3. HIV Flashcards
How is HIV Spread?
- Sexual Transmission
- Injection Drug Misuse
- Blood Products
- Vertical Transmission
- Organ Transplant
Can you test unconscious patients for HIV?
Yes, if you think it is in the patient’s best interest
What does the HIV infection do to the immune system?
It infects and destroys cells of the immune system, especially the T-Helper cells that are CD4+
What does a T-Helper Cell, that is CD4+ mean?
The T-Helper Cell has a CD4 receptor on its surface
Are CD4 receptors exclusive to lymphocytes?
No, they are also present on the surface of:
1. Macrophages and Monocytes
2. Cells in the Brain
3. Cells in the Skin
and many other sites
Over the course of the HIV infection, what happens to the
1. CD4 count?
2. HIV Viral load?
- The CD4 count declines
- The HIV Viral load increases
Over the course of the HIV infection, what happens to the risk of developing infections / tumours?
They increase
How does the severity of the illness relate to the CD4 count?
The severity of the illness is greater, the lower the CD4 count
At what CD4 count do most AIDS diagnoses occur at?
Less than 200
What does a low CD4 count, allow for?
Opportunistic infection
What are Opportunistic infections?
Pathogens which are capable of causing infection only when the host defences are compromised
In HIV, what are the 2 categories of Opportunistic infections?
- New infections (e.g. PCP, cryptosporidiosis)
- Re-activation of existing infection (e.g. toxoplasmosis CMV)
What are the most common New Opportunistic Infections, in HIV?
- Pneumocystis Jiroveci Pneumonia
- Candidiasis
- Mycobacterium Avium Complex
- Cryptosporidiosis
What are the most common Re-Activated Opportunistic Infections, in HIV?
- Cerebral Toxoplasmosis
- Tuberculosis
- CMV disease
What is the natural history of HIV infection?
- Acute infection - seroconversion
- Asymptomatic HIV
- HIV related illness
- AIDS defining illness
- Death
What is the CD4 count between in Asymptomatic HIV?
400+
Note - Normal is 1000-1500
What happens as the CD4 count drops below 350?
- Thrust is likely
- Skin changes
What happens as the CD4 count drops below 200?
Other opportunistic infections can arise:
1. PCP
2. TB
3. Cryptospondiosis
4. Kaposis Lymphoma
5. Toxicoplasmosis
6. Cryptococcal Meningitis
7. CMV, MAC
What is a Seroconversion Illness?
When HIV antibodies first develop
What are the symptoms of Primary HIV (Seroconversion Illness)?
Like Glandular Fever, but EBV Serology is not in keeping:
1. Flu-like illness
2. Fever
3. Malaise / Lethargy
4. Pharyngitis
5. Lymphadenopathy
6. Toxic Exanthema
How is the length of duration of this illness calculated?
- If had a seroconversion illness then date is from then
- Test stored samples of blood (if available)
- Considering when the patient was at most risk