HIV/AIDS

Question 1

HIV is a ___ (DNA/RNA) retrovirus that infects ___ with ___ receptors, which affects T helper lymphocytes and macrophages.

Answer 1

RNA; WBCs; CD4+

Question 2

What is the CD4+ count if a patient has AIDS?

Answer 2

less than 200

Question 3

What does progressive depletion of CD4+ lymphocytes cause in HIV patients?

Answer 3

pancytopenia

immune dysfunction

Question 4

What does AIDS stand for?

Answer 4

Acquired Immunodeficiency Syndrome

Question 5

What is needed to be diagnosed with AIDS?

Answer 5

1. Laboratory confirmation of HIV infection

2. CD4+ lymphocyte counts

Question 6

T/F. All patients with HIV progress to AIDS.

Answer 6

False.

Question 7

What test identifies antibodies to HIV and is sensitive with high false positives?

Answer 7

ELISA: enzyme-linked immunosorbent assay

Question 8

What test is given to confirm the results of an ELISA?

Answer 8

Western blot

99% accuracy that patient has been exposed to AIDS virus
Doesn’t indicate HIV infection status or the presence of AIDS

Question 9

A CD4 count is performed at the time of diagnosis and every ___-___ months after.

Answer 9

3-4

Question 10

> 70% of HIV-infected patients survive beyond 10 years of diagnosis due to the use of ____ therarpy

Answer 10

antiretroviral therapy (ART)

Question 11

What is the goal of ART (HAART) medications?

Answer 11

inhibit HIV replication so viral load not detectable
CD4 count increases
immune function restored
Increases survival, reduces complications, improves quality of life
Many adverse effects & toxicity
No consensus as to when to start treatment

Question 12

What should be considered when planning dental treatment?

Answer 12

1. CD4+ lymphocyte count
2. viral load (increase load = decrease CD4)
3. WBC count
4. platelet count

Question 13

Describe how a asymptomatic, HIV seropositive patient presents.

Is dental care indicated in these patients?

Answer 13

OK CD4+ count
Low viral load
Normal platelets and WBCs
No S/S (wouldn’t know of disease if they did not endorse)

All dental care indicated

Question 14

Describe how a asymptomatic, HIV-Infected patient with decreasing CD4+ count would present.

Is dental care indicated in these patients?

Answer 14

May be developing immune suppression
increased risk of infection (decreased WBCs)
increased bleeding (decreased platelets)
Routine & complex restorative dentistry ok
Invasive surgical procedures: obtain WBC & platelet counts

Question 15

Describe how a AIDS patient (CD4+ less than 200) presents.

Answer 15

Significant immunosuppression

Emergency care and preventive dental care only

Question 16

What must you prepare for if performing an invasive procedure on an AIDS patient?

Answer 16

Infection- antibiotic prophylaxis for patient with WBC 50,000 for treatment
Check drug interactions with ART