Module 3 HIV/AIDS Flashcards
Immune deficiency is acquired through what?
- Medical treatment such as chemotherapy
2. Infection from agents such as HIV
What are the 2 forms of HIV and where is each one more common?
- HIV 1 - more common in the USA
2. HIV 2 - more common in the West Africa region
How is HIV transmitted?
- Blood and blood products
- Seminal fluid
- Vaginal secretions
- Mother-to-child: amniotic fluid, breast milk
NOT THROUGH CASUAL CONTACT
first sign of defense is intact skin
What is HIV prevention education achieved through?
- Behavioral interventions
- HIV testing
- Linkage to treatment and care to enable those with HIV to live longer, healthier lives and to reduce the risk of transmitting HIV
How often should preventative HIV testing be done if someone has a partner with HIV?
Every 3 months
What are different behavioral interventions for HIV prevention?
- Latex condom use
2. Pre-exposure prophylaxis (PrEP)
What is the name of the pre-exposure prophylaxis medication used to prevent HIV? What does it involve? What are the side effects?
Truvada
Involves taking 1 pill containing 2 HIV medications daily in order to avoid the risk of sexual HIV acquisition in adults and teens 12 years and older
Side effects include decreased bone density, GI upset, and impaired kidney function
What are some strategies to protect against HIV infection?
- Consistent and correct use of condoms (only latex material condoms protect against HIV)
- Medical male circumcision
- Female condom
- Harm reduction framework for people who inject drugs
- free needle exchange programs
- use of bleach to clean used needles and syringes
- avoidance of sharing needles and syringes
Why are LGBT youth at a higher risk for HIV infection?
They take more risks
What is the most effective way to prevent transmission of organisms?
Hand hygiene
Post exposure prophylaxis (PEP) protocols
Antiretroviral medications given within 72 hours of exposure (the sooner the better). 2 to 3 drugs are prescribed for 28 days
What are the steps in the life cycle of HIV?
- Attachment/Binding
- Uncoating/Fusion
- DNA synthesis
- Integration
- Transcription
- Translation
- Cleavage
- Budding
What occurs during the attachment/binding step in the HIV life cycle?
HIV glycoproteins bind with the host’s uninflected CD4+ receptor, which results in fusion of HIV with the CD4+ T-cell membrane
What happens during the uncoating/fusion stage of the HIV life cycle?
The contents of the HIV’s viral core (2 single strands of viral RNA and 3 viral enzymes: reverse transcriptase, integrase, protease) are emptied into the CD4+ T cell
What happens during the DNA synthesis stage of the HIV life cycle?
HIV changes it’s genetic material from RNA to DNA through the use of the reverse transcriptase enzyme, resulting in double-stranded DNA that carries instruction for viral replication
What happens during the integration stage of the HIV life cycle?
New viral DNA enters the nucleus of the CD4+ T cell and through the action of the integrase enzyme is blended with the DNA of the CD4+ T cell, resulting in permanent, lifelong infection.
Prior to this step, the uninflected person has been only exposed to, not infected with, HIV. With this step, HIV infection is permanent.
What happens during the transcription stage of the HIV life cycle?
When the CD4+ T cell is activated, the double-stranded DNA forms single-stranded messenger RNA (mRNA), which builds new viruses.
What happens during the translation stage of the HIV life cycle?
The mRNA creates chains of new proteins and enzymes that contain the components needed in the construction of new viruses
What happens during the cleavage stage of the HIV life cycle?
The HIV protease enzyme cuts the polyprotein chain into the individual proteins that make up the new virus
What happens during the budding stage of the HIV life cycle?
New proteins and viral RNA migrate to the membrane of the infected CD4+ cell, exit from the cell, and start the process all over
stages of HIV infection
classified in 5 stages are based off of clinical hx, physical exam, lab evidence, S&S, associated infections and malignancies
stage 1, 2 and 3 are based on what
CD4 and T-lymphocyte count
stage 1: primary/acute
period from infection with HIV to the development of HIV specific antibodies. Dramatic drops in CD4+ T cell counts normally 500 to 1500 cells of blood
+characterized by increase levels of viral replication, widespread dissemination of HIV throughout body + destruction of CD4 and T cells
+ the host responds to the HIV infection throughout a CD4 and T cell response that causes other immune cells to increase their killing of infected virus producing cells.
stage 2
Occurs when T-lymphocytes cells are between 200 and 499.
stage 3
CD4+ count drops below 200 cells of blood. Considered to have AIDS for surveillance purposes. Once at this point, the case can’t be reclassified into a less severe stage even if CD4 T-cells increase
unknown stage
no information on CD4 T lymphocytes count or percentage
gerontology consideration
increasing # of adult aged 50 and older have HIV/AIDS.
- unprotected intercourse,
- do not consider themselves at risk
- may use IV drugs
- may have receive HIV infected blood before 1985
- reduction in immune system function
3 types of HIV DX test
- antibody test- detects antibodies not HIV itself
- antigen/antibody test
- nucleic acid (RNA) test
treatment of HIV/AIDS
antiretroviral therapy. overarching goal to suppress HIV replication. reduce HIV associated morbidity and prolong duration and quality of life. restore and preserve immunologic function. maximally and durably suppress plasma HIV viral load. Prevent HIV transmission.
What are some common side effects of ART?
Hepatotoxicity, nephrotoxicity, and osteopenia
Increased risk of cardiovascular disease and MI
How many ART drugs are used for treatment and from how many different drug classes?
Usually use a combination of 2-3 antiretrovirals from 2+ drug classes
What step do reverse transcriptase inhibitors work at?
Step 3
What step do protease inhibitors work at?
Step 6
What step do nucleosides (NNRTI and NRTI) work at?
Step 3
What step do fusion inhibitors work at?
Step 1
What step do CCR5 coreceptor antagonists work at?
Step 1
What step do integrase inhibitors work at?
Step 4
How do we know if ART is working for a patient with HIV?
CD4+ count increasing between 50-150 per year with an accelerated response in the first 3 months
What are the 2 different types of HIV transmission in children?
Vertical transmission: perinatal (in uterine or during birth) transmission or via breast milk… AKA mother to child
Horizontal transmission: transmission via nonsterile needles (IV drug use or tattooing) or via intimate sexual contact
What test is used to test for HIV in infants older than 1 month?
Polymerase chain reaction (PCR) test
What medication for children born to HIV mothers be on?
6-week course of zidovudine therapy
