immune mediated diseases Flashcards
- HIV disease/AIDS
- Cancer
- Rheumatic diseases
- Asthma
immune mediated diseases
– Retrovirus that is implicated in development of AIDS
– Primary target is the CD4 lymphocyte (helper T cell)
– Causes cell death of CD4 T cells
hiv
– Progressive impairment of the immune system by the
human immunodeficiency virus (HIV)
– A diagnosis is based on
• Low CD4 counts 5000 copies per ml
• The presence of one or more specific opportunistic infections or malignancies
aids
• First appearance is unknown
– Central Africa
– First confirmed case was in the Congo in 1959
– Spread rapidly through heterosexual population
• High rate of extramarital sex
• Low rate of condom use
• High rate of gonorrhea
• Medical clinics reused needles to promote vaccinations
aids history
• End of 2012: Living with HIV/AIDS
– 35.3 million people were living with HIV
• 2.3 million people became newly infected
• 1.6 million died of AIDS-related causes
• Nearly 1 in every 20 adults in Sub-Saharan Africa are living with HIV
(69% of all people with HIV)
• In the US, > 1.1 million people are living with HIV
– Almost 1 in 5 (18.1%) are unaware of their infection
• More than 25 million deaths over the past 3 decades
aids brief history
• HIV is a retrovirus
– Attacks immune system, especially the helper T cells (CD4’s) and macrophages
– Transmitted by exchange of cell-containing bodily fluids, such as semen and blood
– Highly variable time between contracting virus and developing AIDS symptoms
how we get aids: virus
-drug users, homosexual men, heterosexual population, transmission from mother to child
aids transmission
• Acute HIV infection
– Within a week or so
– Mild early symptoms: Fever, sore throat, flu-like
symptoms
• 3 to 6 weeks
– Infection abates, asymptomatic period
• Amount of virus gradually rises: HIV Disease
– Immune system compromised
– Opportunistic infections (viruses and parasites) and malignancies, such as Kaposi’s sarcoma, occur
– Common symptom for women: Gynecologic infection
how hiv infection progresses
• Actions taken to decrease morbidity and
mortality from disease
• Primary
– Avoid development of disease
• Secondary
– Early disease detection to prevent progression
and symptom development
• Tertiary
– Reduce negative impact of established disease
prevention
• Taking measures to combat risk factors for
illness before an illness ever has a chance to
develop
• Two general strategies
– Employ behavior-change methods to alter
problematic behaviors
– Keep people from developing poor health habits in the first place
primary preverntion
– Early detection/screening
– Teach patients behaviors to prevent spread of HIV
– Antiretroviral drug therapy to keep HIV disease from occurring
secondary prevention
– Antiretroviral drug therapy and adherence training
– Cognitive behavioral therapy
tertiary prevention
– Dramatically improved health of those with HIV
– Treatments are complex: combinations of drugs
– Adherence is critical
– Side effects unpleasant
– Adherence is variable
highly active antiretroviral therapy (HAART)
• Test positive for HIV, not yet AIDS – People live with a threatening event – Live with uncertainty and fear • Initial response – Psychological distress – Sharply curtail HIV risk-related behaviors – Make positive changes in health • Interventions that reduce depression are valuable
Psychosocial Impact of HIV
Infection
– Major barrier to controlling spread of HIV: Not disclosing HIV status – Those who don’t disclose: Less likely to use condoms – \_\_\_ has benefits • Positive health consequences • More CD4 cells than non-disclosers • \_\_\_\_ of sexuality – Also linked to HIV outcomes – Remaining “in the closet” associated with • Faster progression of HIV disease
disclosure
• Education
• Health Beliefs and AIDS Risk-Related Behavior
– One must perceive oneself as capable of controlling risk-related activity
– Behaviors become integrated into ‘sexual styles
Interventions to Reduce the
Spread of HIV/AIDS
• Targeting IV Drug Use
– Needle exchange programs
• Cognitive-Behavioral Interventions
– Decrease distress among HIV+ individuals
– Buffer psychological/immunologic consequences
– Improve surveillance of opportunistic infections
• HIV Prevention Programs
– School-based interventions about safe sex
– Communication & condom use skills
– Target behaviors associated with high-risk sex
(alcohol, drugs)
– Target norms (monogamy, abstinence)
Interventions to Reduce the
Spread of HIV/AIDS
• HIV disease/AIDS is now a chronic disease – Employment • Men with HIV continue working • Unemployed may not return to work – Fear and prejudice • Many have an intense fear of AIDS • Many blame the victims for their disease: Especially gay and IV drug users • Coping Skills – Coping effectiveness training – Perceived control & self-efficacy • Social Support
Coping with HIV+ Status and Aids
• HIV-infected gay men
– Rapid course of disease for those with more
stress
– Slower course of disease with more social support
• Negative beliefs about self
– Correlated with decline in helper T cells
• Finding meaning and optimism associated
with better outcomes
• Writing interventions promoting optimistic
thinking about the future
– Led to greater reported adherence to medication
– Less distress from side effects
Psychosocial Factors that Affect its Course
-set of >100 diseases
- all result from dna dysfunction
• Neoplastic growth
– Rapid cell growth and proliferation (unlimited)
– Cancerous cells provide no benefits to body
– Cancerous cells sap the body’s resources
• Neoplastic cells may be:
– Benign
– Malignant
cancer
remain localized and usually less threatneing
benign neoplastic cells
more dangerous; invade and destroy surrounding tissue and may metasasize
malignant neoplastic cells
– Carcinomas
– Sarcomas
– Leukemias
– Lymphoma
malignant growths of cancer
- Cancers of the epithelial tissue
* Skin, stomach lining, mucous membranes, etc.
carcinomas(malignant)
