Module 2.5 HIV/AIDS Flashcards
Original name of HIV
1981 - Discovered (GRIDS)
Gay Related Immune Deficiency Syndrome.
Virus was discovered in 1984
Renamed HIV in 1986
What kind of virus is HIV-1 and HIV-2
Retrovirus
Retrovirus mechanism
vRNA must be converted to DNA (reverse transcriptase) and transcribed back to RNA
HIV infects
CD4+ T Cells (helper), Macrophages, Dendritic Cells
HIV spreads through
Sexual Contact
Blood Exposure
in Utero/Delivery/breast milk
Categories of HIV by T-cell count
Category 1: >500 cells/ul
Category 2: 200-499 cells/ul
Category 3: <200 cells/ul
Clinical Categories of HIV
A: Asymptomatic or Persistant generalized lymphadenopathy. (PGL)
B: Symptoms of immune deficiency but not enough to be AIDS defining.
C. AIDS defining illness.
To be diagnosed with AIDS you must be in
Category 3 or C
Functions of CD4 T cells
Recognize foreign antigens
Activates antibody producing B-Cell
Influences Phagocytic Function of monocytes/macrophages
Orchestrates cell mediated immunity
3 phases of HIV Infection
Primary infection phase
Chronic asymptomatic/Latency phase
Overt AIDS phase
Primary infection phase of HIV
Mononucleosis-like illness. Very nonspecific symptoms
Chronic asymptomatic/Latency phase of HIV
No symptoms
May last around 10 years
May have lymphadenopathy (swollen LN’s)
Overt AIDS phase of HIV
CD4 T cell count under 200
Death in 2-3 years WITHOUT therapy
Characteristics of AIDS
Profound Immunosuppression Opportunistic infections CNS Degeneration Wasting Malignancies
Typical progressors
60-70% aquire AIDS in 10-11 yrs
Rapid Progressors
10-20% acquire AIDS in < 5 years
Slow Progressors
5-15% do not acquire AIDS in more than 15 years
Long Term Non-progressors
~1% infected for 8+ years with high CD4 counts and low viral loads.
Most common Bacterial Opportunistic Infections in AIDS patients.
Bacterial Pneumonia
TB
Salmonella Bacteremia
MYCOBACTERIUM AVIUM-INTRACELLULAR COMPLEX (MAC)
Most common Fungal Opportunistic Infections in AIDS patients
Candidiasis
Coccidiomycosis
Cryptococcosis
Histoplamosis
Most common Protozoal Opportunistic Infections in AIDS patients.
PNEUMOCYSTIASIS
TOXOPLASMOSIS
Cryptosporidiosis
Isosporiasis
Most common Viral Infections in AIDS patients.
Cytomegalovirus
Herpes
Progressive Multifocal Leukoencephalopathy (PML)
Other diseases associated with AIDS
Kaposi Sarcoma
Non invasive cervical carcinoma
AIDS dementia complex (ADC)
Factors that contribute to wasting
Anorexia
Endocrine Dysfunction
Malabsorption
Cytokine Dysregulation
Characteristics of Wasting
Involuntary loss of 10% baseline weight
Diarrhea >2x/day
Chronic weakness
Fever
Metabolic affects of HIV/AIDS
Hypercholesterolemia Hypertriglyceridemia Insulin Resistance Impaired Glucose Tolerance Lipodystrophy
Diagnosing HIV
PCR (gold standard)
ELISA - high + rate
Western Blot - more specificity
OraSure swab
Truvada
Pre-Exposure Prophylactic medication
Routine follow care for HIV pt’s
Viral Load
CD4 cell counts
Appearance of specific opportunistic infections
5 classes of HIV drugs
Reverse transcriptase inhibitor Protease inhibitor Fusion/entry inhibitor Integrase inhibitor Multidrug combination products (always used)
Presentation of HIV in children
Failure to thrive
Developmental delays
CNS abnormalities
What is a major source of mortality in children with HIV? How is it treated?
Pneumocystis Jiroveci pneumonia
TMP/SMX (Bactrim) at 4-6 weeks
Why do we wait 4-6 weeks to treat infants with TMP/SMX (Bactrim)
liver immaturity
