HIV / AIDS Flashcards
What does ELISA (aka EIA) stand for and what does it test? How long does test take? What is the follow up test if results are positive?
Enzyme Linked Immunosorbent Assay
Tests for HIV antibodies
Rapid method takes 20 minutes
F/U with the Western blot for confirmation
What is the window period?
The time period between infection and development of antibodies. U to 2 months.
What lab assessments are done to evaluate the progression of HIV?
CD4+ T-cell count, Viral load
What is seroconversion and what symptoms occur at this time?
When HIV specific antibodies develop. Often accompanied by a mononucleosis like syndrome (fever, swollen lymph glands, sore throat, HA, malaise, nausea, muscle/joint pain, diarrhea, diffuse rash)
How is HIV transmitted?
Contact with infected blood, semen, vaginal secretions, and breast milk via sex, exposure to blood products, and perinatal during pregnancy, at delivery, or through breastfeeding
How soon can HIV be transmitted to others after becoming infected?
Within a few days
The risk of HIV infection due to needle stick is ______ for health care workers. The risk is higher with a ______ _______ wound.
low (0.3% - 0.4%)
deep puncture
On average ____ % of infants born from HIV infected mothers are born with HIV. Fortunately with the use of _______ _______ the risk can be reduced to less than 2%.
25%
antiretroviral therapy
What does retrovirus mean?
A virus that replicates in a backward manner going from RNA to DNA
HIV cant replicate unless it is inside a living cell. How does HIV enter the cell?
HIV binds to specific CD4 and chemokine receptor sites on cell surface. Viral RNA enters cell and is transcribed to viral DNA using REVERSE TRANSCRIPTASE. Then viral DNA enters nucleus and uses INTEGRASE to splice itself into the genome. Viral DNA now directs cell to make new HIV.
Initial infection of HIV results in ________ or a large amount of virus in the blood in which HIV replicates at a rapid and constant rate. How long can it take for S&S to appear during this period?
Viremia
10-12 years
In early stages of HIV infection the immune response functions normally reducing viral loads. How?
B cells make HIV specific antibodies and T cells mount a cellular immune response to viruses trapped in lymph nodes
The normal life span of a CD4 T cell is 100 days compared to ____ days of an HIV infected T cell.
2 days
An immune system will remain healthy with more than _______ CD4 T cells. This is known as Early Chronic Infection.
500
Immune problems start when CD4 T cell count drops below ______ cells/microliter. This is known as Intermediate Chronic Infection
500
Severe immune problems develop when CD4 T cells drop below _______ cells/microliter. This is known as Late Chronic Infection.
200
AIDS is diagnosed when an individual with HIV develops at least one of the following conditions? (5)
CD4 T-cell count drops below 200 Opportunistic infections Opportunistic cancers Wasting syndrome (loss of 10% IBM) AIDS dementia complex
What is the most common infection associated with HIV intermediate chronic infection?
Candidiasis or thrush
What causes painless, white, raised lesions on the lateral aspect of the tongue that is an indicator of disease progression?
Oral hairy leukoplakia, an Epstein-Barr virus infection
What lab abnormal lab values are common in HIV infected patients?
Decreased WBC, neutrophil, platelet
Why is co-infection with hepatitis B or C is extremely important?
They have a more serious course in patients with HIV and it limits options for ART because of liver related morbidity and mortality
What are the two resistance tests used to determine if a patient is resistant to the drugs used in ART?
Genotype assay - detects drug resistant viral mutations
Phenotype assay - measures the growth of HIV in various concentrations of antiretroviral drugs
Collaborative care focuses on (7)
- Monitoring progression and immune function
- ART
- Preventing opportunistic diseases
- Detecting and treating opportunistic diseases
- Managing symptoms
- Prevent/Decrease complications of treatment
- Prevention of further transmission of HIV
The goals of HIV drug therapy are (3)
- Decrease viral load (can reduce by 90-99% when taken consistently and correctly)
- Maintain or raise CD4 T-cell counts
- Delay onset of HIV related symptoms and opportunistic diseases
_______ develops in most drugs when used alone. Combinations of ____ or more prescribed at full strength should be used. This works because _________ therapy can attack viral replication in several different ways keeping the viral load low and thus decreasing ________ that allow HIV to become resistant
Resistance
3
combination
mutations
At least ___ clades (subtypes) of HIV exist around the world
9
Assessing risk for HIV includes (4)
A positive response to any of these questions requires an in-depth exploration
- Ever had blood transfusion/clotting factors?
- Shared drug using equipment w others?
- Sex w penis, vagina, rectum, mouth that came in contact w another person’s penis, vagina, rectum, mouth?
- Ever had an STD?
Nursing interventions include (8)
- adhere to drug regimens
- promote a healthy lifestyle
- protect others from HIV
- maintain/develop healthy relationships
- maintain activities and productivity
- explore spiritual issues
- come to terms with disease, disability, death
- cope with frequent symptoms and treatments
Should exposure to HIV-infected fluids occur, _______ _______ with _______ ART can significantly decrease risk of infection
post-exposure prophylaxis
combination
________ people in the US are not aware they are infected with HIV
250,000
CDC has recommended that all people ages ____ to ____ be tested for HIV.
13 - 64
Initial responses to the diagnosis of HIV include
anxiety, panic, fear, depression, denial, hopelessness, anger, guilt
Metabolic disorders that include changes in body shape include
lipodystrophy, hyperlipidemia, insulin resistance and hyperglycemia, bone disease, lactic acidosis, cardiovascular disease
