Dental relevance of HIV Flashcards
Who was patient 0 or zero
a flight attendant with approx 250 partners/year
affected with Kaposi’s in June 1980
linked by sexual contact to 40 patients
characterised as promiscuous and irresponsible
died of AIDS in 1984
What did GRID stand for
Gay related Immuno Deficiency
What does AIDS stand for
Aquired Immunodeficiency Syndrome
What animal does HIV stem from
Chimpanzees
When do scientists and researchers believe the first transmission of SIV to HIV in humans was
1920
How is HIV transmitted
Unprotected sex
Drug addicts (needles)
Blood transfusion
Pregnancy
Non-sterile instruments
What methods DO NOT transmit HIV
Touching
Through foood
Kissing
Insects
What tests are there for HIV
Oral fluid tests
Direct blood spot
Lab testing
Blood tests
What is the window period for HIV
The point between potential exposure and the point where an accurate test result can be acheived
How can the HIV window period be shortened
Antigen tests and methods to detect viral RNA
Can a person exposed to HIV still test negative during the window period even if they have contracted the disease
Yes
How long is the HIV window period
2-3 weeks
What is ART
Antiretroviral treatment
First version introduced in the 1987
Long term medical treatment (not cure)
Suppresses the virus
Prevents disease from progressing
Saved millions of lives
What is PrEP
Pre exposure profillaxis
Taken by those who dont have HIV but are at risk (sexually active gay men)
What is UNAIDS targets for countries
Requires >95% of people living with HIV to be aware of their status
> 95% with HIV on treatment
> 95% on HIV treatment to be virally supressed
What family of virus does HIV 1 and 2 stem from
Retroviruses
What 2 glycoproteins on HIV attach to the host cell
gp41 and gp120
Where are the glycoproteins found in HIV
In the lipid membrane of envelope
What is the main attachment receptor for HIV
CD4 molecule on macrophages and microglia cells
What are the key stages of the HIV lifestyle
HIV releases genetic material into CD4 cell
Reverse transcriptase copies RNA – DNA
Viral DNA inserted in cell DNA
Many copies of the viral RNA and proteins made
New viral particles assemble and bud from cell
How many HIV particles are produced per day on infection
10 billion
What is the pathology of HIV when untreated
Decline in peripheral blood CD4 lymphocyte count
Wasting disease
Neurological disease
What is the definition of AIDS
AIDS is currently defined as the presence of one of 25 conditions indicative of severe immunosuppression
OR
HIV infection in an individual with a CD4+ cell count of <200 cells per cubic mm of blood
What does having AIDS signify
AIDS is therefore the end point of an infection that is continuous, progressive and pathogenic
What oral lesions are associated with HIV
Oral Candidosis
Hairy Leukoplakia
Kaposi’s sarcoma
Non-Hodgkin’s lymphoma
Periodontal disease
Why are Oral lesions associated with HIV
Severity depends on levels of CD4 count
When should paients be prompted test for HIV
Those not on medication or preventitive messures
Presenting with oral lesions associated with disease
Not already known to have HIV
Patient on immunosuppresant therapy
How Prevelant is HIV in scotland (high risk groups)
5.9% (MSM)
0.7% (PWID)
What regulation was introduced to reduce risk of HIV transmission in dental setting
Health and safety (sharp instruments in healthcare) regulations 2013
What should dental professionals do to prevent spread of HIV
possess adequate knowledge about HIV infection and the significance of oral lesions associated with HIV which may help identify those who would benefit from HIV testing
provide HIV patients with oral healthcare of the highest standards. A focus on routine and preventative care will maintain and improve the quality of life for patients with HIV
Infection control measures should be strictly followed
Dental professionals have a legislative duty to report all sharps injuries and seek appropriate follow up and management as per local policies.
