HIV Flashcards
Is HIV an RNA or DNA virus ?
RNA
What cells are destroyed by HIV ?
CD+4 / T cells
What is the normal CD4 range ?
800-1200 cells/ul
What is the life span of a normal and infected T cell/CD4 ?
- normal: 100 days
- infected: 2 days
At how many CD4+ T cells does immune problems occur ?
below 500 cells/ul
What are the modes of transmission ?
- sex with infected partner
- exposure to infected blood or blood products
- pregnancy, delivery, or breastfeeding
(HIV is fragile outside the body so exposure has to happen quickly for it to survive)
Who is at risk for HIV ?
- received blood transfusion or clotting factors before 1985
- shared needles, syringes, or other injection equipment
- sexually active, inconsistent/no protection with multiple partners
- babies of mothers who have HIV/AIDS
What is viremia ?
large viral levels in blood
Why does viremia occur during initial exposure ?
takes our body a while to create antibodies against the virus
- viremia occurs for 2-3 weeks
- transmission more likely to occur when viral load is high
How long does the acute infection stage last ?
1-3 weeks
What happens in the acute infection phase ?
- CD4 will drop which causes pt to feel flu-like symptoms
- viral load is at it’s highest
How long does it take for the body to build antibodies that can be detected in a positive HIV test ?
3 weeks to 3 months
What are some flu-like symptoms someone in the acute infection phase may feel ?
- fever
- swollen lymph glands
- sore throat
- HA
- malaise
- muscle joint pain
- diarrhea
- diffuse rase
What happens in the asymptomatic chronic infection phase ?
- generally asymptomatic
- CD4 count above 500 (stable)
- viral load is low/plateauted
- most are unaware of infected status and may unknowingly spread the virus
- the best possible phase we can get our patients to stay in
What are some symptoms someone in the asymptomatic chronic infection stage may feel ?
- fatigue
- HA
- low-grade fever
- night sweats
What is the CD4 count of someone who is in the symptomatic infection stage ?
200-500
- viral load is increasing (could happen because they are becoming resistant to their meds)
What are some complications that could happen in the symptomatic infection stage ?
some of these diseases are dormant in the body and then once the pt has HIV it becomes active again
- localized infections
- lymphadenopathy (swollen lymph nodes)
- candida/thrush
- oral hairy leukoplakia
- Kaposi sarcoma
- shingles
What is the CD4 count for someone with AIDS ?
below 200 cells/ul
What does AIDS stand for ?
acquired immune deficiency syndrome
What are some opportunistic infections that happen in those with AIDS ?
- candida (stomatitis, esophagitis, vaginal)
- pneumocystis jiroveci
- herpes simplex virus with chronic ulcers
- toxoplasmosis of the brain
- mycobacterium tuberculosis
- cytomegalovirus (CMV) disease other than liver, spleen, or nodes
What are some opportunistic cancers that happen in those with AIDS ?
- invasive cervical cancer
- Kaposi sarcoma (KS)
- Burkitt’s lymphoma
- immunoblastic lymphoma
- primary lymphoma of the brain
What does the testing for HIV look like ?
it looks for the antibodies to the virus as well as the virus itself
- most diagnostic tests are focused on antibodies
- retesting to confirm is almost always necessary (to be sure it isn’t a false negative)
What kind of precautions are there for prevention of transmission ?
standard precautions
- consider ALL body fluids to be contaminated
- clean blood, body fluids, and surface areas with germicide solution
What are some diagnostic studies for HIV ?
- HIV serum detection of antibodies
- WBCs: neutropenia
- Platelets: thrombocytopenia
- RBCs: anemia (due to disease process & tx)
- the lower the viral load the better
- progression monitored by CD4/T Cell counts and viral load
Why do we use a combination of medications to treat HIV (HAART)?
risk of drug resistance is reduced
- they attack viral replication in different ways
- pt’s need to be ready, financially and emotionally to begin the regimen
What is the reason for PEP medications ?
Post-Exposure Prophylaxis (PEP)
- in case of possible exposure like sexual assault, or needlestick injury
- HAART will be started to reduce risk of infection and protect the pt until testing is confirmed
What is the reasons for PREP medications ?
Pre-Exposure Prophylaxis (PREP) (Truvada-Tenofovir)
- taken daily by high risk individuals to reduce risk of contracting HIV
- like someone whose sexual partner is HIV+
What are some S/E of HIV drug therapy ?
- diarrhea
- peripheral neuropathy pain
- N/V
- fatigue
- insulin resistance which can lead to diabetes and then kidney failure
- bone disease
- cardiovascular diseases
What is the goal for HIV treatment ?
- decrease viral load
- prevent transmission
- raise CD4 counts
- delay symptoms/infections
- prevent opportunistic infection (prophylaxis antibiotics)
