HIV Flashcards
HIV
human immunodeficiency virus
AIDS
acquired immunodeficiency syndrome
aka late-stage HIV
type of virrus
RNA retrovirus
what does virus do
enter and destroy CD4 T helper cells
clinical course
- initial seroconversion flu-like illness within few weeks infection
- asymptomatic
- progress until become immunocompromised
- AIDS-defining illness
transmission
unprotected sex
mother to child (vertical)
mucous membrane, blood, open wound exposure to infected blood/body fluids
AIDS defining illness - examples
Kaposi's sarcoma pneumocystitis Jirovecii pneumonia (PCP) CMV candidiasis - oesophageal, bronchial lymphoma TB
monitring
CD4 count
viral load
monitoring - CD4 count
normal = 500-1200
< 200 = AIDS, high risk opportunistic infectoins
monitoring - viral load
undetectable = 50-100
viral load can be 100,000s in untreated HIV
who is offered antiretroviral therapy (ART)
everyone with HIV diagnosis
regardless of CD4 and viral load
initial starting regime of ART
2 NTRIs (e.g. tenofovir + emtricitabine) plus another agent
aims of ART
normal CD4 count
undetectable viral load
classes of ART for HIV
protease inhibitiors
integrase inhibitors
nucleoside reverse transcriptase inhibitors
non-nucleoside reverse transcriptase inhibitors
entry inhibitors
additional Mx - PCP prophylaxis
co-trimoxazole is given to all patients with CD4 < 200 to protect against PCP
additional Mx - smear tests
yearly cervical smears needed
HIV predisposes to HPV infection + cervical cancer
additional Mx - vaccinations
annual influenza pneumococcal Hep A Hep B tetanus diptheria polia
avoid live vaccines
advice - sex
condom use even if both partners positive
regular HIV testing
pregnancy and childbirth
CS used unless undetectable VL
consider vaginal birth if VL undetectable
newborns to HIV + mums
ART for 4wks after birth to reduce vertical transmissino.
breastfeeding considered if VL undetectable although it is high risk
Post exposure prophylaxis - when
< 72hrs post exposure
Post exposure prophylaxis - regime
truvada + raltegravir for 28days
serooconversion illness features
sore throat lymphadenopathy malaise, myalgia, arthralgia diarrhoea maculopapular rash mouth ulcers rarely meningoencephalitis
