Evidence base of HIV medicine has evolved extremely rapidly in recent past globally, so much so that by the time the knowledge is accumulated in form of a chapter of a book, new evidence will await at the corner. A wealth of information is available on-line, in form of various guidelines and updates. Though crucial, often the on-line information baffles the end users, especially busy clinicians, to choose and apply the knowledge while managing the patients in the clinics. The clinicians deal with diversified situations in practice viz establishing the diagnosis of HIV, when to initiate the anti-retro viral treatment, what anti-retro viral drug combinations will be the most suitable for the patient, how to identify and manage the toxicities of the anti-retro viral drugs, prophylaxis and treatment for the opportunistic infections, management of coinfections, comorbidities and malignancies, prevention of transmission of HIV to others especially from mother to child and also after occupational exposure to infected materials, and palliative care or end of life care for those who need it. The widely available online information often seems in sufficient to aid a treating physician when managing an actual case in a clinic or hospital.

This book is a prudent attempt to match the requirements of those clinicians and practitioners who desire to know a snapshot of vast recent knowledge out there that can benefit them in managing HIV in their clinics or hospitals. Authors of each chapter of this book have displayed dazzling skills by spelling out often complicated and difficult concepts around HIV diagnosis and management in a way that will assist clinicians, practitioners, students, program managers, and others interested, while approaching the HIV infection. I hope the enthusiasm expressed by the team of authors is translated in practice. My best wishes are with the team.

I congratulate Dr Atul Kakar for this great book and the work he is doing for care and support to those infected and affected by HIV/AIDS.

The HIV epidemic has seen three major clinical themes over the past few years. According to many authors, the first decade started in 1981, when we use to treat only the opportunistic infection, manage the crisis and HIV management was limited to palliation provided by primary healthcarers. However, from1991 onwards, with the availability of anti-retro viral therapy, the focus has become more on specialized medicine given by HIV specialists who have a better understanding of viral pathogenesis. From 2001 to 2011, we were in a chronic disease era for HIV management. This also included managing the effects of HIV on the kidney, liver, central nervous system, heart and bone.

Malignancies in people living with HIV/AIDS have also become another area of concern in the last few years. Even nearly two decades into the modern anti-retro viral (ARV) era, the risk of death continues to drop for people living with HIV. Many things resulted in a change in the lives of patients with HIV/AIDS.

These are enumerated below:

Last but not least, we would like to thank Mr Parmanand Tiwari, Junior Executive, in our hospital who has helped us right from the beginning to the completion of this important publication.