L69 Flashcards
Define incidence vs prevalence
Prev = # people living with condition
- Increasing for HIV b/c better treatment
Incidence = # new infections per year
- Constant for HIV
Name the 5 body fluids that can transmit HIV.
Blood Breast milk Semen Vaginal Rectal fluids
What is the key factor driving infectiousness of a donor? How is this measured?
Viral load = amt of virus in the body
Measured by PCR
What are factors that increase your risk for transmission in an occupational setting?
- Visible blood on needle
- Needle from artery/vein
- Hollow bore/large gauge needle
- Deep injury
- From pt w/ high viral load
What is the standard diagnostic method for pots over 18 mo old? What is it testing?
Serum PCR (immunoassay) for plasma viral RNA - IgM - IgG - p24 Testing viral load
Name the order of HIV characteristics you see in pts.
Virus in blood - viral load
What would give you a false positive serum PCR?
HIV vaccine
Autoimmune disease
What is the eclipse period?
No signs of infection b/c localized
During first few days of infection
What is the window period? What is characteristic of this period for diagnostics?
Pt is infected with HIV
False negative test b/c no Abs yet
What is the seroconversion window?
Time to make Abs vs HIV
If the serum PCR is positive, what must you follow up with?
Western Blot to confirm
- Look for Abs against specific HIV antigens
How do you test infants for HIV?
PCR for pro-virus DNA
Abs not tested b/c inherited from mom
What is the cell profile of acute retroviral syndrome?
Increase serum HIV RNA
Decline CD4
What are the clinical symptoms of acute retroviral syndrome?
Fever Lymphadenopathy Pharyngitis Rash Myalgia/arthralgia Aka you'd probably mistake this for mono or flu
What are the big AIDs defining illnesses?
Esophageal candida Cryptococcosis CMG Kaposi sarcoma PCP PML (progressive multifocal leukoencephalopathy) Toxoplasmosis
What are the other AIDs defining illnesses you should be aware of?
Candida of respiratory tract Invasive cervical cancer Cocci Encephalopathy Herpes Histoplasmosis Isosporiasis Lymphoma MAC Recurrent pna Salmonella TB Wasting
What are the serum characteristics of chronic HIV infection?
CD4
Dets when to start drug prophylaxis
Which 2 infections should you expect in pts with CD4 over 500?
Lymphadenopathy
Secondary syphilis
Which infections should you expect in pts with CD4 ct between 200-500?
TB
Oral candida
Shingles
Kaposi sarcoma
Which infections should you expect in AIDs pts (CD4
PCP Toxoplasmosis Crypto meningitis CMV JC virus --> PML
Is PCP prophylaxis 1ary or secondary? What CD ct do you start at? Drug.
PCP:
1 & 2ary
CD4
Is toxoplasmosis prophylaxis 1ary or secondary? What CD ct do you start at? Drug.
Toxo:
1 & 2ary
CD4
Is crypto prophylaxis 1ary or secondary? What CD ct do you start at? Drug.
Crypto:
2ary
CD4
Is MAC prophylaxis 1ary or secondary? What CD ct do you start at? Drug.
MAC:
1ary
CD4
Is CMV prophylaxis 1ary or secondary? What CD ct do you start at? Drug.
CMV:
2ary
CD4