HIV & AIDS Flashcards
HIV
RNA retrovirus
HIV targets cells
- dendritic cells
- macrophages
- CD4+ T cells
pathophysiology of HIV
- rapid viral replication
- susceptible CD4+ T cells
- no HIV- specific immune response
how long does the host’s immune cells take to form a response to HIV?
~6 months
clinical syms of early HIV infection
- nonspecific clinical syms
- flu-like syms
blood HIV viral load correlates with what?
risk of transmission of the virus
T/F: pts with early HIV infection are highly contagious
true
progressive depletion of CD4+ lymphocytes leads to what?
- pancytopenia
- immune dysfunction
pancytopenia
complete wipe out of all cells that are made from bone marrow including WBC, RBC, and platelets
what happens if HIV pt’s CD4+ drops to <200?
disease has progressed to AIDS
how are pts confirmed for AIDS?
- laboratory confirmed HIV infection AND
- CD4+ lymphocyte counts <200 cells/uL
AND/OR - 1 AIDS-defining condition
*if have both then considered to have AIDS
do all HIV pts progress to AIDS?
no
management of AIDS pts
- early detection and diagnosis
- antiretroviral therapy (ART)
- prophylaxis for opportunistic infections with low CD4+ counts
- txtment of HIV-related complications (i.e. Karposi sarcoma)
what percent of HIV-infected pts survive beyond 10 yrs of diagnosis thanks to ART?
> 70%
how long are HIV- infected pts on ART for?
a lifetime, continued indefinitely
how often are CD4+ count taken after HIV diagnosis?
every 3-4 months
ART (HAART)
- cocktail of multiple drugs
- increases survival, reduces complications, improves quality of life
goal of ART
inhibit HIV replication so viral load not detectable so
- CD4+ count increases
- restored immune fxn
why is compliance difficult for HIV-infected pts going through ART?
many adverse effects and toxicity
when should HIV-infected pts start ART?
not sure, there is no general consensus for start of drugs
asymptomatic HIV-infected pts have
- okay CD4+ count
- low viral load
- normal platelets and WBCs
- no signs or syms
can you treat a asymptomatic HIV-infected pt?
yes, all dental care indicated but take universal precautions
asymptomatic, HIV-infected pt with decreasing CD4+ count
- may be developing immune suppression
- increased risk of infection (decreased WBCs)
- increased bleeding (decreased platelets)
is routine and complex restorative dentistry okay for asymptomatic, HIV-infected pt with decreasing CD4+ count?
yes
can you perform invasive surgical procedures on asymptomatic, HIV-infected pt with decreasing CD4+ count?
obtain WBC and platelet counts first
AIDS pts (CD4+ <200)
- significant immunosuppression
check drug interactions with ART
can you provide dental txtment in AIDS pts (CD4+ <200)?
emergency care and preventative dental care only
how do you prepare for infections after an invasive procedure in AIDS pts (CD4+ <200)?
antibiotic prophylaxis for pt with WBC <500uL
how do you prepare for excessive bleeding after an invasive procedure in AIDS pts (CD4+ <200)?
platelets must be >50,000 for 1 tooth minimum
