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Nutrition 452 > HIV > Flashcards

HIV Flashcards

1
Q

WHat is AIDS

A

acquired immunodeficiency syndrome - a condititon in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections

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2
Q

Modes of transmission of HIV

A

sexual transmission
sharing of needles
pregnancy or breastfeeding
blood transfusions (decreased to almost nothing)

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3
Q

Clinical symptoms of HIV/AIDS

A 
difficult or painful swallowing
nausea
mouth ulcers
severe and persistent diarrhea
sweats
weight loss
vision loss
vomiting
fever
mental symptoms
seizures
swollen lymph glands
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4
Q

Diagnosis of HIV

A

CD4 cell count in blood - common laboratory test <200

Detection of HIV antibodies - negative for first three months

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5
Q

Recommendation for testing

A

People at high risk should be screened at least annually

Should be included in the routine panel of prenatal screening tests

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6
Q

What is immunity?

A

Used by the body as protection against environmental agents that are foreign to the body

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7
Q

Beneficial effects of the immune system

A

protection from invaders

elimination of altered self

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8
Q

Detrimental effects of the immune system

A

Discomfort and collateral damage (inflammation)

Damage to self (hypersensitivity or autoimmunity)

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9
Q

The innate immune system is the….

A

First line of defense (non specific)

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10
Q

What races are Aids increasing disproportionately in?

A

African Americans and Latino Americans

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11
Q

Characteristics of acquired ammunity

A

Lag time
Development of Memory
Antigen specific

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12
Q

Characteristics of innate immunity

A

No lag time
No specific antigens
No memory

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13
Q

HIV has been increasing disproportionately in which populations?

A

African americans and Latinos

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14
Q

Characteristics of Innate immunity

A

no lag time, not antigen specific and no memory

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15
Q

Characteristics of acquired immunity?

A

A lag period
Antigen specific
Development of memory

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16
Q

Innate host defenses against HIV infection

A

Surface/mechanical barriers
Humoral components
Cellular components

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17
Q

What are humoral components?

A

complement
coagulation system
cytokines

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18
Q

What are the cellular components?

A

Neutrophils - phagocytosis and intracellular killing, inflammation and tissue damage

Monocytes and macrophages- phagocytosis and intracellular killins, extracellular killing of infected or altered self, tissue repair, antigen presentation

NK cells- killing of virus infected and altered self targets

Eosinophils - killing of parasites

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19
Q

What cell does the HIV retrovirus enter?

20
Q

What does the HIV retrovirus do once it enters the cell?

A

It converts it’s RNA to DNA via reverse transcriptase

21
Q

What are the characteristics of the HIV virion?

A
  1. Envelope - lipid membrane, gp120, gp41

2. Core - RNA, reverse transcriptase, integrase and protease

22
Q

The cycle of HIV

A
  1. Viral entry
  2. Viral transfer
  3. Viral exit
23
Q

How does the virus enter the cell?

A
  • Hiv binds to cell
  • GP120 binds to CD4
  • It fuses with the cell and injects it core
24
Q

What is the 7 steps of the viral transfer?

A
  1. Reverse transcriptase makes single-strand DNA copy of the vrial RNA
  2. DNA polymerase of the host makes second DNA copy
  3. It integrates into cellular DNA
  4. RNA is translated into viral proteins
  5. Protease cleaves the vrial enzymes
  6. Proteins and RNA are assembled into new virions
25
What is the viral exit?
The virus buds from the cell surface
26
What cells do the virus attack after invasion?
White blood cells - T helper lymphocytes (CD4) -it destroys cells, takes over their function, to life weakens the immune system and this increases the vulnerability to life-threatening illnesses
27
What cells produce antibodies?
B lymphocytes
28
What is the HIV classification system?
Based on immune function and clinical status -A number (1 2 or 3) that is reflective of CD4 count and a letter (A B or C) reflective of clinical status -It provides prognostic information about where the patient fits along the continuum of illness and what conditions they may be at risk for A1 = early stage C3 + advanced
29
Stages of HIV
Acute HIV infection Asymptomatic chronic HIV infection Symptomatic HIV infection AIDS or advanced HIV
30
Chatacteristics of the Acute stage
4-7 week period Viral replication is rapid & individuals are very infectious -Flu like symptoms - few days to a monthy (majority of individuals) -Within days it hides out in lymph nodes and central nervous system where it hides out -Seroconversion occurs
31
Asymptomatic chronic stage
Lasts a few months to 10 years Few symptoms, if any Subclinical changes - immune system weakens
32
Symptomatic stage
Fever, sweats, skin problems, fatigue, other non-AIDS defining symptoms Decline in nutrient status and body composition occurs
33
Advanced stage (AIDS)
One or more well defined, life threatening clinical condition that is clearly linked to HIV induced immunosuppression
34
When is an individual diagnosed with AIDS?
When the CD4 count falls below 200 or when an AIDS defining condition is diagnosed Once a diagnosis is made, it stays with the individual even if the person's CD4 count returns to above 200
35
Cycle of malnutrition and Infection in AIDS
Poor nutrition leads to weight loss, muscle wasting, weakness and micro-nutrient deficiency (due to oral thrush) -> That alone PLUS HIV contributes to Impaired immune system (poor ability to fight HIV and other infections)--> That contributes to an increased vulnerability to infections and faster progression to AIDS --> That leads to Increased nutrition needs (due to malabsorption and decreased food intake and also due to the body needing to address infections and viral replication And that contributed even more to poor nutrition ---> and the cycle goes on
36
How does HIV effect Nutrition
It decreases the amount of food consumed - due to mouth pain/thrush Impaired nutrient absorption Changes in metabolism
37
Causes of decreased food consumption
``` Loss of appetite Taste changes Fever Diarrhea Nausea Vomiting Mouth and throat sores Side effects from medication Abdominal pain ```
38
What causes impaired nutrient absorption?
HiV infection of intestinal cells Frequent diarrhea and vomiting opportunistic infection -Poor absorption of fat and vitamins
39
What causes changes in metabolism?
Infection increases energy requirements by 10-15% and protein by 50% or more Infection increases demand for and utilization of antioxidant vitamins -an insuffient amount causes oxidative stress and leads to increased replication and higher viral load High triglyceride levels in blood
40
What causes muscle wasting in HIV?
Use of amino acids to fuel energy needs due to increased resting energy expenditure -Leads to lack of preservation and restoration of lean tissue Continued fat accumulation -more adipose tissue compared to lean tissue
41
What is HIV associated wasting syndrome?
Loss of metabolically active lean tissue - involuntary weight loss of more than 10% - chronic diarrhea or chronic weakness - constant or intemittent fever for 30 days or more - absense of another condition that might cause symptoms As little of 5% loss in body weight is associated with icreased death Nutrient status is a major factor in survival
42
What is the treatment for wasting?
Maintain and restore weight and lead body mass through: Elimination of infectious agents AMple calories and nutrient intake Exercise (progressive weight training)
43
Benefits of exercise for wasting
Increasese lean tissue Reduces serum triglyceride Prevents muscle wasting
44
Treatment
Highly active antiretroviral therapy (HAART) | No cure because it continuously mutates
45
What is highly active antiretroviral therapy?
Combination of at least two fully active retroviral agents know to kill virus or suppress replication
46
Classifications of HAART
``` entry inhibitor reverse transcriptase inhibitor integrase inhibitor protease inhibitor maturation inhibitor ```
47
Entry inhibitor
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Nutrition 452 (7 decks)

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