HIV MODULE Flashcards
What is the most common stage 1 symptom of HIV infection during seroconversion?
A flu-like illness with symptoms such as fever, swollen glands, muscle aches, and tiredness.
What is the prevalence of HIV in South Africa as of 2019?
Approximately 7.7 million people, with a 20.4% prevalence among the general population.
Which phase of HIV infection is characterized by asymptomatic progression, and how long can it last?
Phase 2, the asymptomatic phase, which can last for several years.
What symptoms characterize WHO Stage 2 of HIV?
Mild symptoms such as unexplained weight loss (under 10% of total body weight), recurrent respiratory infections, and skin conditions like angular cheilitis and seborrheic dermatitis.
In the WHO staging of HIV, what distinguishes Stage 3 from earlier stages?
Symptoms include unexplained weight loss (more than 10% of body weight), chronic diarrhea, pulmonary tuberculosis, and oral candidiasis.
What are common infections associated with WHO Stage 4 (AIDS)?
Infections such as Pneumocystis pneumonia, CMV retinitis, and chronic orolabial herpes, as well as cancers like Kaposi’s sarcoma and cervical cancer.
What is the primary purpose of WHO staging in HIV management?
To guide prognosis and treatment decisions based on the severity of symptoms and immune function.
What baseline test is essential before initiating ART in HIV patients?
CD4 count, which helps assess immune status and need for additional tests like Cryptococcal Latex Antigen Test if CD4 <100.
What is the UNAIDS 90-90-90 target?
A goal that aims for 90% of people with HIV to know their status, 90% of diagnosed individuals to be on ART, and 90% of those on ART to achieve viral suppression.
When should ART be initiated in an HIV patient co-infected with TB?
After treating TB for 2 weeks to ensure a positive response before starting ART, unless the TB involves the central nervous system.
A patient with HIV presents with prolonged diarrhea and weight loss over 10% of body weight. Which WHO stage does this align with, and what is the implication?
WHO Stage 3, indicating an advanced HIV infection that requires prompt medical intervention.
In South Africa, what are the first-line medications in the Fixed Dose Combination (FDC) for HIV treatment?
Tenofovir, Emtricitabine, and Efavirenz, which simplify adherence by reducing the pill burden.
What is Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV management, and when is it most likely to occur?
IRIS is an inflammatory response to opportunistic infections triggered by immune recovery after starting ART, often occurring in patients with low CD4 counts.
How does WHO Stage 4 (AIDS) differ from WHO Stage 3 in terms of symptoms and prognosis?
Stage 4 involves more severe, life-threatening conditions such as specific cancers and severe opportunistic infections, indicating a severely compromised immune system.
Why is counseling crucial for ART adherence in HIV patients, and what are potential consequences of poor counseling?
Counseling improves adherence, reduces the risk of treatment default, and prevents resistance; poor counseling may lead to drug resistance and treatment failure.
Which co-infections require additional screening in HIV patients with a low CD4 count before starting ART?
Cryptococcal infection (via Cryptococcal Latex Antigen Test) and tuberculosis, especially if the CD4 count is below 100.
An HIV-positive patient on ART reports intense itching and mild jaundice. What condition might this suggest, and why is it important?
Drug-Induced Liver Injury (DILI), which requires careful monitoring as it can lead to severe liver dysfunction and affect ART adherence.
What skin and oral conditions are commonly seen in WHO Stage 2 of HIV?
Conditions such as recurrent oral ulcers, seborrheic dermatitis, and fungal nail infections, which are indicators of mild immunosuppression.
What is the significance of monitoring viral load in patients on ART, and how often should it be tested?
Viral load helps track the effectiveness of ART, aiming for viral suppression; it is typically checked at baseline and periodically during treatment.
Why must TB treatment be initiated before ART in co-infected HIV patients, and what is the exception?
Starting TB treatment first reduces the risk of IRIS; however, in cases of TB meningitis, ART is delayed 4-6 weeks to prevent severe inflammation.
What is angular cheilitis, and why is it significant in WHO Stage 2 of HIV?
Angular cheilitis is an inflammatory condition causing red, swollen patches in the corners of the mouth, often due to immune suppression, making it a sign of mild HIV-related immunosuppression.
How do recurrent oral ulcerations present in WHO Stage 2 of HIV?
These ulcers appear as painful sores in the mouth that recur frequently, indicating mild immunosuppression.
What is linear gingival erythema, and how is it associated with HIV?
Linear gingival erythema is a distinctive red line along the gum margins, linked to immune suppression in HIV, and seen in Stage 2 as an early sign of disease progression.
Why is herpes zoster (shingles) considered a Stage 2 HIV condition?
Herpes zoster, or shingles, occurs due to reactivation of the varicella-zoster virus, which can flare up due to weakened immunity in HIV patients, indicating moderate immune compromise.
What is extensive Human Papillomavirus (HPV) infection, and how does it present in Stage 2?
Extensive HPV infection can cause widespread warts or lesions, often more severe in HIV patients with weakened immunity, and is a sign of moderate immunosuppression.
What are papular pruritic eruptions, and what do they indicate in HIV?
Papular pruritic eruptions are itchy, small bumps on the skin that can indicate moderate immune system suppression, commonly appearing in WHO Stage 2 of HIV.
How does seborrheic dermatitis manifest in HIV-positive individuals at Stage 2?
Seborrheic dermatitis appears as flaky, scaly patches, often on the scalp or face, and becomes more severe with HIV-related immunosuppression.
Why are fungal nail infections categorized under WHO Stage 2 in HIV?
Fungal nail infections, like onychomycosis, are common in immunosuppressed patients, and their prevalence in HIV indicates moderate immune decline.
In HIV, what is the significance of recurrent dermatological infections or conditions in WHO Stage 2?
Recurrent infections suggest a decline in immune function and act as markers of early disease progression, as seen in conditions like herpes zoster and oral ulcerations.
How can WHO Stage 2 dermatological conditions impact quality of life in HIV patients?
Conditions like chronic itching, painful oral sores, and skin lesions can lead to discomfort, social isolation, and may affect nutritional intake if oral lesions are severe.
What level of weight loss characterizes WHO Stage 3 in HIV?
Unexplained weight loss exceeding 10% of total body weight, often a result of chronic illness and malnutrition associated with advancing HIV.
Why is prolonged diarrhea (lasting over a month) a Stage 3 symptom of HIV?
Chronic diarrhea, often due to infections, indicates significant immune suppression and can lead to severe dehydration and nutrient loss.
What respiratory condition is a hallmark of WHO Stage 3 in HIV?
Pulmonary tuberculosis is common, as the weakened immune system allows latent infections like TB to become active and symptomatic.
What is lymphocytic interstitial pneumonia (LIP), and how does it relate to HIV?
LIP is a rare chronic lung disease, presenting with cough and breathing difficulties, associated with HIV-related immune suppression in Stage 3.
How does severe recurrent pneumonia present in WHO Stage 3 of HIV?
Patients experience multiple episodes of bacterial pneumonia, which is an indicator of weakened immunity and a defining feature of Stage 3.
What type of bacterial infections are commonly seen in WHO Stage 3?
Severe systemic infections like pyelonephritis, empyema, and meningitis, which are hard to control due to immunosuppression.
What is pyomyositis, and why is it significant in HIV?
Pyomyositis is a bacterial infection of skeletal muscles, leading to abscess formation and often requiring drainage, more common in HIV due to immune deficits.
Why is oral candidiasis significant in WHO Stage 3?
Oral candidiasis (thrush) suggests moderate immune suppression, as it occurs due to overgrowth of fungi in the oral cavity, commonly found in advancing HIV.
How does oral hairy leukoplakia manifest in WHO Stage 3, and what causes it?
It appears as white, hairy patches on the sides of the tongue, caused by Epstein-Barr virus reactivation due to weakened immunity in HIV.
What is acute necrotising ulcerative gingivitis/periodontitis in HIV?
It’s a severe gum infection that leads to painful ulcers and tissue death, indicative of advanced immune system suppression.
What differentiates oral hairy leukoplakia from oral candidiasis?
Oral hairy leukoplakia is often painless and cannot be scraped off, whereas candidiasis is often painful and can be removed with scraping.
Why are bone and joint infections more frequent in WHO Stage 3 of HIV?
Weakened immune responses in Stage 3 allow bacteria to infect bones and joints, leading to conditions like osteomyelitis and septic arthritis.
How do bacterial blood infections present in WHO Stage 3?
Bacteremia, or the presence of bacteria in the bloodstream, can lead to sepsis and is more common as the immune system weakens in advanced HIV.
What lung conditions beyond TB are common in WHO Stage 3?
Chronic HIV-associated lung diseases, including chronic bronchitis and lymphocytic interstitial pneumonia (LIP), reflect pulmonary immune damage.
How do WHO Stage 3 conditions affect HIV treatment considerations?
Severe infections and chronic conditions may necessitate adjustments in ART and supportive care to manage complex symptoms and improve patient outcomes.
