HIV

Question 1

Define HIV

Answer 1

Infection caused by retrovirus that replicates within lymphocytes and macrophages
AIDS is the condition that develops from HIV-which is the constellation of infections conditions and malignancies

Question 2

Aetiology and risk factors of HIV

Answer 2

HIV is a retrovirus that replicates in CD4+ cells
transmitted via blood, sexual fluid and milk, delivery
Transmission via sex only happens 0.1 % of sexual contact with another infected
HIV infects T cells and can become latent or activate-sharp rise in load, which leads to a decrease of T cells. In initial response, immune system reactivates and viral loads reduces-and goes latent.
Prognosis is dependent of how good intial response goes

Risk factors
Needle sharing-IV use
Anal intercourse
Unprotected sex
needle stick injury
high maternal viral load

Question 3

Epidiemology of HIV

Answer 3

38 million people have HIV in 2018
1.7 million newly infected
70% are from sub-sahara Africa
declining now
80% of new infection are from people who weren't aware

Question 4

Signs and Sx of HIV

Answer 4

Viral infection: acute
Fever, night sweats, weight loss, skin rash, oral thrush, ulceration

diarrhoe, headache

depression and anxiety are common

social history is very important here-sexual activity, work (hospital), IV drug use

Lymphadenopathy
rashes, scars, Kaposi's sarcoma
Examine for infection anwhere (lung, etc)
Hepatosplenomegaly
angular stomatitis,

Question 5

Investigations of HIV

Answer 5

ELISA-serum HIV-false negatives if too early
Rapid HIV test-positive
HIV PCR-positive

CD4 cell count-low
HIV rna (viral load)-prognostic value

check pregnancy, hep status

need FBC, U&E and LFT before starting anti-retrovirals