HIV/AIDS

Question 1

HIV/AIDS

Answer 1

destroy CD4 and T cells (retrovirus)
1 = most prevalent; 2 = less pathogenic, W aftrica
causes AIDS (severe immune system dusfunction), untreated HIV in 8-10 yr

Question 2

patho: retrovirus

Answer 2

reverse transcriptase to translate its genetic info (RNA) into DNA
for life, blood and body fluids, compromised cell mediated immunity, opportunistic infection, neoplasms (cancer)

Question 3

patho: target cd4

Answer 3

protein on T lymph (memory), monocytes, macrophages
create DNA and insert into human genome via HIV integrase -> make more virus
HIV protease: release particles to attack, replicate prolifically, release - target helper T lymph
body makes anti HIV antibodies but they are just markers, they are not protective

Question 4

stage 1

Answer 4

early infection (acute)
rapid replication, not detected by labs, no S (non specific), infectious!
seroconversion = antibodies detectable, flu like S several weeks, highly infectious

Question 5

stage 2

Answer 5

clinical latency (chronic)
viral levels stable, body fighting infeciton
3-12 yr w/o treatment, decades with treatment
asymp or mild S
rapid virus progression: persistent decline in CD4, antiviral fight less effective, viral load increase

Question 6

stage 3

Answer 6

AIDS

Question 7

initial S

Answer 7

usually 2-4 wk post infection
fever, sore throat, swollen lymph, rash, muscle ache, night sweats, mouth ulcers, chills, fatigue

Question 8

diagnose

Answer 8

need AIDS defining condition (immune doesnt work): kaposi’s sarcoma, wasting S, pervasive candidiasis, AIDS dementia complex, pneumocystis jiroveci pneumonia, TB, invasive cervical cancer, HIV encephalopathy
CD4 < 200 regardless of presence of condition

Question 9

oral manifestations

Answer 9

seen with decreasing CD4, higher risk of progression to AIDS
teach: oral care, dentistry
oral hairy leukoplakia
periodontal disease

Question 10

HIV associated dementia

Answer 10

S: poor [], mental slowness, forgetful, memory loss, changes in behavior, difficult word finding, depression, withdrawal from activities, motor/speech/balance/visual problems
can cause cognitive issues, HIV xBBB (declining in recent years)

Question 11

rf

Answer 11

men having sex with men
injection drug use
male to male sexual contact + IDU
heterosexual contact
mom to child (perinatal)
other (blood transfusions and unknown)

Question 11

transmission

Answer 11

sex without condom, mom to baby, injection equipment sharing, contaminated blood transfusions and organ transplants
NOT: kissing, hugging, sharing food, insect bites, toilets, bathing, sneeze/cough, sweat

Question 11

parenteral transmission

Answer 11

needle/syringe sharing btw IDUs
blood or blood products
health care exposure to blood, body fluids, needles/sharp instruments

Question 12

why doesnt everyone exposed develop an active infection

Answer 12

duration and freq of contact
volume, virulence, [] of virus
host immune status
genetic protective factors