HIV Flashcards
(81 cards)
How is HIV spread?
sexual transmission - multiple partners - MSM Injection drug misuse Blood products (haemophiliacs etc) Vertical transmission Organ transplant
What does HIV do to the body?
Infects and destroys of the immune system, especially T helper cells that are CD4+
What does CD4+ mean?
Have a CD4 receptor on their surface
What are CD4 receptors present on the surface of?
LYMPHOCYTES macrophages and monocytes Cells in the brain skin probably many other sites
Over the course of the infection, relationship between CD4 count and HIV viral load
CD4 declines and viral load increases
Normal CD4 count
> 500
What CD4 count do most AIDs diagnoses occur at?
< 200
As the viral load increases, what is there an increased risk of?
Developing infections and tumours
Levels of CD4 over time of infection
The immune system brings the virus under control after a while -> until the HIV RNA increases
Then the CD4 starts to plummet -> this is where you get symptoms and opportunistic infections
What does AIDs stand for?
Acquired immune deficiency syndrome
Clinical stages and their presentations of HIV
Clinical stage I
- asymptomatic
- persistent generalised lymphadenopathy
- performance scale 1 (asymptomatic, normal activity)
Clinical stage II
- weight loss < 10% of body weight
- minor mucocutaneous manifestating (fungal nail infections, recurrent oral ulcerations, seborrheic dermatitis)
- herpes zoster (within last 5 years)
- recurrent URTIs
- and/or performance scale 2 (symptomatic, normal activity)
Clinical stage III
- weight loss > 10% of body weight
- unexplained chronic diarrhoea > 1 month
- oral candidiasis (thrush)
- oral hairy leucopenia
- pulmonary TB within past year
- severe bacterial infections
- and/or performance score 3 (bedridden <50% of the day during the last month)
Clinical stage IV
- HIV wasting syndrome
- Toxoplasmosis of brain
- pneumocystic cariniipneumonia
- Cryptospiridosis with diarrhoea > 1 month
- CMV disease of an organ other than liver, spleen or lymph nodes
- HSV (mucocutaneous > 1 month, visceral any duration)
- PML
- candidiasis of oesophagus, trachea, bronchi or lungs
- atypical mycobacteriosis, disseminated
- extrapulmonary TB (lymphoma)
- HIV encephalopathy
- And/or performance score 4 (bedridden > 50% of the day during the last month)
What is the average time on average from getting HIV to progressing to AIDs?
7-8 years
What is the time on average from AIDs to dying?
Roughly 2 years
What would be classified as an AIDs illness?
Certain infections and tumours that develop due to weakness in the immune system
If have no symptoms, do you have an HIV or an AIDs illness?
No symptoms = HIV illness only
AIDs defining conditions for an adult infection
TB, pneumocisitis Cerebral toxoplasmosis, PML Cryptococcal meningitis Kaposi's sarcoma Peristen cryptosporidiosis Non-hogkin's lymphoma Cervical cancer Cytomegalovirus retinitis
Relationship between CD4 count and mortality
The lower the CD4 count, the higher the mortality
Natural history of HIV infection
- acute infection
- asymptomatic
- HIV related illness
- AIDs defining condition
- Death
What happens during a seroconversion illness?
The HIV antibodies are first developing
Presentation of HIV seroconversion illness
Like a dose of glandular fever that lasts longer and has associated features Diarrhoea Rashes liver dysfunction malaise lethargy pharyngitis lymphadenopathy toxic exanthema
When after exposure does seroconversion illness occur?
2-4 weeks after exposure time
What does ART stand for?
Antiretroviral therapy
Before the CD4 count drops to what do you want to start ART?
approx. 320
what is key to ART to work?
Adherence needs to be over 90%
