HIV Flashcards
Which cells does HIV attack?
CD4 T cells
WBC
How can vertical transmission of HIV be decreased?
Antiretroviral treatment (ZDV) during pregnancy
Blood transfusion or contaminated needles would be an example horizontal or vertical transmission.
horizontal transmission
- What is pneumocystis jiroveci pneumonia (PJP)?
- funal infection of the lungs
Acquired perinatally
What is length of treatment of pneumocystis jiroveci pneumonia (PJP) prophylaxis?
Begins by 4 weeks of age and continues until 1 year for HIV(+) or D/C for confirmed HIV(-)
What is the difference in infection time and AIDS diagnosis b/w children and adults?
1 year in children vs 10 years in adults.
Name 4 out 7
What are the clinical manifestations HIV/AIDS
- Lymphadenopathy (swollen lymph nodes)
- Hepatosplenomegaly (liver and spleen enlargement)
- Oral candidiasis (thrush)
- Parotitis (inflammation of parotid gland)
- Chronic or recurrent diarrhea
- Failure to thrive
- Developmental delays
Which test is not accurate in diagnosing HIV in children under 18 months of age?
Why?
ELISA or Western Blot
False positive may result from detecting maternal antibodies
How often is an infant tested for HIV if they are exposed?
First PCR test, repeat at 1 to 2 month, and again at 4 to 6 months.
May confirm absence with HIV antibody assay at 12-18 months of age
What is the treatment course for a baby born to an HIV+ mother?
- Whether the initial PCR test confirms/denies infancy HIV status, they are put on ZDV.
- If there PCR comes back positive at 4 to 6 months other medications would be added w/ ZDV. If negative ZDV is removed.
What are the four clinical stages of HIV?
- Stage N (infected but asymptomatic)
- Stage A (mild symptoms)
- Stage B (moderate symptoms)
- Stage C (severe symptoms)
Can only progress in stages, can’t go back a stage
What are the three immunological stages of HIV?
- Stage 1 = no evidence of suppression
- Stage 2 = moderate suppression
- Stage 3 = severe supression
suppression of immune system
What are the immunological stages of HIV based on?
CD4 count or percentage
CD4 = CD4 T lymphocyte
What are the immunological stages of HIV affected by? Why?
age, CD4 counts and % are higher in younger children.
Why is it important to assess for CD4+ counts/percentages?
- Infected immune system’s response to therapy
- Risk for disease progression
- Need for PJP prophylaxis beyond 1 yr. of age
When is an elective cesarean indicated for HIV+ pregnant woman?
women with an HIV viral load of > 1000 copies/ml.
What the management of HIV+ women for vaginal delivary?
Administration of antiretroviral prophylaxis (ZDV) during pregnancy **and labor **and to the infant for 6 weeks after birth.
IV ZDV, if ZDV was not administered during pregnancy.
Which tanner stage does the dosing change from pediatric to adult dose?
- Tanner 1 and 2 – Pediatric dosing
- Tanner 3 to 5 – Adult dosing
Which antiretroviral should be avoided during pregnancy?
efavirenz
What does the regimen for ART consist of?
Two NRTI’s and one of the following:
* Protease Inhibitors (PI)
* Non-Nucleoside Reverse Inhibitors (NNRI)
* Integrase Strand Transfer Inhibitors (ISTI)
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
What is the rationale for NOT using several drugs from 1 category of Antiretroviral for treatment?
Minimize viral resistance to the drugs
Which vaccines need a CD4 % of ≥ 15 in order to be administered to children with HIV+?
All other vaccines do not need this requirement
MMR and Varicella
Measles, mumps, rubella and chickenpox
