The clinical features of HIV and AIDS Flashcards
What are the 2 markers used to monitor HIV infection?
- CD4 cell count
- HIV viral load
What non-specific symptoms in a patient would you think about investigating?
fever, rash, sore throat, myalgia (muscle pain/ache)
What are all non-specific symptoms someone with HIV may present with?
- Fever
- Sore throat
- Myalgia
- Rash
- Vomiting + diarrhoea
- Headache
- Lymphadenopathy
- Weight loss
What would you ask a patient with fever, rash and non-specific symptoms?
● Ask about sexual history
● Think of HIV seroconversion
When would you think about doing a HIV test?
● An unexpected patient
● No clear underlying cause
● Recurring infections
Describe acute HIV
- Primary Infection, Seroconversion
- Symptoms usually start within 2-4 weeks of infection
- Similar to glandular fever/flu
What can happen when CD4 count drops below 200?
a range of opportunistic infections and cancers can occur
What is seen in early symptomatic HIV?
Early symptomatic HIV may present with a range of conditions seen in normal hosts, but more frequently and with more severity
What is AIDS defined as?
- AIDS = CD4 <200
- or “AIDS defining illness” present
What is the most common opportunistic infection in HIV?
PCP (pneumocystis pneumonia)
What are symptoms of PCP?
Fevers, SOB, dry cough, pleuritic chest pain, exertional drop in oxygen saturations
How can you treat PCP?
- Fungal, but susceptible to some antibiotics
- Co-trimoxazole
- +/- prednisolone (steroids) if hypoxic
What can a late diagnosis of PCP lead to?
- Increased transmission
- Increased morbidity
- Increased mortality
Which disease are all patients required to take a HIV test?
All patients with TB require a HIV test
TB in HIV at any CD4 count: AIDS defining
In a patient with HIV and a headache what is there a low threshold for?
Lumbar puncture
What are AIDS defining cancers?
Kaposi’s sarcoma, lymphomas, Cervical carcinoma
What virus can cause Kaposi’s sarcoma?
Human Herpesvirus 8
What virus can cause lymphomas?
Epstein Barr Virus
What virus can cause cervical carcinoma?
Human Papillomavirus
What does HIV do to cancers?
HIV increases the risk of any cancer that is associated with a virus
Why is HIV infection a manageable disease with good prognosis?
HAART is very effective in suppressing viral replication, resulting in good prognosis
What is HAART?
Highly Active Anti-Retroviral Therapy
How many antivirals are needed?
- 1 antiviral on its own isn’t enough
- (Usually) 3+ antiretroviral drugs
- Act on different points in replication cycle to suppress viral replication
What is an NRTI?
Nucleoside reverse transcriptase inhibitor
What does good adherence and avoidance of drug interactions key for?
● Suppress HIV replication
● Avoid drug resistance
What type of drug taken with antiretroviral drugs can cause toxicity?
Recreational drugs
