HIV infections

Question 1

CD4 200-500

Answer 1

Oral thrush - Candida albicans
Shinges - VZV
Hairy leukoplakia - EBV
Kaposi’s sarcoma - HHV8

Question 2

CD4 100-200

Answer 2

Cryptosporidosis
Pneumocystic jirovecii pneumonia
HIV dementia

Question 3

CD4 50-100

Answer 3

Aspergillosis
Oesophagial candidiasis - candidia albicans
Cryptococcal meningitis
CNS lymphoma - EBV

Question 4

CD4 < 50

Answer 4

Cytomegalovirus retinitis

Question 5

What is Kaposi’s sarcoma? Cause
CF?
Mx?

Answer 5

Caused by HHV-8 (human herpes virus 8)
Presents as purple papules or plaques on the skin or mucosa (e.g. gastrointestinal and respiratory tract)
Skin lesions may later ulcerate
Respiratory involvement may cause massive haemoptysis and pleural effusion

Mx?
Radiotherapy + resection

Question 6

What is Cryptosporidiasis?

Answer 6

Cryptosporidiosis is the commonest protozoal cause of diarrhoea in the UK.

Cryptosporidium hominis and Cryptosporidium parvum

Features
watery diarrhoea
abdominal cramps
fever
In immunocompromised patients the entire gastrointestinal tract may be affected resulting in complications such as sclerosing cholangitis and pancreatitis

Diagnosis
stool: modified Ziehl-Neelsen stain (acid-fast stain) of the stool may reveal the characteristic red cysts of Cryptosporidium