8 HIV

Question 1

what are the HIV screening guidlines?

Answer 1

Screen any paGent, aged 13-64 once • Any healthcare se]ng

• Any pregnant paGent • IniGal visit
• ?also in 3rd trimester

• Annually, if • IVDU

• Commercial sex worker
• More than 1 sexual partner since last HIV test

Question 2

what things are seen in HIV?

Answer 2

2-6 weeks aier infecGon

• Primary response to infecGon
• Symptoms (seen in ~80%) • Fever (80%)
• Arthralgia/myalgia (54%)
• Anorexia/weight loss (54%) • Rash (51%)
• Lymphadenopathy
• FaGgue/Malaise (68%)
• PharyngiGs/oral ulcers (44%)

Question 3

when is the antigen test useful?

Answer 3

2 weeks after the infection

only works in the range of 2-6 weeks after the intial infection.

Question 4

when is the antobody test useful?

Answer 4

4-6 weeks after the infection

only good after that point.

but before that point it will be negative.

Question 5

Pooled HIV RNA tesGng

what happens in this?

Answer 5

they sample alot of patients together and if one pool is positive they make smaller and smaller pools.

Question 6

what are teh chances of perinatal transmission?

what if you take AZT?

what if you take the standard of care?

Answer 6

25% if there is no drugs

8% if given AZT

0-1% if you give standard of care.

• HAART to mother – 2nd trimester
• IV AZT during labor
• AZT to baby x 6 weeks
• Formula feeding (developed naGons)

Question 7

what determines the likelihood of transmission?

Answer 7

HIV Viral load determines likelihood of transmission

so if you do the treatment you are more likely to lower the viral load.

there was no transmission if the viral load is lower than 1500

Question 8

How transmissible is HIV?

Answer 8

much higher for receptive anal sex

Question 9

what is teh likelyhood of exposure for Hep B hep C and HIV

Answer 9

hep B is 30%

hep C is 3%

HIV is 0.3%

Question 10

what is health care exposure?

Answer 10

• Percutaneous injury (needlesGck, cut) OR
• Contact of mucous membrane or non- intact skin

with blood tissue or other internal fluid.

Question 11

what fluids arent considered infectious for HIV unless bloody?

Answer 11

• Feces
• Nasal SecreGons • Saliva
• Sputum
• Sweat • Tears
• Urine
• Vomitus

Question 12

ARVs for Post-exposure prophylaxis (PEP)

Answer 12

• IniGate 2-3 drug therapy ASAP following exposure ( <72 hours) • CDC protocols help determine risk and uGlity
• Case-control study: HIV seroconverters were 80% less likely to have taken PEP • Standard of care – OccupaGonal Health responsibility
• No healthcare-related transmissions since 2001

Question 13

what is PrEP

Answer 13

• In PrEP, an HIV uninfected individual uses an anGretroviral medicaGon ahead of an HIV exposure.
• By having the anGretroviral in blood/Gssues, PrEP may make it so that HIV is unable to establish infecGon.
• Analogous to prophylaxis for malaria in travelers.