HIV Flashcards
HIV types
HIV-1 most common type
HIV-2 rare outside West Africa
HIV transmission methods
Unprotected anal/vaginal/oral sex with an infected person
Vertical transmission (mother to baby via pregnancy or breast feeding)
Needle sharing, needle stick injury, infected blood in eye
HIV pathophysiology
Enters and destroys CD4 T helper cells
CD4 death by CD8 cells leads to acute CD4 depletion
HIV phases
Initial seroconversion, flu like illness weeks after infection
Asymptomatic phase
<200 CD4 = AIDS
HIV epidemiology
38 million people living with HIV in 2019
690 thousand deaths in 2019
Most ~65% Africa
AIDS defining illness definition
End stage HIV infection
CD4 drops <200
Unusual opportunistic infections and malignancies
AIDS defining illness examples (6)
Kaposi’s sarcoma
Pneumocytis Jirovecii Pneumonia (PCP)
Cytomegalovirus infection
Candidiasis
Lymphomas
TB
Post Exposure Prophylaxis
Within 72 hours
ART (truvada and raltegravir) for 28 days
Initial HIV test + 3 months later
Abstain from unprotected activity for 3 months until negative
HIV additional management (3)
Prophylactic co-trimpxazole (septrin) for AIDS patients to protect against PCP
CVD and cervical monitoring
Up to date vaccines (no live vaccines)
HIV treatment aim
Undetectable viral load
Normal CD4 count
HAART medication
Highly Active Anti-Retroviral Therapy
Protease inhibitors
Intergrase inhibitors
Nucleoside reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
Entry inhibitors
HIV treatment BHIVA guidelines
Starting regime 2 NRTIs (e.g. ten of Ivor and emtricitabine) plus a third agent
Types of HIV tests
Antibody test
P24 antigen test
PCR test
HIV antibody test
Typically used to screen for HIV
Can be negative for 3 months
Must be repeated
Option to self sample at home
HIV P24 Antigen test
Direct test for specific antigen in blood
Can be positive earlier than antibody test
HIV PCR testing
Shows number of HIV RNA copies in blood
Used to detect viral load
Useful for monitoring
HIV testing consent
Verbal consent needs to be documented before testing
Consider counselling
HIV monitoring
CD4 count
500-1200 = normal
<200 = AIDS
Viral Load
undetectable = v unlikely to transmit (<50-100)
Can be 100,000+ if untreated
Conceiving in HIV
Undetectable Viral Load - unprotected sex may be considered
Sperm washing, IVF
Birth in HIV
C-section unless undetectable viral load
If undetectable viral load, vaginal may be an option
Newborns HIV
ART 4 weeks to avoid vertical transmission
May still contract via breastfeeding, even when undetectable viral load
Sex in HIV
Condoms/dams should be used even if both positive
