The HIV patient Flashcards
What is Primary/Acute infection of HIV like
Within 7-21 days HIV becomes detectable in the blood stream- acute HIV symptoms due to extremely high levels of viraemia (MAY occur within weeks to few months of infection)
Main target CD4 T Helper cells
By 6 months, CD4 recovers to a level as viral load falls to a set point
What are the presenting symptoms usually of an early infection of HIV
-What are the rare infections
Fever
Rash
Lymphadenopathy
Meningitis
-Rarely opportunistic infections
How do you monitor HIV
CD4 count
Viral Load
What does CD3 count tell you
Measure of immune function
Predicts risk of opportunistic infection
What does Viral Load monitoring tell you
Measure of viral replication
Predicts rate of disease progression
What are the 3 stages of HIV infection
Seroconversion
Asymptomatic
Symptomatic
What is the ‘Seroconversion’ stage of HIV
What is the viral load and antibodies like at this stage
May experience flu-like illness shortly after infection
-Viral load high, no anti-HIV antibodies
What is the Asymptomatic stage of HIV
What is the viral load and antibodies like at this stage
Stable infection, no symptoms, lasts for years
-Viral load low, anti-HIV antibodies, stable CD4
What is the Symptomatic stage of HIV
What is the viral load and the CD4 like at the stage
Signs of damaged immune system, infections, tiredness, weight loss, diarrhoea, cancers
-Ant viral load, low CD4
Common HIV related illnesses
Candidiasis (thrush)
TB
Shingles
Cytomegalovirus
Common Side Effects of Antiretrovirals
- GI upset: nausea, diarrhoea
- Rashes and allergies
- Renal toxicity
- Liver toxicity
- Reduced bone mineral density
- Lipodystrophy and weight gain
- Increased cardiovascular risk/blood pressure/ lipids, blood sugars
- Peripheral neuropathy (damage to nerves which supply the limbs)
When can HIV multiply in presence of drugs
If levels are inadequate
May be caused by:
-Drugs interactions, food restrictions, poor adherence, pregnancy
What does adherence of Antiretrovirals need to be like
Very strict. Need high levels of drugs in blood all the time to stop virus multiplying
No late doses. No missed doses. Follow food restrictions
What is prevalence of HIV like in UK
increasing - combination of new diagnoses and those with existing diagnoses living longer
When does transmission occur potentially from mother to baby
In utero (very little) At Delivery (15-25%) During Breastfeeding (5-20%)
