HIV Disease: Diagnosis and Management Flashcards
HIV modes of transmission similar to what disease?
What three modes?
Hepatitis B
- Sexual,
- parenteral, and
- vertical (perinatal)
What are the bodily fluids that HIV is transmitted through?
4
Blood products
Semen
Vaginal fluids
Breast Milk
What are the ways that HIV can be transmitted through sex?
- Intercourse (penile penetration into the vagina)
- Oral
- Anal
- Digital Sex
When can a mother spread HIV during pregnancy?
3
Before Birth
During Birth
Postpartum
(breast feeding)
What has a higher risk of infection with HIV: insertive or receptive?
receptive
Stage 1 Primary: when will symtpoms occur and what will they be like?
2
Are they infectious at this point?
- Short, flu-like illness occurs one to six weeks after infection
- could be no symtpoms at all
Yes
Stage 2:
Lasts for how long?
What are symtpoms like? 2
What are the HIV levels in the blood like?
What about HIV antibody levels?
Asymptomatic
- Lasts for an average of ten years
- stage is free from symptoms, may be swollen glands
- The level of HIV in the blood drops to very low levels
- HIV antibodies are detectable in the blood
HIV ANTIGENS TOO
Stage 3:
What are symptoms like?
What happens to the immune system?
What emerges at this stage?
2
Symptomatic
- The symptoms are mild
- The immune system deteriorates
- emergence of opportunistic infections and cancers
What kind of virus is HIV?
What is the mechanism of action?
4
retrovirus (RNA creates DNA instead of DNA creating RNA)
- Reverse transcription of the viral RNA genome into double stranded DNA occurs
- imported into cell nucleus and integrated into cellular DNA
- rapid viral replication!
- CD4 cells drop, CD8 tells kill all the HIV infected cells
WHat cells does HIV target?
3
affects
- CD4-Helper T cells!
- macrophages and
- dendritic cells (B cells)
Infections that are thought to early defining diseaase in the diagnosis of AIDS?
4
- Slim disease
- Esophagel candidiasis
- Aggressive Kaposi’s sarcoma
- Crypotococcal meningitis
What country has the largest infection rate of HIV?
What country has the fastest spreading HIV?
Spreading fastest in Asia
Largest infection rate is in Africa
Whats HAART?
highly active antiretroviral therapy
Following infection what happens to the T cells?
So what kind of defect is the most important in understanding the pathology of HIV?
they become nonfunctional
There is a qualitative defect in T-cells which overshadows the simple quantitative defect
Clinically, the syndromes of HIV are from one of 3 mechanisms. What are they?
3
- Immunodeficiency
- Autoimmunity
- Allergy/Hypersensitivity reaction
What syndromes do we see do to immunodeficiency in HIV? 3
- Spectrum of infections and neoplasms
- Very low incidence of certain infections seen in other causes of immudeficiency (listeriosis and aspergillosis)
- Higher incidence of other infections (Kaposi’s sarcoma)
What syndromes do we see due to autoimmunity in HIV?
2
- Lymphocytic infiltrate infiltrate of organs (lymphocytic interstitial pneumonitis)
- Autoantibody production (immunologic thrombocytopenia)
What syndromes do we see due to Allergy/Hypersensitivity reactions in HIV?
2
- Higher rates of allergic reactions to unknown allergens (eosinophilic pustular folliculitis)
- Increased rates of hypersensitivity to medications
HIV disease is a continuum, but will be crudely broken down into four phases:
Primary HIV Infection
Asymptomatic Infection
Symptomatic Infection
AIDS
Length and severity of each phase is dependant on what?
Therapies?
2
on host and virus
- Use of antiretroviral therapy
- Use of chemoprophylaxis for opportunistic infections
How long is each phase of HIV: Primary? Asymptomatic? Symptomatic? AIDS?
3-14 days
4-8 years
4-8 years
2-20 years
Primary infection is brief, mononucleosis type of illness.
What are its symptoms?
12
Fever Sweats Lethargy Malaise Myalgias Arthralgias Headaches Photophobia Diarrhea Sore throat Lymphadenopathy Truncal maculopapular rash
Onset of primary infection of HIV?
How long does it last?
What percent of pts have symtpoms of the primary infection?
Sudden onset
Lasts 3-14 days
50%
Most common neuro symptoms in primary HIV?
2
are headache and photophobia
Most commonly seen symptom in ALL HIV+ patients is what?
generalized lymphadenopathy