AIDS Flashcards
If the CD4 count is above 500, what sx are likely?
skin disease: seborrheic dermatitis, papulopruritic eruptions, nodular prurigo (may require prednisone)
If CD4 count is under 350 what sx are likely?
pulmonary TB is a risk: lower lobe
What has been the trend in HIV death and dx since 1992?
decreasing, but male (MSM) dx has been increasing since 2009
What happens to the CD4 count early on in HIV infection?
plummets within 6 wks of infection, rebounds from 6-12 wks but not to pre-infection levels
When do anti-HIV Ab starts to appear?
6-12 wks post-infection
What happens to the viral load at 0-6 wks post-infection? 6-12 wks? Beyond?
0-6 wks: increases rapidly
6-12 wks: starts to fall
stays very low for several yrs then begins to rise –> CONSTITUTIONAL SX –> opportunistic infections –> death
Do males or females have a higher prevalence of HIV?
males
goals of antiretroviral tx:
suppress HIV-1 replication
prevent deadly destruction of immune system
achieve normal survival
When should you begin tx for HIV?
if they are symptomatic treat no matter what the CD4 level is
if asymptomatic: tx when CD4 is 350 or less
concerns about early tx
drug-related tox.
non-adherence
drug resistance
cost
When do you rapidly initiate tx?
pregnancy AIDS-defining disease acute opportunistic disease low CD4 ct acute/recent infection rapid CD4 decline high viral load HBV or HCV coinfeciton
When do you defer ART?
barriers to adherence,
certain comorbidities
long term non-progressors
AIDS defining illness
kaposi sarcome
AIDS assoc. illness
oral hairy leukoplakia thrush lymphadenopathy esophageal candidiasis toxoplasmosis PML CMV retinitis MAI, MAC
