HIV/AIDS Flashcards
What is HIV?
HIV, or Human Immunodeficiency Syndrome, is a retrovirus causing immunosuppression. Clients with HIV are more susceptible to infections due to decreased immune response. The virus replicates backwards going from RNA to DNA.
What is the pathophysiology of HIV?
Target cell for HIV is CD4 T cells. A normal CD4 T cell count is 500-1600 cells/mm3. 1 billion CD4 T cells are destroyed each day by HIV. Initial infection results in viremia. Viral load remains low after initial period, even without treatment. When a CD4 T cell count drops below 300, the client is diagnosed with AIDS. Viral load is increased upon initial HIV infection, returns to baseline, then increases in AIDS.
What is AIDS?
AIDS is determined when an HIV client presents with one of the four criteria: CD4 T cell count below 200, development of an opportunistic infection (fungal, viral, protozoal, bacterial), development of an opportunistic cancer, wasting syndrome 10% or more of body mass.
How is HIV transmitted?
Sexual- most common route. Parenteral- needles or contaminated equipment, blood products. Perinatal- placental transfer, maternal blood/body fluids during birth, breast milk infected mother. HIV is found in all blood and body fluids, but HIGHEST concentration in semen and blood. Viral load is highest in the first 5-6 months, then again in end stage.
What precautions should be taken in care of a client HIV?
Standard precautions: routinely wear barriers (gowns, gloves, goggles), immediately wash hands and other skin surfaces after contact with blood or body fluids, carefully handling and disposing of sharp instruments during and after use (needle sticks main means of occupation-related HIV infection.
What is PEP?
Post-exposure prophylaxis: post contact with HIV positive or Hep C positive persons. Involves taking anti-HIV drugs as soon as possible following an exposure. Treatment begins within 72 hours of exposure and consists of 2-3 antiretroviral drugs taken for 28 days. May be needed if engaged in unprotected risky sex, shared needles, sexual assault, possible health care worker exposure.
What is PrEP?
Pre-exposure prophylaxis: used for people who don’t have HIV but are at high risk. Taking PrEP daily can reduce risk of infection. Indications may include an HIV positive partner or someone who shares needles.
What occurs in Stage 1 of HIV?
Acute infection: may have flu-like symptoms such as fever, swollen lymph nodes, sore throat, headache, malaise, muscle pain, joint pain, diarrhea, rash. HIGH viral load, very infection, low CD4 T cell count temporarily, seroconversion (development of specific HIV antibodies)
What occurs in Stage 2 of HIV?
Chronic infection: asymptomatic, may be from 2 months to 10-11 years. Symptomatic- viral load increases, persistent fever, frequent night sweats, chronic diarrhea, recurrent headaches, severe fatigue, thrush, shingles, leukoplakia
What occurs in Stage 3 of HIV?
AIDS- must have 1 of the criteria. CD4 count drops below 200, opportunistic diseases such as cancers develop, wasting syndrome (loss of 10% or more of body mass)
What are diagnostics used for HIV/AIDS?
ELISA test- detects specific HIV antibodies, may take several weeks, delay known as window period, repeat if possible, if second is positive, Western blot test. Labs- decreased WBC, low platelets, anemia (disease itself or due to antiretrovirals), altered liver function from meds (monitor)
What are the goals of the medication regimen for HIV?
Decrease viral load, maintain or raise the CD4 T cell count, prevent HIV related signs/symptoms, prevent HIV related opportunistic diseases, prevent transmission (good health teaching).
What are fusion (entry) inhibitors?
This medication prevents binding of HIV to cells, thus preventing entry of HIV into cells where replication would occur.
What are NNRTIs?
Non-nucleoside Reverse Transcriptase Inhibitors- inhibit the action of reverse transcriptase.
What are NtRTIs?
Nucleotide reverse transcriptase inhibitors- combines with reverse transcriptase enzyme to block the process needed to convert HIV RNA into HIV DNA.
