Sexually Transmitted Diseases - HIV

Question 1

Pathology : HIV.

Answer 1

1. RNA Retrovirus - HIV1 (commonest); HIV2 (rare outside West Africa).
2. Virus enters and destroys CD4 T-Helper Cells.
3. Initial Seroconversion Flu-Like Illness within weeks of infection.
4. Asymptomatic until Condition progresses to AIDS years later.
5. Transmission : Unprotected Sexual Activity; Vertical Tranmission; Exposure to Bodily Fluids.

Question 2

AIDS-Defining Illnesses (associated with End-Stage HIV Infection) : CD4 Count drops to low level allowing opportunistic infections) (6).

Answer 2

1. Kaposi’s Sarcoma.
2. PCP (Pneumocystic Jirovecii Pneumonia).
3. CMV Infection.
4. Candidiasis.
5. Lymphomas.
6. Tuberculosis.

Question 3

Investigations of HIV.

Answer 3

1. Screening Test : Antibody Testing (request online for self-sampling) but takes 3 months to develop antibodies to virus so repeat testing.
2. P24 Antigen Test : Specific HIV Antien in Blood (positive result earlier).
3. PCR Testing : HIV RNA Levels : Viral Copies - Viral Load (Undetectable means very low).
4. Monitoring : CD4 Count (500-1200 = Normal; Below 200 is AIDS).

Question 4

Management of HIV.

Answer 4

1. Combination of ART (Antiretroviral Therapy) Medications.
2. Offered to anyone with a diagnosis of HIV.
3. Starting Regime of 2 NRTIs (Tenofovir and Emtricitabine) + 3rd Agent.
4. Aim : Normal CD4 Count and Undetectable Viral Load.