[Exam 1] Chapter 36: Management of Patients with HIV Infection and AIDS (Page 1025-1053) Flashcards
HIV-1 is transmitted by
body fluids containing HIV or infected CD4 lymphocytes
fluids include blood, seminal fluid, vaginal secretions, and breast milk
HIV: Most prenatal infections occur during
Delivery
HIV: And Casual Contact
Does not cause transmission
HIV: Breaks in skin or mucosa increases
risk
HIV and Gerontologic Considerations: signs of HIV/AIDS can be mistaken for
the aches and pains of normal aging
HIV and Gerontologic Considerations: Older adults living with HIV/AIDS also experience development of other comorbidities such as
cardiovascular disease, and diabetes
HIV and Prevention: In order to prevent the spread of HIV during intercourse, what can be done?
Pre-Exposure Prophylaxis (PrEP) involves taking one pill containg two HIV medications daily in order to avoid risk of sexual HIV acquisiton.
HIV and Prevention: Women who are pregnant can take this to reduce perinatal HIV transmission
ART. Should also not breast-feed their infants
Preventiion for Health Care Workers
Hand Hygiene
PPE
Soiled Patient Care Equipment Handling
environmental Control
Textiles and Laundry
Needles and Other Sharps
Patient REsuscitation
HIV and Health Care PRovider Treatment: If exposed, what must be done?
Post-Exposure Prophylaxis (PEP) includes taking antiretroviral medicine as soon as possible but no more than 3 days after exposure. 2-3 drugs prescribed must be taken for 28 days
STages of HIV Disease
Primary Infection
HIV Asymptomatic
HIV Symptomatic
AIDS
HIV Patho: HIV is a retrovirus because
it carries its genetic material in the form of RNA
HIV Patho: Illness is closer when caused by
HIV-2, which is more common in WEstern Africa
HIV Patho: What cna be done to screen for HIV-1?
Blood tests
HIV Patho: HIV cosnsits of a viral core contianing viral RNA surrounded by an envelope cosisiting of protruding
glycoproteins
HIV Patho: Virusees target cells with
CD4 receptors, which are expressed on surface of T Lymphocytes, Monocytes, Dendritic Cells, and Brain Microglia
HIV Patho: Stage 0, known as acute/recent infection, attacks T Cells how?
USe chemokine cell receptor molecule CCR5 to entry to T cells in addition to CD4 REceptors
HIV Patho Life Cycle: (1) Attachment / Binding Stage
First step, GP 120 and GP 41 glycoproteins of HIV bind with CCR5 which results in fusion of HIV with CD4
HIV Patho Life Cycle: (2) Uncoating / Fusion
Two strands of RNA nd three vital enzymes (reverse transcriptase, integrase and protease) emptied in here
HIV Patho Life Cycle:(3) DNA Syntehsis:
HIV changes its genetic material from RNA to DNA
HIV Patho Life Cycle: (4) Integration
New Viral DNA enters nucleus of CD4 and bleds with DNA of CD4
HIV Patho Life Cycle: (5) Transcription
When Cf4 T is acivated, DNA forms isngle stranded RNA which builds new viruses
HIV Patho Life Cycle: (6) TRanslation
MRNA creates chains of new proteins and enzymes
HIV Patho Life Cycle:(7) Cleavage
HIV protease enzyme cuts the polyprotein chain into the indivudual protein
HIV Patho Life Cycle:(8) Budding
New proteins and viral RNA migrate to the memrbane o fthe infacted CD4 and exit the cell
Hiv Patho: REsting CF4 T Cells can be stimuled to produce new particles if
something activates them, such as another infection
Hiv Patho: Whenevr the CD4 is activated, HIV replication and budding occur which..
can destroy the host cell. Newly formed HIV released into blood can infect over CD4 cells
Hiv Patho: Calculasins may have a mutation of CCR5, which may leave them
protected against HIV infection even if exposed
Hiv Patho: What determiens T Cells influence on HIV Acquisition?
CCR5
How many stages are there of HIV infection?
Five
Stages of HIV Infection: Period from infection with HIV to development of HIV specific antibodies is known as
primary infection or acute HIV infection and is part of stage 0
Stages of HIV Infection:Acute HIV infection is the inerval between
appearance of detectable HIV RNA and first detection of antibodies
Stages of HIV Infection:Primary or acute infection is characterized by
high levels of viral replication, widespread dissemination of HIV throughout the body, and destruction of CD4 T Cells.
Stages of HIV Infection:What is Viral Set Point?
The amount of virus in the body after the initial immune response subsides
Results in equilivrium betwee HIV levels and the immune response.
Stages of HIV Infection: The higher the set point, the poorer the
prognosis
Stages of HIV Infection:Stage 2 occurs when
CD4 T Lymphocytes are between 200 and 499 stages.
Stages of HIV Infection:Stage 3 occurs when
count drops bellow 200 cells . At this point, patient is considered to have AIDS for survillence purposes.
Primary Infection: PArt of CDc Categorry
A
Primary Infection: Symptoms are
none to flulike syndrome
Primary Infection: WIndow PEriod is
lack of HIV antibodies
Primary Infection: THis is a period of
rapid viral replication and dissemination through the body
HIV Asymptomatic: CDC category is
A
HIV Asymptomatic: How many T Lymphocytes / MM^3 do youhave?
> 500
HIV Asymptomatic: Upon reaching the virsl set point, what happens?
Chronic asymptomatic state begins
HIV Asymptomatic: Body has sufficent immune response to defend against
pathogens
HIV Symptomatic: CDC category
B
HIV Symptomatic: T Cell Count is between
200-499
HIV Symptomatic: CD4 T Cells grdually
fall
HIV Symptomatic: Patient develops symptoms or conditions releated to the HIV infection, which are not classified as
Category C infections
HIV Symptomatic: Patients who are once treated for Category B condiiton are considered
Category B
AIDS: CDC category
C
AIDS: How many T Lymphocytes?
< 200
AIDS: What happens as levels drop below 100?
Immune system is significantly impaired
Gerontology Considerations: what percentage of populcation over 50 hasHIV?
25%
Gerontology Considerations: Reasons for high number of cases in this population?
Unprotected Intercourse
Dont consider themselves a risk
Social bias toward homosexuality
MAy use IV drugs
May have received HIV infected blood before 1985
REduction in immune system function
HIV Tests: What is used to determine if HIV infection is recent or ongoing?
Serologic Testing Algorithm (STARHS)
HIV Tests: What are the three types of HIV diagnostic tests?
Anti-body tests, antigen/antibody tests, and nucleic acid (rna) tests