Human Immunodeficiency Virus Infection Flashcards
How is HIV transmitted?***
Through contact with infected blood, semen, vaginal secretions or breast milk**
Sexual intercourse
Exposure to HIV blood or blood products
Perinatal transmission during pregnancy at: delivery or breast feeding
After a few days post exposure they can transmit it
Variables that tell if infection will take place after exposure are:
- Duration and frequency of contact with organism
- Volume, virulence and concentration of the organism
- Host immune status
** concentration of virus is an important variable **
Where can the most HIV be found and lease be found?
Most in the blood and least in the semen in the beginning and end of disease
Most common mode of HIV transmission
Sexual transmission
What does sexual transmission involve?
Contact with semen, vaginal secretions and/or blood. Genital lesions, STI and sex that causes trauma to the tissues increases contraction.
During all types of intercourse the partner receiving the semen is at the greatest risk.
High blood transmission risk is only met if:
Patient with high level of circulation HIV
A deep puncture wound
A needle with a hollow bore and visible blood
A device used for venous or arterial access
A patient who digest within 60 days
Splash exposures of blood on skin with an open lesion present some risks but is much lower than from a puncture wound
How can mother to child transmission be reduced during pregnancy?
Routine HIV testing and antiretroviral therapy ART
When can HIV replicate?
When it inside a living cell
What is reverse transcriptase
An enzyme made by retroviruses. It is a strand of DNA and copies itself becoming double stranded viral DNA entering cells nucleus using another enzyme called integrase. Splicing itself becoming a permanent part of the cells genetic structure either all genetic material is replicated during cell division all daughter cells are also infected a viral DNA in the genome directs the cell to make new HIV
Initial HIV infection results in what? (Pathophysilogy)
Virginia = large amounts of virus in the blood
Followed by low HIV levels causing someone to not show clinical manifestations for up to ten years.
Clinical Manifestations: Acute Infection
Fever Swollen lymph glands Sore throat Headache Malaise Nausea Joint pain Diarrhea And/or diffuse rash often accompanies seroconversion (when HIV specific antibodies develop.
Some people develop ascetic meningitis, peripheral neuropathypathy, facial palsy or Gillian barre syndrome.
Clinical manifestations: acute infections
What are these symptoms called and when do they occur?
Acute HIV infection
Occur 2-4 weeks after initial infection and last for 1-3 weeks
During this time a high amount of HIV is circulating the body
Clinical Manifestation: Asymptomatic chronic HIV infection
Body's viral load is low CD4T cells count is normal or decreased Fatigue Headache Low-grad fever Night sweats
Clinical Manifestations: Symptomatic Infection of chronic HIV infection
CD4T cells drop Viral load increases Early stage symptoms worsen: - persistent fever -frequent drenching night sweats - chronic diarrhea - recurrent headaches - fatigue severe nought to interrupt daily life
Other:
- localize infection
- lymphadenopathy
- nervous system manifestations
Most common chronic HIV symptomatic infection?
Other infections that can occur at this time as well are?
Candidiasis or thrush***
- shingles
- persistent vaginal Candida’s infections
- outbreaks of oral or genital herpes
- bacterial infections
- kapok I sarcoma
Clinical Manifestations of Oral Harry leukoplakia
Painless white raised lesions on the lateral aspect of the tongue which is an indication of disease progression
What is Acquired immunodeficiency syndrome (AIDS)?
AIDS, made when HIV infected pt meets criteria established by the CDC
- immune system is severity compromised
Diagnosis of HIV infection is made by
Testing for HIV antibodies and or antigen in the blood. However these antibodies take several weeks after the infection to be detected/ window period.
- Standard antibody test - blood or oral fluid specimens sent to the lab
- Rapid HIV-antibody - done in the doc office or at home. Followed up by confirmation test if initial was positive
- Elisa - test is done first and if it is positive they confirm it with the western blot if it is negative they are retested in 3-6 months because of lag time between exposure
Laboratory studies in HIV infection: progression is by two important lab assesments
CD4T cell counts = as the disease progresses this cell found decreases (800-1200)
Viral load = lower the load the less active the disease. Results reported in numbers or undetectable meaning the load is too small for the test to count.
What abnormal test are common with HIV infection? Why are they abnormal?
Blood test results are abnormal:
- decreased wbc
- low lymphocytes and neutrophils
- low platelets
___ is associated with the chronic disease process and with a/e of ____.
Anemia/art
Altered liver function is common and is caused by:
HIV infection
Drug therapy
Or co-infection with a hepatitis virus
What are the 2 types of HIV resistance test to see how with ART will work?
Genotype assay - detects drug resistant viral mutations that are present in reverse transcriptase and protease genes
Phenotype assay - measures HIV growth in diff concentrations of antiretroviral drugs
These assays help theater in new drub combinations for patients who are not responding to therapy
What is hiv?
A retrovirus that causes immunosuppression.
