5. Viral Infections 1 Flashcards
(40 cards)
What is the immunopathogenesis during the early acute phase HIV infection?
Self limiting illness within weeks (immunocompetent)
High levels of virus production, viremia and reduction of CD4+ T cells
Seroconversion: production of anti-HIV ABs (used for clinical screening for HIV infection)
at end, CD4 numbers return to normal
What is the immunopathogenesis during the middle clinical latent period of HIV infection?
Stage relative containment of the virus
continue HIV replication at low levels
continue CD4 cell loss
asymptomatic , some may have persistent lymphadenopathy and minor opportunistic infections
What is the immunopathogenesis during the final crisis phase of HIV infection?
Break down of host defensive system
Profound loss of CD4+ cells
full blown AIDS
How is HIV transmitted?
Sexual
Parenteral
Mother to infant
Body fluids such as semen and blood are usually source of infection
Saliva of HIV pts contain virus but transmission via saliva is rare
What are the EC-Clearinghouse Classifications of oral manifestations of HIV disease in adults?
Group 1: oral and maxillofacial lesions strongly associated with HIV infection
Group 2: less commonly associated with HIV infection
Group 3: seen in HIV infection
Group 1 manifestations are rare outsideo f HIV setting
Group 2 and 3 can be seen with HIV pts but also non-HIV pts
What are the group 1 HIV oral manifestations?
Candidiasis
Oral hairy leukoplakia
Kaposi’s sarcoma
Non-hodgkin’s lymphoma
Periodontal dz
What is the most common intraoral manifestation of HIV infection?
oral candidiasis
most common agent of oral candidiasis?
Candida albicans
What is an inidication of a patient’s immunosuppression when sen with oral candidiasis?
low CD4
how to lower oral candidiasis frequency in HIV pt?
HAART
What is the most common EBV related lesion in HIV pts?
Oral hairy luekoplakia
S/S of Orla hairy leukoplakia?
Faint or thickened white vertical streaks that do not rub off usually on lateral tongue
histopathology of oral hairy leukoplakia?
Hyperkeratosis and layer of balloon cells in upper spinous layer
Detect EBV by immunohistochemistry or insitu hybridization
Oral hairy leukoplakia Tx
Not needed
What is kaposi’s sarcoma?
Systemic malignant vascular tumor caused by HHV-8/KSHV
Kaposi’s sarcoma appearance?
Red to purple skin or mucosal lesions with or without internal involvement
What are the 4 subtypes of kaposi’s sarcoma?
Classic subtype: Western world
African endemic subtype: Sub-saharan Africa
Latrogenically immunosuppressed subtype: transplant pts
Epidemic AIDS related subtype
Kaposi’s sarcoma classic subtype S/S
middle-aged and elderly men of Mediterranean or European descent
Relatively indolent
Affects lower extremities but stays on skin. does not spread internally
Laposi’s sarcoma African endemic subtype S/S
Mostly young patients (<40)
begin in lower extremities but expand ot other areas
Kaposi’s sarcoma AIDs related subtype S/S
Agressive
spreads to various parts of the body including internal organs
What is the most common malignancy in HIV pts?
Kaposi’s sarcoma
how does HIV associated Kaposi’s sarcoma manifest?
multiple lesions of the skin, oral mucosa and viscera
How does HIV related kaposi’s sarcoma appear in the mouth?
Start as purple macular lesions and later develops into nodules
invade bone
affects palate (most common), tongue and gingiva
Dx of oral HIV related Kaposi’s sarcoma
Biopsy is necessary
Will see vascular proliferation
Presence of HHV8
