoea, with a simplified approach for management, it did not provide an algorithm that led to a treatment recommendation that could be used by a clinician with limited experience.

The book contains a large amount of practical information such as advice given in the chapter on the HIV-infected traveller which includes vaccination recommendations, a check list of what to take with you when travelling, useful resources for travellers etc. Similarly the chapter on women and HIV infection is also practical and useful, containing tables that remind clinicians of important primary care issues for women, differences in CD4 and viral load results in women compared to men, etc.

A big advantage of this book is that the editors (Paul Volberding, Joep Lange, Merle Sande and Warner Greene) have sufficient clout to have been able to draw together a cadre of highly respected physicians and scientists from around the world as authors, including Donald Abrams, Elly Katabira, Dick Chaisson, Bruce Walker, Julio Montaner, John Bartlett, the Greenspan duo of Deborah and John, Mark Wainberg, David Cooper, Steve Deeks, Kevin de Cock and Kate Hankins. This has resulted in many instances with the world expert of a subject being the author of that chapter. Another advantage is that the book is attractively presented and information is provided concisely in many chapters in useful tables and figures. However, when reading the section on new HIV drug development, which includes drugs such as etravirine and raltegravir (using earlier nomenclature) I noted the references ceased at 2005. This prompted me to check other chapters, e.g. on immune reconstitution and hepatitis, where the most recent references were from 2006 and vaginal microbicides where the most recent references were from 2005. This creates a concern for me as the field is rapidly moving and too much has changed during the time it has taken for publication of the book in 2008.

The book would appear to me to be aimed at an audience of clinicians treating patients with HIV infection rather than students. I think it is likely it will appear on the shelf of all hospital infectious diseases units and primary care clinicians who treat HIV infection.

Professor Suzanne Crowe

Macfarlane Burnet Institute for Medical Research and Public Health