1.3a Immune Flashcards
External Factors:
External Factors:
nutritional status, chemical exposure, UV radiation, and environmental Pollution
Internal Factors:
Internal Factors:
Genetics, functioning of neurological and endocrine systems, chronic illnesses, variations on our anatomy and physiology
Increased morbidity and mortality related to infections
Increase in cancer and autoimmune disorders
The Patient with H I V Infection
what is it
Human immunodeficiency virus (H I V)
Progresses to acquired immunodeficiency syndrome (AIDS)
Final, fatal stage of H I V
Retrovirus
Spread by direct contact with infected blood and body fluids
Blood, semen, vaginal secretions, cerebrospinal fluid
Not spread by casual contact
The Patient with H I V Infection
Behavioral risk factors
Behavioral risk factors Unprotected anal intercourse Heterosexual intercourse Injection drug use Needle and paraphernalia sharing Small occupational risk of health care providers
Manifestations of H I V
May be overlooked by healthcare providers Delay in care and treatment Asymptomatic to severe immunodeficiency Multiple opportunistic infections Fever Sore throat Malaise Arthralgias and myalgias Headache Rash
Manifestations of AIDS
H I V progresses to AIDS CD4-T cell count <200 mcL General malaise Fever Fatigue Night sweats Involuntary weight loss Skin dryness, rashes, diarrhea, oral lesions (hairy leukoplakia, candidiasis, gingival inflammation and ulcerations)
Neurologic Effects of H I V
HAND
H I V-associated neurocognitive disorders (H A N D)
Complex neurologic manifestations of H I V
Motor function and cognitive function affected
Neurologic Effects of H I V
Inflammatory, demyelinating, degenerative changes
Neurologic Effects of H I V
HAD
H I V-associated dementia (H A D; formerly AIDS dementia complex) Late complication of H I V Fluctuating memory loss Confusion Apathy (lack motivation to do anything or just don't care about what's going on around you) Diminished motor speed Lethargy Difficulty concentrating
Opportunistic Infections Associated with H I V
Most common manifestations of AIDS
Risk predictable by C D4 T-cell count
<200/m c L opportunistic infections and cancer likely
Opportunistic Infections Associated with H I V
Most common
Pneumocystis pneumonia (serious infection caused by the fungus Pneumocystis jirovecii. Most people who get PCP have a medical condition that weakens their immune system, like HIV/AIDS, or take medicines (such as corticosteroids) that lower the body's ability to fight germs and sickness.) Most common opportunistic infection
Opportunistic Infections Associated with H I V
Tuberculosis
Tuberculosis
Reactivation of prior infection
Leading cause of death among those with H I V
Opportunistic Infections Associated with H I V
Other
Other infections
Toxoplasma gondii
Cryptococcus neoformans
Candida albicans
Secondary Cancers to H I V Kaposi Sarcoma (K S)
Kaposi Sarcoma (K S)
Seen in fewer than 1% of patients with H I V due to antiretroviral therapy (A R T)
Herpes virus transmitted through sexual contact
Vascular macules, papules, or violet lesions
Secondary Cancers to H I V
Lymphomas
Lymphomas
Malignancies of lymphoid tissue
Late manifestation of H I V
Secondary Cancers to H I V
Cervical Cancer
Cervical Cancer
Frequently develops in women with H I V
Pap smear every 6 months
Other Conditions Associated with H I V/AIDS
Cardiovascular
Cardiovascular complications
Coronary heart disease
Dyslipidemia
Other Conditions Associated with H I V/AIDS
Hepatic
Hepatic complications
90% of patients with H I V are also infected with H B V
A R T may have negative affects on liver
Other Conditions Associated with H I V/AIDS
nephropathy
H I V - a s s o c i a t e d nephropathy
Disproportionately affects African-Americans and Hispanic/Latinos
Excessive protein in urine, nitrogen in blood
Glomerular lesions
Diagnosis of H I V
H I V rapid antibody test
H I V rapid antibody test: finger prick used to provide blood sample for antigen test strip; turns color if positive antibody present and takes <30 minutes.
Diagnosis of H I V
Enzyme-linked immunosorbent assay (E L I S A)
Enzyme-linked immunosorbent assay (E L I S A): Most common screen test. Only detects antibodies, not virus. Can have false negative if done prior to 13 weeks from infection
Diagnosis of H I V
Western blot antibody testing
Western blot antibody testing: Blood serum mixed with HIV proteins to detect antibody/antigen reaction. 99.9% sensitive if done with ELISA test
Diagnosis of H I V
viral load testing
H I V viral load testing: Measures amount of active replicating HIV. Correlates with disease progression/treatment effectiveness
Diagnosis of H I V
C B C
C B C: checks for anemia, leukopenia, and thrombocytopenia