Exam 1 - HIV/AIDS Flashcards
HIV
- human immunodeficiency virus
- a retrovirus that destroys CD4 and T cells
AIDS
- acquired immune deficiency syndrome
- typical untreated HIV infection turns to AIDS in 8-10 years
- severe immune system dysfunction present when AIDS occurs
who has the highest rate of HIV infections
- black men
- men who have sex with men
what is a retrovirus
- a type of virus that uses an enzyme and reverse transcriptase to translate its genetic information into DNA
what causes an individual to be infected for life
- HIV invades CD4+ cells and becomes part of cell DNA
what causes the virus to be present in blood and body fluids
- virus proliferates in infected cells and shed virus particles
what causes antibodies to be a marker of infection but is not protective
- body forms anti-HIV antibodies
what causes compromised cell-mediated immunity
- progressive destruction of helper T cells
what causes opportunistic infection and neoplasms
- immune defense collapses
why is HIV such a problem
- decreases the number of CD4+ T helper cells
- HIV replicates prolifically
- completely overwhelms the body’s defenses
stage 1 - early infection (acute)
- rapid replication
- no symptoms
- infectious
- seroconversion
- antibodies are detectable, flu-like symptoms
- HIGHLY INFECTIOUS
stage 2 - clinical latency (chronic)
- virus levels have stabilized
- body is fighting the infection
- last 3-12 yrs without tx, decades with tx
- asymptomatic or mild symptoms
- rapid virus production
- persistent drop in CD4+ T cell count
stage 3
- symptomatic HIV infection to AIDS
initial symptoms of HIV
- usually happen 2-4 weeks post infection
- flu-like symptoms
diagnosis of AIDS
- must have an AIDS-defining condition
- CD4 count less than 200 cell/mm3
AIDS defining illnesses
- pneumocystis jiroveci pneumonia
- HIV-related encephalopathy
- mycobacterium tuberculosis (pulmonary or extra pulmonary)
- invasive cervical cancer
- kaposi’s sarcoma
- wasting syndrome
- pervasive candidiasis
- AIDS dementia complex
oral manifestations
- seen with falling CD4+ counts
- higher risk of progression to AIDS
- importance of oral assessment *
types of oral manifestations
- fungal
- viral
- bacterial
- cancerous
names of oral manifestations
- oral hairy leukoplakia
- periodontal disease
AIDS dementia complex
- poor concentration, mental slowness
- forgetfulness, memory loss
- changes in behavior
how is HIV transmitted
- sex without a condom
- passed from mother to baby
- sharing injecting equipment
- contaminated blood transfusions and organ transplants
why doesn’t everyone who is exposed develop active infection?
- duration and frequency of contact
- volume, virulence, and concentration of the virus
- host immune status
- genetic protective factors
MOA: NRTIs
- inhibits reverse transcriptase
- blocks the HIV retrovirus ability to incorporate its RNA into the host cell’s DNA
adverse effects: NRTIs
- peripheral neuropathy
- pancreatitis
- lipoatriphy
- hepatic steatosis
blackbox warning: NRTIs
- lactic acidosis syndrome
when should you start ART
as soon as possible after diagnosis
what is the goal of ART
decrease viral load to undetectable level
what is the CD4 count
- tells you how many CD4 cells there are in a drop of blood
- the more the better
what is viral load
- measures how much HIV there is in a drop of blood
- you want to have as little HIV as possible
pre-exposure prophylaxis
- use of antiretroviral medications
- detailed sexual and drug use history to determine risk
- condom use
- determine potential barriers
- can reduce risk of HIV transmission by greater than 90%
post exposure prophylaxis
- recommendations based on exposure and barriers
- ART therapy for 28 days
- HIV testing initially and at 6 and 12 weeks after exposure