HIV Flashcards
What are features of early stage HIV?
Generalised lymphadenopathy
Skin disorders: seborrhoeic dermatitis, eosinophilic folliculitis, psoriasis
What are complications of HIV if CD4 count 200-500?
Worsening skin disorders
Recurrent herpes simplex
Herpes zoster (multi-dermatomal)
Weight loss and diarrhoea
Community acquired pneumonia
What are complications of HIV if CD4 count 50-200?
Oral and oesophageal Candidiasis
Cervical dysplasia
PCP pneumonia
Kaposi Sarcoma, lymphoma
Mycobacteria Avium Intracellulare
Histoplasmosis
What are complications of late stage HIV - CD4 count <50?
Cervical cancer
CMV retinitis
Disseminated Mycobacterium avium intracellulare
Cerebral Toxoplasmosis
Who should be tested for HIV?
All those who present to health care with a condition where HIV is a differential
All those who belong to a group with high prevalence of HIV
When is HIV anti-retroviral therapy started?
ASAP regardless of CD4 count
How does antiretroviral therapy work?
Suppress virus to allow immune reconstitution
What is the mainstay of treatment for HIV?
Triple therapy (HAART)
What are behavioural prevention strategies for HIV?
Condoms
Abstinence
Sero-sorting
What are medical prevention strategies for HIV?
Circumcision
TASP (treatment as prevention)
Prevention of mother to child transmission
PEP/PEPSE (post-exposure prophylaxis)
PREP (pre exposure prophylaxis)
What are factors that increase occupational risk HIV transmission?
Deep injury
Visible blood on device
Injury with needle been in artery or vein
Large volume blood transfusion
How is mother to child transmission prevented?
Women with VL<40 (undetectable) can deliver vaginally - infants have 1 month Zidovudine as PEP and HIV tests till 18mths
Use of HAART to suppress viral load in mum
No breastfeeding
What are the aims of PEP?
Reduce the replication & dissemination of HIV into tissues following HIV exposure
When is PEP given?
Give PEP within 72 hrs (earlier the better; in case of needlestick injuries, initiation within an hour is ideal) and continue for 4 weeks
What is the aim of PREP?
Taking antiretrovirals prior to risky sexual exposure
