HIV Flashcards
how is HIV spread?
> sexual transmission > vertical transmission > blood products > injection misuse > organ transplant
what immune cells specifically does HIV disrupt?
t helper cells
what is the normal CD4 count?
> 500
at what CD4 level is the diagnosis of AIDS?
<200
how is the disease progression monitored?
> symptoms and signs
CD4 lymphatic count
HIV viral load
how is the HIV viral load measured?
PCR to monitor the number of copies
true or false
HIV viral load is low during acute infections
false it is high
what are the symptoms of a patient with primary HIV?
abrupt onset and self limiting (2weeks) > fever > flu > malaise/lethargy > pharyngitis > lymphadenopathy > toxic exanthema
how soon after exposure do symptoms of primary HIV/seroconversion begin?
2-4 weeks
describe the 6 stages of HIV replication in the human cell starting from binding and entry
- Binding and entry
- Reverse transcriptase
- Integration
- Transcription
- Assembly
- Release and protease
what are the 4 stages that HIV medications can act on?
> entry inhibition
reverse transcriptase inhibitors
integrase inhibitor
protease inhibitor
what does combination therapy of anti-retrovirals entail?
3 drugs from 2 different groups
> reverse transcriptase inhibitors
> protease inhibitor
> integrase inhibitor
when should HIV treatment be commenced?
> consider in all patients at diagnosis
encourage at <350 cells/mm^2
CD4 count <200 ASAP
3rd trimester in pregnancy
when might you readjust HIV medication?
if their viral load is not sufficiently suppressed at 4-6 weeks
what stages do antivirals act on?
> integrase inhibition
protease inhibition
non-nucleoside reverse transcriptase inhibitors
nucleoside reverse transcriptase inhibitors
what are the side effects of nucleoside reverse transcriptase inhibitors?
> neuropathy
> lipodystrophy
what are the side effects of non-nucleoside reverse transcriptase inhibitors?
> rashes
> drug interactions
what are the side effects of protease inhibitors?
> lipodystrophy
diarrhoea
hyperlipidaemia
what is a side effect of integrase inhibitors?
rashes
what is lipodystrophy?
redistribution of fat
how is lipodystrophy managed?
> changing drugs
> face lift/fillers/liposuction
what can poor adherence to treatment lead to?
> viral mutation and resistance
what preventative measures are there for HIV?
> circumcision?
behavioural change
treatment (undetectable viral load means transmission is impossible in pregnancy)
post exposure prophylaxis
what is the life expectancy of an individual with a CD4 count of <100?
52 years
what is the life expectancy of an individual with a CD4 count of 100-200?
62 years
what is the life expectancy of an individual with a CD4 count of >200?
70+years
you become exposed to blood from and HIV positive person.
what are your immediate actions?
> wash with soap and running water
encourage bleeding if skin is broken
wash out splashes in eyes nose and mouth
report incident
what is the risk assessment to blood and bodily fluid exposure (not just for HIV)?
> source of contamination
extent of injury
vaccination status of the victim
how can blood/bodily fluid exposure be avoided?
> disposing of contaminated waste safely
clear spillage and body fluids promptly
avoid sharp usage where possible
use good hand hygiene
cover pre-existing wounds with dressings
protect mucous membranes of eyes, mouth and nose
what are the risk of infection if exposed to Hep B with surface antigens and e antigens?
30%
what is the risk of infection if exposed to hep c antigens?
3%
what is the risk of infection if exposed to HIV blood and bodily fluids?
0.3%
