hiv/aids Flashcards
What cell does the HIV virus “hijack”
CD4+ T-cell
AKA the CD4+ cell, helper/inducer T-cell, or T4-cell.
- Similar to those with the flu and can include a rash or sore throat
o Headache, nausea, sore throat, chills, night sweats - Rapid rise in HIV viral load, decreased CD4+ (but only temporary), increased CD8+
- Symptoms go away with a decline in viral HIV load
- Acute HIV infection stage ends when HIV antibodies can be detected
Acute HIV infection
2-4 weeks after infection
- Asymptomatic, CD4+ >500 cells/mm3 & viral load
- Body is able to produce an adequate # of CD4+ T cells to replace those destroyed by the virus
- Anti-HIV antibodies are produced (HIV+), CD4+ >500 cells/mm3
- Over time, virus begins active replication using the host’s genetic machinery causing CD4+
destruction, increased viral load, & dramatic loss of immunity
Chronic HIV infection
10 years or more after infection
- End stage of HIV infection. AIDS diagnosis.
- Diagnosis of AIDS REQUIRES that the adult be HIV positive and have either a CD4+ T-cell
count of less than 200 cells/mm3 or less than 14% (even if the total CD4+ count is above 200
cells/mm3) or one of 27 opportunistic infections or conditions. - Without treatment, death occurs within 5 years
Late Chronic Infection
Complications of HIV/AIDS
Kaposi’s sarcoma
Wasting syndrome
Candida
Hair oral leukoplakia
shingles
Oral or genital herpes lesions
Cytomegalovirus (CMV)
Pneumocystis jiroveci pneumonia
TB
Complication of HIV characterized by diarrhea, malabsorption, anorexia, and oral & esophageal lesions that contribute to persistent weight loss and an emaciated appearance.
Wasting syndrome
What to do after sharps injury and possible exposure to HIV/AIDS?
1 bleed the wound
#2 was for at least 1 full minute
#3 immediately contact employee health or ED at night for guidance
#4 Three drug cART within 2 hrs of exposure
What is PrEP?
Pre-exposure prophylaxis
Truvada is given for high risk individuals. It reduces the risk of getting HIV from sex by about 99% when taken daily. Not protected until 4 consecutive days of treatment.
Renal function must be monitored q3 months.
HIV treatment reminders
- Medications do not cure the client but decrease the viral replication and slow disease process.
- Adherence to drug schedules is critical; nonadherence to drug regimen can lead to mutations of the virus and in-creased virus resistance.
HIV treatment
Combination antiretroviral therapy (cART) is the treatment for HIV and AIDS
o Nucleoside reverse transcriptase inhibitors (NRTIs)
o Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
o Protease inhibitors (PIs)
o Integrase inhibitors
o Fusion inhibitors
o Entry inhibitors
o Ensure that cART drugs are not missed, delayed, or administered in
lower-than-prescribed doses in the inpatient setting.
Teach patients the importance of taking their drugs exactly as prescribed to maintain the effectiveness of cART drugs. Even a few missed doses per month can promote drug resistance (remember the 90% rule)
Goal of HIV treatment
Increase CD4+, Increase WBC, Increase lymphocytes, Decrease viral load
Is there an at home HIV test?
Yes. Currently there is only one home HIV test available
in the United States, the OraQuick In-home HIV
test. The test provides rapid results in the home. The
testing procedure involves swabbing your mouth for
an oral fluid sample and using a kit to test it. Results
are available in 20 minutes. If you test positive, you
will need a follow-up test.
Ways of transmission
Parental blood transmission- needlesticks
Sexual- most common
Perinatal- exposure during pregnancy, during delivery, through breastmilk
Nursing Care
- Prevent & Educate Patients
- Avoid Stigma
- Manage Pain
- Enhance Nutrition
- Minimize Diarrhea
- Skin Care
- Cognition
- Psychological Distress
- Care Coordination
If someone has a positive antibody test, does it mean that they have HIV or AIDS?
No. It only means that they have been infected with the virus.
