HIV/AIDS and OI Flashcards
What are the lab tests available for diagnosing HIV?
- combination assay (HIV Ab and p24 antigen)
- HIV-1/2 Ab differentiation immunoassay
- HIV-1 NAAT
What abnormal physical exam findings would be specific of HIV infection?
- oral hairy leukoplakia
- disseminated Kaposi sarcoma
- cutaneous bacillary angiomatosis
What are possible complications when CD4+ count is >300?
- pneumococcal pneumonia
- pulmonary tuberculosis
- herpes zoster
- oral candidiasis
- vaginal candidiasis
- fatigue
What are possible complications when CD4+ count is <300?
- oral hairy leukoplakia
- thrush
- fever
- weight loss
- diarrhea
What are possible complications when CD4+ count is <200?
- pneumocystis jirovecii
- disseminated histoplasmosis
- primary CNS lymphoma
- Kaposi sarcoma
- extrapulmonary TB
- non-hodkins lymphoma
What are possible complications when CD4+ count is <100?
- Cryptococcosis (cryptococcal meningitis)
- esophageal candidiasis
- toxoplasmosis
What are possible complications when CD4+ count is <50?
- Mycobacterium-avium complex
- cytomegalovirus
- primary CNS lymphoma
What are the opportunistic infections associated with HIV that give you the diagnosis of “AIDS-defining illness”?
- multiple/recurrent bacterial infxn
- Pneumocystis jirovecii pneumonia*
- Kaposi sarcoma
- lymphoma
- CMV infection
- Coccidioidomycosis
- Cryptococcosis
- Histoplasmosis
- Mycobacterium tuberculosis
What are the clinical associations with Pneumocystis pneumonia and AIDS?
- Chest radiograph (diffuse/peri-hilar infiltrates)
- Wright-Giemsa stain
- DFA of sputum
- BAL
- increased [LDH]
- increased [B-glucan]
What are the clinical associations with Toxoplasmosis and AIDS?
- multiple subcortical lesions with predilection for basal ganglia
- CD4 < 100
- MRI with multiple ring-enhancing lesions with surrounding edema
What are the clinical associations with primary CNS lymphoma and AIDS?
- CD4 < 50
- EBV in CSF PCR
- single ring-enhancing lesion
- focal neurologic deficits
What are the clinical associations with CMV and AIDS?
- retinitis
- colitis
- esophageal ulceration
- encephalitis
- pneumonitis
What are the clinical associations with Kaposi sarcoma and AIDS?
- vascular tumor with HHV-8
- skin lesions on LE, nose/face, oral mucosa, genitals
What is pharmacological therapy for prophylaxis of Pneumocystic Jirovecii in AIDS patients?
TMP-SMX (bactrim)
1 DS table daily PO
