CSIM 1.22 Case 41 Launch: A Young Woman from Africa

Question 1

How is HIV transmitted?

Answer 1

• Vertically
  
  • Sexually
  • Blood

Question 2

What is the period between HIV and AIDS?

What is the implication of this?

Answer 2

10 years

The patient feels well during this period, during which seroconversion is occurring and HIV levels are very high. Therefore the patient is very infectious and oblivious.

Question 3

What measurements are used as markers for progression?

Answer 3

CD4 count (T cell receptor)

Viral load

Question 4

What can increase the risk of HIV transmission?

Answer 4

• Ulcerative/inflammatory genital disease

* Viral load (affected by age, viral coinfection)

Question 5

What are the most common features of an acute HIV infection?

Answer 5

• Recurrent opportunistic infections & pneumonia
  
  • Opportunist neoplasms
  • Oral hairy leukoplakia
  • Oral candidiasis

Question 6

What are the common opportunistic infections seen in those with AIDS?

Which other infections are more common in AIDS?

Answer 6

• Pneumocystis pneumonia (PCP)
  
  • Toxoplasmosis
  • Shingles
  • Cryptococcus
  • TB

Question 7

Below what CD4 count are opportunistic infections often seen?

Answer 7

200

Question 8

Which (opportunistic) neoplasms does HIV increase the risk of acquiring?

Answer 8

Virally-induced neoplasms (due to immunosuppressive effect)
  •  Kaposi's sarcoma
  •  Lymphomas
  •  Cervical carcinoma
  •  Hepatocellular carcinoma (hep B)

Question 9

When does HIV transmission from mother to baby occur?

Answer 9

• Third trimester
  
  • During childbirth
  • Breast feeding