HIV

Question 1

how can HIV be spread

Answer 1

• sexual transmission
• injection drug misuse
• blood products
• vertical transmission (mother to child in utero/during pregnancy/birth)
• organ transplant

Question 2

when can unconscious patients be tested

Answer 2

if you think it is in the patients best interest to have the test

Question 3

what cells does HIV affect

Answer 3

infects and destroys cells of the immune system - esp T-helper cells that are CD4+ (have a CD4 receptor on surface)

Question 4

where are CD4 receptors present

Answer 4

not exclusive to lymphocytes - also present on macrophages, monocytes, cells in the brain, skin and other organ sites

Question 5

what can occur if cells in the brain re affected

Answer 5

HIV encephalopathy - type of dementia

Question 6

what occurs to the CD4 count as the infection progresses

Answer 6

body can initially keep up with damage by producing new cells but after a period time it cannot keep up and CD4 count goes down - HIV viral load increases

Question 7

what determines the severity of the illness

Answer 7

severity is greater the lower the CD4 count

Question 8

what is the normal CD4 count

Answer 8

> 500

Question 9

what happens when CD4 count <200

Answer 9

most aids diagnoses (severe infections) occur after this point

Question 10

when do symptoms start to show in an individual with HIV infection

Answer 10

immune system able to control for a little while - symptoms and opportunistic infections occur when CD4 levels fall below that of the virus

Question 11

what is AIDS

Answer 11

Acquired immune deficiency syndrome - describes a possible syndrome of HIV

can have AIDS from HIV or AIDS that can be treated then leaves

Question 12

how many clinical stages of HIV are there

Answer 12

4

Question 13

what can occur at clinical stage 1

Answer 13

• asymptomatic
• persistent generalised lymphadenopathy

performance scale 1
- asymptomatic , normal activity

Question 14

what can occur at clinical stage 2

Answer 14

• weight loss <10% BW
• minor mucocutaneous manifestations
• HZV in last 5 years
• recurrent URTI

performance scale 2 - symptomatic, normal activity

Question 15

what can occur at clinical stage 3

Answer 15

• weight loss >10%BW
• unexplained chronic diarrhoea >1month
• unexplained prolonged fever >1month
• oral candidiasis (thrush)
• oral hairy leuoplakia
• pulmonary TB in past year
• severe bacterial infections

performance scale 3 - bedridden <50% of the day in past month

Question 16

what can occur at clinical stage 4

Answer 16

• HIV wasting syndrome
• pneumonia
• toxoplasmosis of the brain
• diarrhoea >1month
• CMV disease of organ other than liver, spleen or lymphs
• HSV >1 month
• progressive multifocal leukoencephalopathy
• Candidiasis of the oesophagus, trachea, bronchi, lung
• atypical mycobacteriosis
• extrapulmonary TB - lymphoma
• Kaposis sarcoma
• HIV encephalopathy

performance scale 4 - bedridden > 50% of the day during the past month

Question 17

what is the average time from getting HIV to getting AIDS

Answer 17

7/8 years

Question 18

what is the average time from getting AIDS to dying

Answer 18

~2 years

Question 19

what are the most common opportunistic infections in HIV

Answer 19

From earliest on:
THRUSH (very prominent sign)
PCP
TB
Cryptosporidiosis
Kaposis, lymphoma
Toxoplasmosis
cryptococcal meningitis
CMV, MAC

Question 20

How do you differentiate HIV and AIDS in diagnosis

Answer 20

AIDS illness - certain infections and tumours that develop due to a weakened immune system

HIV - no symptoms mean hIV infection only

Question 21

what are some respiratory indicator disease in HIV

Answer 21

AIDS defining:
TB
pneumocystis

Other:
bacterial pneumonia
aspergillosis