HIV Flashcards
Faulty reverse transcriptase is what causes serotype switching
why our bodies don’t recognize it
Highest risk of transmission in male to male sexual contact the heterosexual male
stage 3 AIDS: male to male, then IV drug use then heterosexual contact
The problem with eradicating drug is
that people don’t know that they have disease
If the patient has family in the room, don’t mention HIV
even if you know that they know and that their family knows. If you are given permission then you can
==>viral meningitis, AIDS
Clinical Suspicion is Diagnosing
o Clinical – High risk behaviors/exposures, Febrile illness, Aseptic meningitis, Rash, Diarrhea, Lymphadenopathy, Mucocutaneous Ulcers
o Lab - HIV immunoassay (antibody / antigen ), HIV RNA detection, Western blot (day 45-60)
o Differential – Mononucleosis, Syphilis, Toxoplasmosis, Lupus, Hepatitis, Gonococcal disease
On the fourth gen immunoassay if you get a negative result then no further testing is necessary. If you get a positive then you do an HIV-1/HIV-2 antibody differentiation immunoassay
If they are HIV-1 + but HIV-2 (–) then you detected those antibodies and vice versa.
If you detected both HIV-1 and HIV-2 antibodies then you have detected HIV antibodies
If both HIV-1, HIV-2 are negative or indeterminate then you check their RNA
If RNA (+) then you have acute HIV infection if RNA (--) then it is not HIV
time to positivity for IgG, IgM, p24 is 15-20 days but the
RNA can be detected earlier
AIDS Defining Illnesses
--Bacteria Recurrent bacterial pneumonias Tuberculosis TB --Fungi Pneumocystis jirovecii (carinii) pneumonia Other endemic fungi --Virus CMV, CMV-retinitis, herpes simplex (chronic ulcers, respiratory –itis), PML viral meninginitis, always consider HIV ---Parasites Isosporiasis, toxoplasmosis Cancers: invasive cervical, Kaposi (HHV8), Lymphomas (Burkitt, immunoblastic, brain)
Cough and Fever in HIV positive patient history
endemic fungi
multiple skin lesions - dissminated Histoplasmosis
Diarrhea caused by a lot of organisms
small bowel, large bowel, anorectal or food poisoning
–use trichrome stain and AFB stain for stool for Isospora, Cryptosporidium or Cyclospora
Viral entry with gp120:CD4
produces a conformational change allowing a 2° interaction between CCR5/CXCR4.
Viral entry with gp41
works to pull the viral and cellular membranes together, fusing them.
What is considered normal stage?
o Normal: CD4>1000, negative test
If you have a negative test in the last 180 days of a positive test, what stage are you at?
stage zero
If you have a CD4 > 500, what stage are you in?
stage one
