Clinical features of HIV and AIDS Flashcards
What are the 2 markers used to monitor HIV infection?
CD4 cell count
HIV viral load
What kind of rash can sometimes be seen in acute HIV?
Symmetrical maculopapular rash
What would a rash involving palms and soles be a warning of?
Secondary syphilis
What does a maculopapular rash look like?
Raised red lumps
How long does it take from point of infection to developing symptoms in acute HIV?
2-4 weeks
What are some factors to consider to flag possible HIV?
Tattoos, injected drugs, sexual partners, condom-use
What are the most common symptoms in acute HIV?
Fever, fatigue, myalgia, rash and sore throat. Sometimes aseptic meningitis.
In a patient with fever, rash and non-specific symptoms then…
Ask about sexual history
Think of HIV seroconversion
What is clinical latency?
No symptoms. May notice some enlarged lymph nodes (persistent generalised lymphadenopathy)
CD4 cell population increases and viral load temporarily decreases but then CD4 population slowly declines until the person is immunosuppressed - opportunistic infections
What are common symptoms when CD4 cell begins to get moderately low?
Shingles (in HIV normally more sever and can be multidermatomal)
Oral candida
Oral hairy leucoplakia (similar to thrush but can’t be scraped off. Caused by EBV)
Molluscum contagiosum
Think about doing a HIV test when faced with a common problem when…
It present in an unexpected patient
It is recurring
No clear underlying cause
What is AIDS?
Acquired Immune Deficiency Syndrome
When CD4 count is less than 200
What is PCP and its symptoms
Pneumocystis Pneumonia (fungal pneumonia)
Exertional drop in oxygen saturations, Fevers, SOB, dry cough, pleuritic chest pain
How to diagnose PCP
Get an induced sputum sample - patient inhales nebulised saline to acquire sputum (needs to be a “deep” sample). Sent for PCR
What is the first line treatment for Pneumocystic Pneumonia (PCP)?
Co-trimoxazole (which is 2 antibiotics: trimerthoprim + seulfamethoxazole)
PCP is the most common o______ infection
opportunistic
What are some AIDS defining illnesses? (slide 34)
All patients with __ require a HIV test
TB
How to diagnose TB
Sample for Acid Fast Bacilli staining
TB CNS presentations
Tuberculoma, Ocular TB, TB meningitis
Tuberculoma
Ocular TB
TB meningitis
CNS presentations in HIV
CNs Lymphoma, CNS Toxoplasmosis, CMV retinitis, Ocular Toxoplasmosis
CNS Lymphoma (slide 37)
CNS toxoplasmosis (slide 37)
CMV retinitis (slide 38)
Ocular Toxoplasmosis (slide 38)
Cryptococcal Meningitis (slide 39)
Low threshold for l_____ p______ in a patient with HIV and headahce
lumbar puncture
HIV increases the risk of any cancer. Name some AIDS defining cancers
Kaposi’s sarcoma
Lymphomas
Cervical
Women who are known to have HIV should…
have annual smear test due to the risk of cervical cancer
Kaposi’s sarcoma (slide 42)
What is HAART?
Highly Active Anti-Retroviral Therapy
Aim to reduce viral load to undetectable levels and increase CD4 count
Is there a vaccine or cure for HIV?
Not yet
Slide 45
What will the HIV specialist take into account when putting together a regime?
Viral resistance, other medications, lifestyle, co-infections
Slide 47
With current HAART regimes, HIV infection is…
an entirely manageable condition with a good prognosis
Slide 49
Many drugs interact with antiretrovirals and therefore cause…
subtherapeutic levels of the HIV drugs. HIV can then replicate
Slide 51
Good adherence and avoidance drug interactions are key to:
Suppress HIV replication
Avoid drug resistance
