SEXUALLY TRANSMITTED DISEASE (STD) Flashcards
Results from the infection of retroviruses that destroy the CD4+ lymphocytes and impair cell-mediated immunity (Cachay, 2022)
HIV INFECTION
Late stage of an HIV infection
AIDS (Aquired Immunodeficiency Syndrome)
HIV targets
CD4 T- lymphocytes
Normal CD4 count
500-1,500 cells/mm3
HIV binds with host cell
Binding
HIV fuses with host cells
Fusion
Inside host cell, HIV RNA is converted to DNA using reverse transcriptase
Reverse transcription
Integrase enzyme allows HIV DNA to be integrated into host DNA
Integration
HIV can produce long chains of HIV proteins which is used to build more HIV
Replication
HIV proteins and RNA move to host cell surface and are assemble into immature HIV
Assembly
Immature HIV is pushed out to the cell and proteases activate immature to mature infections HIV
Budding
Stages of HIV Infection
-Very early infection
-Acute HIV infection (Stage 1)
-Chronic HIV infection (Stage 2)
-AIDS (Stage 3)
A positive HIV test occuring within six months of a negative or indeterminate HIV test
Very early infection
Generally develops within 2 to 4 weeks after infection
Acute HIV
Flu like symptoms are common as a result of
Seroconversion
CD4 ≥ 500 cell/mm3
Acute HIV Infection (Stage 1)
Asymptomatic period/clinical latency
Chronic HIV Infection (Stage 2)
Virus continues to multiply at a very slow rate
Chronic HIV infection (Stage 2)
CD4 ≥ 200 cells/mm3 but <500 cells/mm
Chronic HIV Infection (Stage 2)
Immune system is severely damaged
AIDS (Stage 3)
Diagnosed if CD4 count is <200 cells/mm3 or if with opportunistic infection
AIDS (Stage 3)
Risk Factors of HIV
-Having multiple sexual partners
- MSM (Men having sex with men)
- IV drug use/sharing equipment for IV Drugs
HIV/AIDS Mode of transmission
-Anal sex is the riskiest (unprotected)
-Receptive partner has higher risk than insertive partner
-Vaginal sex, unprotected
-Perinatal transmission
-Sharing of infected needles/syringes
Mode of transmission (rare)
-Oral sex
-Needle stick injuries
- Blood transfusion, organ transplants (1978-1985)
- Food contamination (infants only)
- Biting and spiting (in presence of broken skin)
- Deep, open-mouth kissing
- Tattoos and body peircings
Taken daily to avoid risk of sexual HIV acquisition in adults and adolescents age 12 and older
PrEP (Pre-Exposure Prophylaxis)
HIV is checked every
Every 3 months
Diagnostics of HIV
Detects antibodies, not HIV itself
Antibody test
Diagnostics test of HIV
Directly detect HIV
Antigen tests
Diagnostic test of HIV
Also directly detect HIV
Refers to the time between HIV exposure and when a test can detect in your body.
The window period for an HIV Test
The window period of nucleic acid test (NAT)
10-33 days
The window period of antigen/antibody lab test
18-45 days
Rapid antigen/antibody test window period
18-90 days
Antibody Test window period
23-90 days
Clinical Manifestations (Acute)
-Fever
-Sore throat
-Night sweats
- Mouth Ulcers
- Chills
- Fatigue
- Rash
- Swollen lymph nodes
- Muscle ache
Involuntary loss of more than 10% of one’s body weight while having experienced diarrhea or weakness and fever for more than 30 days
HIV Wasting Syndrome
Caused by human herpesvirus
Kaposi Sarcoma
Affects men 8x more than women
Kaposi Sarcoma
Involves epithelial layer of blood and lymphatic vessels
Kaposi Sarcoma
AIDS Defining Illnesses
-Tuberculosis
-Pneumocystis carinii pneumonia
-Recurrent pneumonia
-HIV encephalopathy
A clinical syndrome that is characterized by a progressive decline in cognitive, behavioral, and motor functions as a direct result of HIV
HIV encephalopathy
A clinical syndrome that is characterized by a progressive decline in cognitive, behavioral, and motor functions as a direct result of HIV
HIV encephalopathy
Techniques to strengthen ART Adherence
-Use a multidisciplinary team approach
- Provide necessary resources
- Use positive reinforcements to foster adherence success
- Identify type and reason of non-adherence
Nutritional Therapy
-Megestrol acetate (Megace)
- High calorie, high protein, low fat diet
Appetite stimulant increases body weight by increasing fat stores in patients with HIV infection
Megestrol acetate (Megace)
Supportive Care
-Provide assistance in obtaining or preparing food
-Provide meticulous skin care to prevent skin breakdown
-Administer pain medications, and non-pharmacologic pain management
- If with pulmonary manifestations, facilitate oxygen therapy, relaxation training and energy conservation techniques
-Offer emotional and psychological support
Syphilis causative agent
Treponema pallidum
Mode of transmission of syphilis
-Direct contact (Sexual)
-Congenital
Diagnostics of Syphilis
-VDRL (Venereal Disease Research Laboratory)- screening test
-Treponemal test (Fluorsecent treponemal antibody absorption test [FTA-ABS]- confirmatory test
Occurs 2 to 3 weeks after initial inoculation with CA
Primary syphilis
Main characteristics of primary syphilis that manifest painless lesion at site of infection
Chancre
Hematogenous spread of organism leads to generalized infection
Secondary syphilis
Characteristics of Secondary Syphilis
-Macular rash (pink to brown) on palms or soles
-Mucous patches (oral lesions)
- Condyloma lata
Characteristics of secondary syphilis that manifest a large, whitish-gray lesion found in moist areas
Condyloma lata
Infected but asymptomatic
Latency
Final stage in stages and manifestations in syphilis and natural history of disease slowly progressive inflammatory disease with potential to affect multiple organs
Tertiary syphilis
