HIV + AIDS Flashcards
Modes of transmission
- sexual contact (75%)
- parenteral exposure (transfusion/needle sharing)
- perinatal exposure
HIV/AIDS
prominent systemic complaints
4
- night sweats
- diarrhea
- unintentional wt loss
- wasting
HIV/AIDS
why do opportunistic infections occur?
diminished cellular immunity
HIV/AIDS
Pathophys
CD4+ T lymphocytes are damaged which means the body cannot maintain cell-mediated immune function
HIV/AIDS
What CD4+ level says that infection has advanced to AIDS?
CD4+ count below 200 cells/mm3
HIV/AIDS
Types of HIV
2 types
- HIV-1 (most common, fast disease progression)
- HIV-2 (rare, Africa/Asia)
HIV/AIDS
age group w/ largest number of new diagnoses
25-34 y/os
HIV/AIDS
Risky sexual practices
- receptive anal intercourse
- multiple partners
- unprotected intercourse
HIV/AIDS
Risks of accidental needle sticks
4 factors
- depth of penetration
- hollow bore needles
- visible blood on needle
- advance stage of disease in source patient
HIV/AIDS
what to do after needle stick?
post-exposure prophylaxis (PEP)
HIV/AIDS
How is HIV transmitted mother to fetus?
- crosses placenta
- contact with blood during delivery
- breast milk
HIV/AIDS
which body fluids are not infectious?
4
- saliva
- sweat
- stool
- tears
HIV/AIDS
what is acute HIV infection called?
Acute retroviral syndrome
HIV/AIDS
when does the acute HIV infection stage begin?
2-6 wks post-infection
HIV/AIDS
Identifying sx for actue phase
key sx to watch for- 5
- night sweats
- fatigue
- unintentional wt loss
- lymphadenopathy
- Oral hairy leukoplakia
HIV/AIDS
describe oral hairy leukoplakia
2 characteristics, 1 viral cause
- cannot be scraped off
- caused by Epstein Barr
- white plaques on lateral tongue
HIV/AIDS
General sx pts can present with in acute phase
10
- non-specific sx that seem to be self limited
- fever/chills
- myalgia/arthralgia
- mucocutaneous ulceration
- headaches
- diarrhea
- pharyngitis
- rash/yeast infection
HIV/AIDS
once the acute HIV infection period has resolved, it enters what?
the latency phase (asx), but damage continues to occur
HIV/AIDS
what skin infections become more likely in HIV/AIDS pts?
- zoster (could be present at normal CD4 counts)
- HSV 1 and 2
- HPV
- Staph aureus skin infections
HIV/AIDS
Defining lab results of AIDS
- pos HIV serology
- CD4 count < 200 cells/mcL
- CD4 lymphocyte count below 14%
HIV/AIDS
non-speicifc AIDS sx
10
- blurred vision
- dry cough/SOB
- fever/sweats
- unintentional wt loss (n/v/d)
- lymphadenopathy
- white spots on tongue
HIV/AIDS
Defining AIDS Sx
10
- candidiasis of esophagus, bronchi, trachea, or lungs
- PJP
- kaposi sarcoma
- CNS lymphoma
- non-Hodgkin lymphoma
- toxoplasmosis of brain
- recurrent Salmonella septicemia
- CMV disease
- disseminated histoplasmosis
- recurrent bacterial pneumonias
HIV/AIDS
describe kaposi sarcoma
- oval, violaceous plaques
HIV/AIDS
3 labs for acute HIV infection
- antibody/antigen combo
- antibody test
- RNA/DNA test
HIV/AIDS
which is the recommended first test for suspected HIV infection?
joint antibody/antigen test
HIV/AIDS
laboratory workup for new HIV pt
6 categories?
- CBC, CD4, viral load, CMP
- CMV IgG, toxoplasmosis IgG
- STI/Hepatitis screening
- TST/PPD
- Chest imaging
- Blood cultures
HIV/AIDS
AIDS defining sx for children
6
- PJP
- recurrent bacterial infections
- wasting syndrome
- esophageal cadidiasis
- HIV encephalopathy
- CMV infection
HIV/AIDS
which test is first line in children?
RNA/DNA test
HIV/AIDS
prevention
4
- abstinence/safe sex
- latex condoms
- avoid needle sharing
- universal precautions
HIV/AIDS
screening recs
4
- everyone 13-64 at least 1x
- all health care settings
- high risk (MSM/sex workers/IV drug users)
- pregnant women
HIV/AIDS
what is ART? HAART?
- antiretroviral therapy
- highly active ART (combo drugs)
HIV/AIDS
function of treatment for HIV?
- suppress replication of HIV to restore immune function
- no cure, but helps pts live longer, healthier lives
HIV/AIDS
Drug classes (which 3= first line?)
6
- Integrase inhibitors
- Protease inhibitors
- NRTI
- NNRTI
- CCR4 antagonists
- Fusion inhibitors
HIV/AIDS
when is PrEP recommended?
- ongoing relationship w/ HIV+ partner
- IV drug use
- risky sexual behavior w/out protection
HIV/AIDS
what meds are given for PrEP?
2
- tenofovir
- emtricitabine
HIV/AIDS
when must PEP be given?
48-72 hrs after known epxosure
ideally within 2 hrs
HIV/AIDS
who might be given PEP?
- those with known exposure (needle sticks, unprotected sex)
- sexual assault
HIV/AIDS
what meds are given for PEP?
3
- tenofovir
- emtricitibine
- raltegravir/dolutegravir
