Human Immunodeficiency Virus Flashcards
What type of virus is HIV?
HIV is an RNA retrovirus
HIV primarily infects CD4+ T helper lymphocytes.
What is Acquired Immunodeficiency Syndrome (AIDS)?
AIDS occurs when HIV is not treated and the disease progresses
It leads to severe immunodeficiency.
What are the consequences of immunodeficiency caused by HIV?
Leads to opportunistic infections and AIDS-defining illnesses
Immunodeficiency makes the body vulnerable to infections.
What are the stages of HIV disease progression?
- Primary HIV infection (seroconversion)
- Longstanding HIV infection
- AIDS
What are the modes of HIV transmission?
- Sexual contact
- Vertical transmission
- Contaminated needles
Who are at higher risk for HIV infection?
- MSM
- Female sexual contacts of MSM
- IV drug users
- Individuals engaging in unprotected sex or with other STIs
What symptoms are associated with primary HIV infection (seroconversion)?
- Fever
- Malaise
- Arthralgia
- Maculopapular rash
- Oral ulcers
How long after exposure do flu-like symptoms occur in primary HIV infection?
2-4 weeks post-exposure
What are persistent symptoms of longstanding HIV infection?
- Fever
- Weight loss
- Lymphadenopathy
- Cough
- Neutropenia
- Anemia
- Opportunistic infections
How is AIDS defined?
By either CD4+ count <200 cells/nanoL or presence of AIDS-defining illness
What are examples of AIDS-defining illnesses?
- Kaposi’s sarcoma
- Pneumocystis jirovecii pneumonia (PCP)
- Cytomegalovirus infection
- Candidiasis (oesophageal or bronchial)
- Lymphomas
- Tuberculosis
Where is HIV screening offered?
- Sexual health services
- Antenatal services
- Substance misuse services
What do 4th generation HIV tests detect?
- HIV antibodies
- p24 antigen
How long can it take for a 4th generation HIV test to turn positive after exposure?
Up to 45 days
What do 3rd generation HIV tests include?
- Point-of-care tests
- Self-sampling kits including 4th generation tests
What should be provided during HIV testing?
Pre-test and post-test counselling
What does active monitoring of HIV involve?
- Testing CD4+ count
- Testing HIV RNA (viral load)
What is the normal range for CD4+ count?
500-1200 cells
< 200 indicates opportunistic infection risk
What does undetectable viral load mean?
Approximately <20 copies/ml
What is the treatment for HIV?
Anti-retrovirus therapy (e.g. NRTIs)
What are the aims of HIV treatment?
- Achieve normal CD4+ count
- Achieve undetectable viral load
What prophylactic treatments are recommended for CD4 count <200?
Prophylactic co-trimoxazole to protect against PCP
What vaccinations are recommended for HIV patients?
- Influenza - yearly
- Pneumococcal
- HPV
- Hepatitis A and B
What is the recommendation regarding live vaccines for HIV patients?
AVOID LIVE VACCINES (e.g. BCG, typhoid)
What delivery method is recommended for a viral load <50 copies/ml?
Normal vaginal delivery
What delivery method is considered for a viral load >50 copies/ml?
Consider pre-labour c-section
What is the recommended action for a viral load >400 copies/ml?
Pre-labour c-section
What is the risk of breastfeeding for HIV-positive mothers?
HIV can be transmitted during breastfeeding
What is recommended for HIV-positive mothers regarding breastfeeding?
Recommend to avoid breastfeeding
What is the most common causative organsim of diarrhoea in HIV patients?
Cryptosporidium (a protozoa)
What is Kaposi’s sarcoma?
- caused by human herpes virus 8
- purple papules or plaques on skin/mucosa
- skin lesions may ulcerate
- respiratory symptoms - massive haemoptysis, pleural effusion
An AIDS-defining disease
What are the most common focal neurological lesions in HIV?
- toxoplasmosis (headache, confused, drowsy)
- primary CNS lymphoma
