HIV Flashcards
Can you test an unconscious patient for HIV
Yes, if you think it is in the patient’s interest
How does HIV affect the immune system
Infects and destroys immune cells especially T-HELPER CELLS that are CD4+ (have a CD4 recpetor on their surfcae)
Normal CD4 count
> 500
At what CD4 count are most AIDS diagnoses made
<200
AIDS-defining conditions of Respiratory system
TB
Pneumocystis
AIDS-defining condition of Neurological system
Cerebral toxoplasmosis
Dermatological AIDS-defining condition
Kaposi’s sarcoma
AIDS-defining condition of GI system
Persistent cryptosporidiosis
AIDS-defining cancer
Non-Hodgkin’s lymphoma
Cervical Cancer
In what would you offer a HIV test
Pyrexia of unknown origin +/- any lympahdenopathy of unkown cause
Bacterial pneumonia
Aspergillosis
Aseptic meningitis/encephalitis
Multidermatomal or recurrent Herpes Zoster
Oral Candiasis
Hodgkin’s lymphoma
What is seroconversion illness
Abrupt onset (2-4wks post exposure), usually self limitting 1-2wks Generally non-specific symptoms and DD includes a wide range of conditions
Symptoms of seroconversion illness
Flu-like symptoms Fever Malaise + lethargy Pharyngitis Lymphadenopathy Toxic exanthema
“Looks like Glandular fever but EBV serology not in keeping”
When do you start treatment for HIV
Consider starting all patients at diagnosis regardless of CD4
If CD4 < 350 cells/mm3, encourage them to start treatment
If CD4 < 200 NEED to start immediately
Treatment for HIV
Combinatim antiretroviral therapy (cART) [at least 3 drugs from at least 2 different groups]
Side effects of cART
Metabolic
Lipodystrophy
