HIV: Presentation Flashcards
what kind of life expectancy do those with HIV have?
near normal
target site for HIV?
CD4+
CD4 is found on what kinds of cells
CD4+ cells (these contain the receptors)
dendritic cells
macrophages
microglial cells
what do TH cells do?
recognise MHC class 2 cells
activate B and cytotoxic T cells
cytokine release
what does HIV do to CD4+ cells?
reduces circulating CD4+ cells
reduces proliferation
reduces cytokine release
reduces CD8+ cell activation
normal number of TH cells per mm cubed?
500-1600
what TH cell level puts you at risk of opportunistic infections?
<200
average time to death without treatment?
9-11 years
what happens at initial infection with the virus?
infects mucosal CD4 cells
transported to lymph nodes
dissemination of virus within 3 days
patients with primary HIV infection tend to be aysmptomatic T or F
F, present with symptoms
when do symptoms begin afterf infection?
2-4 weeks
how do patients with primary HIV infection present?
fever rash myalgia pharngitis headache aseptic meningitis
what kinds of meningitis do HIV patients get
aseptic
cryptococcal
after how long after contraction of the infection do HIV patients become asymptomatic?
3 months
presentation of pneumocystis pneumonia?
insidious onset
SOB
DRY cough
“exercise desaturation”
Ix of pneumocystis pneumonia?
CXR
bronchoalveolar lavage
immunofluorescence
(PCR)
signs on CXR of pneumocystis pneumonia?
interstitial infiltrates
reticulonodular markings
Tx of pneumocystis
high dose co-trimoxazole
(steroid)
low dose co-trimoxazole prophylactically
what kinds of TB are more common in HIV +ve individuals?
miliary
extrapulmonary
drug-resistant
CD4 levels are lower in CMV or cerebral toxoplasmosis?
CMV (<50)
name the 3 causes of CMV
the “itis”es
retinitis
colitis
oesophagitis
presentation of CMV?
reduced visual acuity floaters abdo pain diarrhoea PR bleeding
presentation of cerebral toxoplasmosis?
headache fever focal neurology seizures reduced consciousness raised ICP
main pathology in cerebral toxoplasmosis
toxoplasma gondii infection causing multiple cerebral abscesses
HIV patient presenting with reduced short term memory and motor dysfunction….
HIV associated neurocognitive impairment
how does progressive multifocal leukoencephalopathy present?
rapidly progressing focal neurological impairment
confusion
personality change
what infectious neuropathy can HIV patients present with?
GBS
name an AIDS related cancer
kaposi’s sarcoma
non-hodgkins
what organism cause kaposi’s sarcoma?
human herpes virus 8
pathology of kaposis sarcoma?
vascular tumour
Tx of kaposis sarcoma?
HAART
local therapies
systemic chemo
what kind of lymphoma is AIDS related?
non-hodgkins lymphoma
pathological organism in non-hodgkins lymphoma?
EBV
presentation of non-hodgkins lymphoma
b symptoms
bone marrow involvement
extranodal disease
increased CNS involvement
how should HIV patients be investigated and diagnosed in NHL?
as a HIV -ve patient would
Tx: add HAART to other Tx
what are b symptoms?
fever
night sweats
weight loss
(present in lymphomas)
skin symptoms of HIV
seborrhoeic dermatitis
psoriasis
skin infections eg HPV/HSV/HZV
what is seen on haematology in HIV?
PERISISTENT: thrombocytopania neutropaenia leucopenia anaemia of chronic disease (unexplained)
what factors increase transmission risk?
anoreceptive sex
trauma
genital ulceratiom
concurrent STI
most common mode of transmission of HIV
sexual
risk of transmitting HIV to child?
1 in 4
who are the most at-risk group for HIV?
MSM
what group are most likely to present late/be undiagnosed?
heterosexual men
high prevalence countries with HIV?
sub-saharan africa
caribbean
thailand
what is the viral marker used to detect HIV infection?
p24 capsule protein
