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MNT II > HIV and AIDS > Flashcards

HIV and AIDS Flashcards

1
Q

Acquired Immune Deficiency Syndrome (AIDS)

A

Caused by the human immunodeficiency virus (HIV).

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2
Q

Human Immunodeficiency Virus (HIV)

A
  • Affects the bodies ability to fight off infections and disease
  • Ultimately results in death
  • Effective interventions are now available
  • Is one of the most important health threats of modern time
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3
Q

HIV Transmission

A

Transmitted from person to person through infected body fluids:

  • Sexual contact
  • Needle and syringe sharing
  • Contaminated transfusions
  • Transmission before and during birth
  • Through breast feeding
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4
Q

HIV Retrovirus

A

Contains RNA, is transcribed to dual strand DNA and integrated into the host cell DNA to reproduce. Invades the CD4+ cells and causes progressive depletion of CD4+ cells, leads to immunodeficiency.

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5
Q

HIV CD4+ Cells

A

Principal agents involved in protection against infection.

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6
Q

Biomarkers Used to Assess HIV

A
  • Viral load

- CD4+ count

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7
Q

4 Clinical Stages of HIV

A
  1. Acute HIV infection
  2. Clinical latency
  3. Symptomatic HIV
  4. Progression of HIV to AIDS
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8
Q

Acute HIV Infection

A

Time of transmission to the host until production of detectable antibodies. Half of individuals experience symptoms of fatigue, fever, malaise, or swollen lymph glands 2-4 weeks following infection. Nonspecific.

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9
Q

HIV Acute Stage

A

Virus replicates rapidly. If testing is done before seroconversion (production of detectable antibodies against the virus) occurs, will produce false negative results.

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10
Q

Clinical Latency or Asymptomatic HIV Infection

A

Further evidence of the disease may not occur for up to 10 years. Virus is still active and replicating.

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11
Q

Symptomatic HIV Infection

A

CD4+ cells fall below 500 cells/mm3. Signs and symptoms develop: fever, chronic diarrhea, weight loss, and fungal infections.

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12
Q

Progression to AIDS

A

CD4+ cells drop to less than 200 cells/mm3 or documentation of an AIDS defining condition with increased risk of opportunistic infections (OIs).

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13
Q

Opportunistic Infections (OIs)

A

Oral candidiasis, herpes simplex, hepatitis C, Kaposis sarcoma, lymphoma, pneumonia, toxoplasmosis of the brain, and TB.

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14
Q

HIV CD4+ Count

A
  • Used to determine ART initiation
  • Strongest predictor of disease progression
  • Monitored every 3-4 months
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15
Q

HIV Antiretroviral Therapy Drugs (ART) Goals

A
  • Achieve/maintain viral suppression
  • Reduce HIV related morbidity and mortality
  • Improve QOL
  • Restore and preserve immune function
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16
Q

HIV Adverse Effects of ART

A
  • Toxicities
  • Metabolic complications
  • Non adherence can lead to drug resistance
17
Q

HIV 6 Mechanistic Classes of ART Drugs

A
  1. Nucleotide reverse transcriptase inhibitors (NRTIs)
  2. Non-nucleotide reverse transcriptase inhibitors (NNRTIs)
  3. Protease inhibitors (PI)
  4. Fusion inhibitors
  5. Chemokinase receptor 5 antagonists (CCR5)
  6. Integrase strand transfer inhibitors (INSTIs)
18
Q

HIV ART Food and Drug Interactions

A

Pt needs to report ALL vitamins, supplements, medications and recreational substances they are using. Interactions can influence the efficiency of the drugs.

19
Q

HIV Side Effects of ARTs

A
  • Nausea
  • Emesis
  • Fatigue
  • Insulin resistance
  • Dyslipidemia
  • Must be taken on a schedule
20
Q

HIV Energy and Fluid Intake

A
  • Difficult due to issues of wasting, obesity, HALS
  • Asymptomatic HIV increases energy expenditure by 10%
  • After OI, requirements increase by 20-50%
21
Q

HIV Protein Requirements

A
  • .8g/kg of body weight sufficient
  • After an OI additional 10% intake in protein recommended due to increased protein turnover
  • Renal insuff, cirrhosis, pancreatitis are present, adjust protein accordingly
22
Q

HIV Fat Requirements

A
  • General heart healthy guidelines

- Increase omega 3 intake

23
Q

Micronutrients in HIV

A

Deficiencies common due to malabsorption, drug nutrient interactions, altered gut barrier function, gut infection and altered metabolism.

24
Q

Micronutrients and HIV Infection

A
  • Low levels of vitamin A, B12, and Zn associated with faster disease progression
  • Higher intakes of vitamin C and B have been associated with increased CD4 counts and slower disease progression
  • Vitamin A, Zn and selenium are low in response to infection
  • Recommended balanced healthy diet with multivitamin meeting 100% of DRI
25
Q

HIV Wasting

A
  • Unintentional weight loss
  • Loss of lean body mass (LBM)
  • Associated with disease progression and mortality
  • Related to inadequate intake, malabsorption, increased metabolic rate, and complications of the disease
26
Q

HIV Obesity

A
  • Continuous weight gain is not protective against wasting or progression of disease
  • Monitor for dyslipidemia, insulin resistance and diabetes
  • Encourage physical activity to achieve healthy weight and LBM
27
Q

HIV Associated Lipodystrophy (HALS)

A

Metabolic abnormalities and body shape changes seen in HIV.

  • Fat deposition in abdominal region, dorsocervical fat pad, breast hypertrophy
  • Loss of subcutaneous fat in extremities, face and buttocks
28
Q

HIV HALS Metabolic Changes

A
  • High triglycerides, high LDL, low HDL and insulin resistance
  • Varies in pts
  • Each part may occur simultaneously or independently
29
Q

HIV HALS Multifactorial Causes

A
  • Duration of disease
  • Duration of ART
  • Age
  • Gender
  • Race
  • Ethnicity
  • BMI
30
Q

HIV HALS Nutrition Intervention

A
  • Aerobic exercise
  • Resistance training
  • Overall adequate diet
  • Increased fiber intake
  • Omega 3 fatty acid may reduce inflammation and improve depression and decrease triglyceride levels
31
Q

HIV Complementary and Alternative Medicine (CAM)

A
  • Dietary supplements
  • Yoga
  • Meditation
  • Acupuncture
  • Herbal treatments
  • Megavitamins
  • Only 1/3 of pts disclose CAM`
32
Q

HIV Nutrition Diagnosis

A
  • Inadequate food and beverage intake
  • Involuntary weight loss
  • Food-medication interaction
  • Food and nutrition related knowledge deficit
33
Q

HIV Nutrition Interventions

A
  • Nutrition educations regarding methods to increase nutrient density for all foods
  • Consume smaller, frequent meals
  • Add high calorie and protein beverage between meals
  • Recommend multivitamin daily
34
Q

HIV Monitoring and Eval

A
  • Monitor weight and nutrition assessment indices

- Evaluate 24 hour recall for nutrition adequacy

MNT II (8 decks)

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