HIV & SAIs Flashcards
What cells in a human body does HIV attack? What does this cause?
- Immune cells (T lymphocytes)
- Immunosuppression
Which tests are used for the diagnosis of HIV?
- ELISA (antibody test)
- PCR (tests RNA of HIVE or HIV DNA in WBCs)
How long is the post-infection period that a diagnosis may be negative for?
6-12 weeks
What diseases are associated with HIV when CD4 cell count is reduced?
- Bacterial skin infections, HSV, VZV, fungal infections
- Kaposi’s sarcoma
- Hairy leukoplakia, TB
- Lymphoma
What viral co-factor is involved with Kaposi’s sarcoma?
HHV8
What is Kaposi’s sarcoma?
- Systemic vascular tumour with cutaneous presentation
- With/ without internal involvement
- Caused by co-virus HHV8 commonly seen in immunosuppressed pts (e.g. HIV/AIDS)
- Lesions clinically seen as red, purple, brown or black and papular (raised/ palpable)
What therapy is involved in the treatment of HIV?
HAART (Highly Active Anti-Retroviral Therapy)
What are the oral manifestation lesion groupings?
- Group 1 = STRONGLY associated with HIV infection
- Group 2 = LESS COMMONLY associated with HIV infection
- Group 3 = SEEN in HIV infection
What are the group 1 oral lesions seen in those infected with HIV?
- Candidosis
- -> Erythematous = angular cheilitis, denture stomatitis, median rhomboid glossitis - EARLY
- -> Pseudomembranous - LATE
- Hairy leukoplakia
- Kaposi’s sarcoma
- NHL
- Perio diseases = linear gingival erythema, NUG (young otherwise health mouths), NUP
What is the clinical appearance of oral hairy leukoplakia?
- White, non-removable, corrugated lesion on the lateral surface of tongue
What is the histological appearance of oral hair leukoplakia?
- Hyperkeratosis
- Epitehlial hyperplasia (koilocyte-like cells)
- EBV
- No infiltrate cells (clear evidence of immunosuppression)
What are the group 2 oral lesions seen in those infected with HIV?
- Ulceration (not otherwise specified); usually apthous (from trauma)
- Wide range viral infections (HSV, HPV, VZV)
What are the clinical features of a HSV I/II infection?
- Pyrexia, sore mouth and throat, lymphadenopathy
- Primary herpetic gingivostomatitis (widespread vesicles –> painful ulcers)
- Recurrent herpes labialis
- 2 primary infections may occur (secondary infection not protected by first)
What is the treatment for HSV I/II infections?
- Self-limiting –> bed rest, paracetamol, fluids
- Aciclovir; will only help things settle quicker but only effective BEFORE vesicular stage
What are the group 3 oral lesions seen in those infected with HIV?
- Wide range of rare bacterial/ fungal infections
- Unusual things including facial palsy and trigeminal neuralgia
What are the causes for UPPER motor neurone facial palsies?
- Stroke
- Cerebral tumour
- Trauma
What are the causes for LOWER motor neurone facial palsies?
- Middle ear infections (mastoiditis, esp chronic/ recurrent)
- MS
- HIV
- Lyme’s disease (tick bites)
- Parotid tumour
- Ramsay-Hunt Syndrome (shingles complication)
- Idiopathic (Bell’s palsy)
Which half of the face (upper/lower) is affected by a LMN lesion?
BOTH
What is the treatment for a facial palsy?
- Prednisolone 50-80mg (orally) every morning for 10 days (NOT antiviral but steroid to reduce compression of nerve)
- Protect cornea of eye with eye patch
What bacteria causes gonorrhoea?
N. gonorrhoea
How does gonorrhoea affect men?
Infection of urethra
How does gonorrhoea affect women?
- Infection of cervix
- Pelvic inflammation –> infertility
What are the oral manifestation of gonorrhoea?
- Dry/ burning of mouth
- Diffuse mucosal erythema
- Lymphadenopathy
How is gonorrhoea diagnosed?
- Swab culture and sensitivity
What is the treatment for gonorrhoea?
AB
What bacteria causes syphillis?
T. pallidum (spirochaete)
What are the primary presentation of syphillis?
(3 weeks post-infection)
- Chancres (painless round ulcers) around lips, genitals
Resolves in 2-3 months
What are the secondary presentation of syphillis?
(1-4 months post-infection)
- Macular/ generalised skin rash
- Oral papules
- ‘Snail-track’ ulcers
Resolves 2-6 weeks
What are the tertiary presentation of syphillis?
(Years later post-infection)
- Gumma of palate (form of granuloma)
- Atrophic glossitis
- Any organ may be affected
How is syphillis diagnosed?
Serology with AB testing
What is the treatment for syphillis?
High dose penicillin or tetracycline
What bacterial causes clamydia?
Clamydia trachomatis (obligate intracellular pathogen)
How does clamydia affect men?
- Urethritis (burning, urinary freq, discharge)
- Prostatitis
- Epididymitis
How does clamydia affect women?
- Often asymptomatic
- Dysuria
- Cervical discharge
- Pelvic inflammatory disease –> infertility
What is the treatment for clamydia?
AB
