Week 6 - Blood Borne Viruses Flashcards
1
Q
How does HIV present?
A
- Fever
- Dry cough
- Weight loss
- Skin lesions on legs (Kaposis’ sarcoma)
- Sore mouth (candida)
- PCP (pneumocystis pneumonia)
2
Q
How can HIV be transmitted?
A
- Sexual
- – Vaginal, anal or oral
- Sharing of injecting equipment
- Vertical transmission
- – In utero
- – During childbirth
- – Breast feeding
- Medical procedures
- – Blood/blood-products
- – Skin grafts
- – Organ donation
- – Artificial insemination
- Transmission is more likely to be from male to female
3
Q
What are the factors that can affect HIV transmission?
A
- Type of exposure
- Viral level
- Other STIs
- – Local effects
- – Effects of immune system
- Condom use
- – Can break
- Breaks in skin or mucosa
4
Q
Describe HIV (as a virus)
A
- Retrovirus
- Infects and replicates in immune system cells
- – CD4 cells
- It replicates inside the cells then destroys them
- Spreads to/infects more cells
5
Q
What are the main symptoms of an acute HIV infection?
A
- Flu-like illness
- – Occurs 2-6 weeks after infection
- Systemic:
- – Fever
- – Weight loss
- Pharyngitis
- Mouth:
- – Sores
- – Thrush
- Oesophagus
- – Sores
- Muscles
- – Myalgia
- Central:
- – Malaise
- – Headache
- – Neuropathy
- Lymph nodes
- – Lymphadenopathy
- Skin
- – Rash
- Gastric
- – Nausea
- – Vomiting
6
Q
What diagnostic tests can be used for HIV?
A
- Blood tests
— HIV antigen
— HIV antibody - Rapid tests
— Blood test
— Oral (Saliva)
— In-home tests
— Postal testing
— If negative, they are very accurate
o If positive, need to confirm with a blood test since may be a false positive
7
Q
Who should be tested for HIV?
A
- Everyone, if rate >2/1000 in population (i.e. in Leicester!)
- Pneumonia
- Meningitis
- Dementia
- Severe psoriasis
- Hep B/Hep C
- Any STI
- Recurrent shingles/fungal infection
- Cancers – lymphoma, cervical, lung
- Unexplained weight loss/fever/diarrhoea
8
Q
How can you treat HIV?
A
3 drugs
- Makes it harder for virus to develop resistance
- Patient MUST keep taking drugs
9
Q
How can Hep B be transmitted?
A
- Blood
- – IV drug use
- – Needlestick injuries
- Sexual contact
- Vertical
- Long term close household contacts
10
Q
What are some symptoms of acute Hep B infection?
A
- Jaundice
- Fatigue
- Abdominal pain
- Anorexia/nausea/vomiting
- Arthralgia
- AST/ALT in 1000s
- Normally clear infection within 6 months
11
Q
What is chronic hep B?
A
- Acute Hep B becomes chronic in ~6-10% of infected adults
- Presence of HBsAg (Hep B surface antigen) after 6 months
- 25% of chronic infection leads to cirrhosis
- ~5% will develop hepatocellular carcinoma
12
Q
How can you prevent infection with Hep B?
A
Vaccination
- Genetically engineered surface antigen
- 3 doses + boosters if required
- Effective in most people
- Needs surface-antibody levels checked
