Chapter 5 Flashcards
(268 cards)
1
Q
Infection and communicable disease can lead to?
A
Illness, disability, and loss of work time.
2
Q
Aside from the clinician, infection and communicable disease can also lead to?
A
Patients and family members also become exposed, become ill, lose productive time, and suffer permanent aftereffects.
3
Q
(DHCP) stands for?
A
Dental healthcare personnel.
4
Q
For training of DHCP, facilities/healthcare offices must?
A
Operate under an organized system for training of DHCP.
5
Q
For training of DHCP, facilities/healthcare offices training must have strict adherence to?
A
Standard precautions, transmission-based precautions, safe injection practices, and sharp safety.
6
Q
All DHCP are responsible for?
A
Preventing direct and indirect cross-contamination and preventing disease transmission between DHCP and patients and patient to patient.
7
Q
What are infectious agents?
A
Infectious agents are organisms that are capable of producing infection and/or infectious diseases.
8
Q
Each infectious agent has?
A
Specific characteristics that make specific reactions in an infected individual and can be pathogenic.
9
Q
Nonpathogenic agents may have pathogenic outcomes in?
A
Susceptible individuals.
10
Q
Humans’ response to infectious agents varies with?
A
The status of the host immune system and the pathogenicity of the invading agent.
11
Q
Infectious agents include?
A
Bacteria, virus, fungi, protozoa, helminths, and prions.
12
Q
List four characteristics of bacteria.
A
Microscopic, living organisms, single-celled, and found in every habitat and environment.
13
Q
Some diseases caused by bacteria can be treated by or with?
A
Antibiotics.
14
Q
Other diseases caused by bacteria can be prevented with?
A
Vaccines.
15
Q
List characteristics of viruses.
A
Microscopic, non-living, subcellular, capable of gaining entrance into a limited range of living cells, use host mechanisms to reproduce/replicate inside of a host cell, and only contains DNA or RNA, not both.
16
Q
Some diseases caused by viruses can be treated with?
A
Antiviral medication.
17
Q
Some diseases caused by viruses can be prevented through?
A
Vaccinations.
18
Q
List two characteristics of fungi.
A
Living organisms and single-celled or multicellular.
19
Q
Diseases caused by fungi can be treated with?
A
Antifungal agents.
20
Q
Diseases caused by fungi can/cannot be prevented with vaccinations?
A
Cannot.
21
Q
List two characteristics of protozoa.
A
Single-celled and cause parasitic infections.
22
Q
An example of a disease-causing protozoa would be?
A
Plasmodium that is transmitted by mosquitoes to humans causing malaria.
23
Q
Three characteristics of helminths?
A
Multicellular, invertebrates, and cause parasitic infections.
24
Q
An example of a helminth that causes disease?
A
The roundworm Trichinella spiralis is transmitted to humans causing trichinosis.
25
What are prions?
Misfolding proteins transmitted to humans by infected meat products that prompt normal proteins to misfold, causing neurodegenerative diseases.
26
Example of prions causing diseases?
Creutzfeldt-Jakob disease (CJD) and bovine spongiform encephalitis (BSE).
27
What is immunity?
Resistance that a person has against disease; it may be natural or acquired.
28
Immunity to a disease occurs when?
The immune system develops antibodies in order to eliminate the infectious agent.
29
What are antibodies?
A soluble protein molecule produced and secreted by body cells in response to an antigen is capable of binding to that specific antigen.
30
What are antigens?
A toxin or other foreign substance capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that specific antibody.
31
What is immunity?
The resistance that a person has against a disease. It may be natural or acquired. Occurs when the immune system develops antibodies in order to eliminate the infectious agent.
32
What is passive immunity?
Protection transferred from one animal or person to another.
33
How long does passive immunity last?
Provides immediate but temporary immunity.
34
An example of passive immunity?
Antibodies passed from a mother to her infant; intravenous transfusion of immunoglobulin IgG to prevent hepatitis B after exposure.
35
What is active immunity?
Protection acquired in the body by having the disease and recovering, or by vaccination.
36
How long does active immunity last?
Protection takes time to develop but can provide lifelong immunity.
37
An example of active immunity?
A child who contracts measles and recovers, or a child who receives the measles vaccination and does not suffer the disease symptoms.
38
What are vaccines?
Products that provide immunity by stimulating the immune system to produce antibodies to a specific infectious agent.
39
How are the vaccines administered?
Vaccines can be administered enterally (oral) or parenterally (injection or nasal).
40
The more similar a vaccine is to the infectious agent?
The better the immune response to the vaccine.
41
What do live attenuated vaccines contain?
A weakened form of the infectious agent that can provide lifelong immunity.
42
Example of a live attenuated vaccine?
Measles, mumps and rubella (MMR) and varicella vaccines.
43
What do inactivated vaccines contain?
Whole or partial inactive infectious agents manipulated to elicit an immune response.
44
Immunity from inactivated vaccines may not last?
Multiple doses, and booster vaccines may be necessary.
45
An example of an inactivated vaccine?
Poliomyelitis and hepatitis A virus vaccines.
46
What are messenger RNA vaccines?
Vaccines that use messenger ribonucleic acid inside of live attenuated or inactivated virus.
47
How do mRNA vaccines work?
They take a message to cells that prompts them to make a specific protein, which is then recognized by the immune system as an antigen.
48
How does the immune system respond to mRNA vaccines?
It makes antibodies against the specific protein that the mRNA vaccine made the cells make.
49
Why do the mRNA vaccines work?
When the specific virus finally enters the body, the immune system recognizes the protein and sends antibodies to destroy the protein, which in turn destroys the virus.
50
Messenger RNA vaccines only?
Deliver the message to make the protein. They cannot enter the cell nucleus or interact with, alter or damage DNA.
51
List 3 significances with vaccinations?
The World Health Organization lists 27 vaccine preventable diseases, of which 20 can be life threatening, and diseases that were once common are now at an all-time low after extensive and decades long vaccination programs.
52
All microorganisms are capable of?
Replicating and evolving to survive.
53
When infectious agents replicate, they can develop?
Mutations.
54
What are mutations?
Change in a gene because of alteration of units of the DNA or RNA.
55
What causes mutations in infectious agents?
Errors in replication, stress from the immune system, vaccines, and medications.
56
Mutations allow the infectious agents to?
Develop mechanisms that can evade the immune system and vaccines and develop resistance to drugs used to treat the disease they cause.
57
When enough mutations of an infectious agent have occurred, a new?
Variant of the infectious agent emerges that can be more infectious, drug resistant, and difficult to treat.
58
When a variant has developed distinct biologic characteristics that differ from the original version, it is called a new?
Strain.
59
In utero, the oral cavity is?
Sterile.
60
After birth, microorganisms are transmitted to the infant from?
The mother, other family members, and caretakers.
61
As the infant grows, there is continuing introduction of diverse microorganisms that colonize the oral cavity forming complex?
Oral biofilms.
62
The microbiota of the average adult harbors?
50 to 100 billion bacteria, represented by over 700 different organisms.
63
What is the correlation between Infection Potential and dentistry?
Pathogenic, potentially pathogenic, or non-pathogenic microorganisms may be permanently or transitorily present in the oral cavity of each patient.
64
Intact mucous membranes of the oral cavity provide some protection against infection and?
Decrease infection potential.
65
What is cross contamination?
The spread of microorganisms from one source to another: person to person or person to an inanimate object and then to another person.
66
Recognition of possible transfer of transmissible diseases provides the basis for?
Planning a system of disinfection, sterilization, and management of instruments, equipment and environment.
67
Disease transmission within a dental facility may occur because of inappropriate work practices such as?
Careless hand washing and/or unhygienic personal habits, inadequate sterilization and handling of sterile instruments and materials, and inadequate or inappropriate personal protective equipment, ventilation and overall infection control practices.
68
What are standard precautions?
Standard precautions represent a minimum standard care to both protect DHCP and prevent the HCP from transmitting infectious agents among themselves and their patients.
69
Standard precautions apply to?
All patients and procedures.
70
Which bodily fluids apply to standard precautions?
Blood, saliva, nonintact or broken skin, mucous membranes, and all body fluids secretions and excretions, except for sweat, regardless of whether they contain blood.
71
What are transmission based precautions?
Transmission-based precautions are to be used in addition to standard precautions when a patient has or is suspected of having a disease that can spread through contact, droplet, or airborne routes.
72
List the four precautions under transmission-based precautions.
Droplet precautions, contact precautions, airborne precautions, and sharps precautions.
73
Transmission based precautions must be used in addition to?
Standard precautions when a patient has or may have a disease that could be transmitted via contact, droplet, or airborne routes.
74
What is the purpose of Droplet precautions?
They are intended to prevent disease transmission from close (short distance) respiratory or mucous membrane contact with respiratory secretions transmitted through airborne droplets (sneezing, coughing, talking).
75
What is the purpose of contact precautions?
Intended to prevent disease transmission from direct or indirect contact with the patient or patient's environment.
76
What is the purpose of airborne precautions?
Intended to prevent transmission of diseases that remain infectious while suspended in the air over long distances.
77
In accordance with Airborne precautions, dental facilities must have?
Special air handling and ventilation.
78
What is the purpose of sharps precautions?
Intended to prevent bloodborne pathogen transmitted by percutaneous sharps injury.
79
What does percutaneous mean?
Passing through the skin.
80
A chain of events is required for the spread of an infectious agent?
True.
81
What are the six essential links for the spread of an infectious agent?
1. Infectious agent. 2. A reservoir. 3. Portal of exit. 4. Mode of transmission. 5. Port of entry. 6. Susceptible host.
82
All 6 links need to be present for the infectious agent to spread?
True.
83
Chain of infection can be broken with?
Standard precautions, infection control plan, sterilization, disinfection and more.
84
A break in the chain of one or more of the six major links in the chain of disease transmission is required to stop the spread of an infectious agent?
True.
85
What can be applied at every link of the chain of disease transmission to interrupt the chain?
Standard precautions and transmission-based precautions.
86
List just some examples of infectious agents.
Bacteria, viruses, fungi, protozoa.
87
Each infectious agent has its own?
Specific reaction in an infectious host.
88
What is a reservoir?
Where the infectious agents are found in their own essential environment.
89
List out 4 examples of reservoirs of disease.
People: lungs are reservoirs for M tuberculosis; equipment; instruments; dental unit waterlines: potential reservoir of L. pneumophila.
90
What is a port of exit?
Mode of escape from the reservoir.
91
Infectious agents exit from their reservoirs through various modes, such as?
Coughing, sneezing, speaking, bleeding periodontium, sharps use or in water from a contaminated water line.
92
Aerosol generating procedures (AGPs) facilitate the aerosolization of infectious agents from their respective reservoirs?
True.
93
List out 4 examples of ports of exit.
Body fluids, skin and mucous membrane, droplets and spatter, aerosols.
94
What is a mode of transmission?
The way the infectious agent moves from the reservoir and is transmitted to the susceptible host.
95
List out 6 examples of transmission.
Direct contact: person to person by respiratory aerosols; indirect contact: person with contaminated hands to object, percutaneous sharps injury; aerosols: direct from person respiratory to person oral cavity via coughing, sneezing, speaking; indirect by aerosol to hands or instruments then to receiving host.
96
What is a port of entry?
Mode of entry of the infectious agent into the new host.
97
List out 6 examples of transmission.
1. Direct contact: person to person by respiratory aerosols
2. Indirect contact: person w/ contaminated hands to object, percutaneous sharps injury
3. Aerosols: direct from person respiratory to person oral cavity via coughing, sneezing, speaking; indirect by aerosol to hands or instruments then to receiving host.
98
List out some ports of entry.
The respiratory tract, eyes, mucous membranes, non intact periodontium or skin or percutaneous sharps injury.
99
What is a susceptible host?
Person or animal that does not have immunity or defense to the invading infectious agent.
100
Example of a susceptible host.
A patient taking an immunosuppressant drug to control autoimmune diseases, prevent solid organ transplant rejection and as cancer chemotherapy.
## Footnote
A patient who has not had or has not maintained recommended vaccinations or does not seroconvert after vaccination. A patient who is medically compromised, elderly, or has pre-existing transmissible disease.
101
What is included under airborne transmission of infectious diseases?
Aerosol, droplets and splatter.
102
What is an aerosol?
An aerosol is a solid or liquid particles suspended in the air.
103
All dental procedures produce contamination in the form of ___ that become airborne with the potential to transmit infectious disease.
Aerosols.
104
Aerosol particles range in size from
1 to 100 um.
105
List the different aerosol sizes from smallest to largest.
Droplet nuclei <5um, Droplets 5-100 um, Spatter >100 um
106
Particles up to what size are capable of being inhaled?
200 um
107
What can be inhaled deep into the lungs?
Aerosolized droplet nuclei
108
What can be inhaled into the upper respiratory tract?
Droplets
109
Where can spatter be inhaled?
Oropharynx and may come in direct contact with mucous membranes of the eyes, nose and mouth
110
How far can particles <100 um travel when produced by coughing?
Up to 4 m
111
How far can particles <100 um travel when produced by speaking?
Up to 2 m
112
Why does spatter remain airborne for a relatively short time?
Due to size and weight
113
What happens to splatter?
Drops or spatters in a ballistic pattern where it may be visible, particularly after it has landed on skin, hair, clothing or environmental surfaces.
114
What may spatter come in direct contact with?
Mucous membranes of the eyes, nose and mouth.
115
Where can larger spatter particles be trapped?
Higher in the respiratory tract and may be coughed or sneezed out
116
What do all dental procedures produce?
Aerosols directly through AGPs and indirectly, when the patient coughs, sneezes and speaks.
117
What do AGPs include?
Sonic and ultrasonic scalers, air polishing, high and low speed handpieces, and air water syringes.
118
What can almost any dental procedure result in?
The production of aerosolized particles
119
What may aerosols and spatter contain?
Single or clumps of infectious agents, tooth and restoration fragments, tissue, saliva, biofilm, blood, sputum, oil from handpieces and water from dental unit water lines.
120
Where are aerosols in greater concentration?
Close to the site of instrumentation
121
How do aerosols travel?
With air currents and move from room to room
122
What influences the distribution of aerosols?
Temperature, humidity, and ventilation.
123
How can spatter be transferred to all areas of the dental office?
Contact transfer and result in self inoculation if patient or DHCP touches their own eyes or mucous membranes with contaminated hands
124
Where can aerosols and spatter settle?
Dust particles, which can then be sources of contamination
125
What happens when doors are opened and closed and people pass in and out?
Dust is set into motion and can settle on instruments, working surfaces and equipment or people
126
What are among the infectious agents that may travel in dust and around dental treatment areas?
C. tetani and enteric bacteria
127
What are bloodborne pathogens?
Microorganisms that can be transmitted to anyone exposed to contaminated body fluids
128
In dentistry, exposure to bloodborne pathogens is considered what?
An occupational hazard
129
What dental procedures expose DHCP to potentially infectious body fluids?
ALL
130
Is blood always visible in saliva?
No
131
Which three bloodborne pathogens are most common to DHCP?
HBV, HCV, HIV
132
Which bloodborne pathogen has a vaccine recommended for all healthcare workers?
HBV
133
How can bloodborne pathogens be transmitted?
Accidental percutaneous injury, contact with cuts, abrasion or eyes, and mucocutaneous exposure to infected blood.
134
What occurs during percutaneous injury to DHCP?
A sharp object pierces the skin.
135
What are examples of dental sharps that can cause injury?
Dental anesthetic needles, burs, endodontic files, scalpels, suture needles, scalers, and curettes.
136
When can sharp injury also occur?
During instrument processing and sterilization procedures.
137
Do all dental procedures have the potential to transmit infectious diseases?
Yes.
138
Must all dental procedures be carefully monitored for all patients?
True
139
What must all DHCP adhere to?
Standard and transmission based precautions
140
Do dental facilities need to have written infection control and safety protocols?
Yes. Dental facilities must have written infection control and safety protocols and provide appropriate training of DHCP.
141
How can a dental facility control the transmission of airborne disease?
Installation of air control methods to supply clean air, adequate ventilation, filtration, and relative humidity in the operatory area.
142
What can be used during all procedures to control airborne disease transmission?
High volume extraoral suction
143
What should be used with ultrasonic instrumentation and air polishing?
High volume intraoral evacuation
144
What should be done for patients with known or suspected infectious disease?
Use manual instrumentation as much as possible
145
What should be done prior to beginning a procedure?
Oral biofilm removal by patient
146
What can routine pre-procedure rinsing with antiseptic or antimicrobial mouth rinse reduce?
The numbers of microorganisms contained in aerosols.
147
How does a dental facility control the transmission of bloodborne diseases?
Strict adherence to sharp safety protocols.
148
What should be used when handling contaminated instruments?
Puncture resistant gloves
149
What can dental water lines harbor?
Microorganisms such as Legionella, Mycobacterium and Pseudomonas species
150
What must be used in dental facilities for water?
Water that meets Environmental Protection Agency regulatory standards for drinking water
151
What can reduce cross contamination with planktonic microorganisms in waterlines?
Flushing of water lines for at least 20 to 30 seconds between patients
152
What will flushing water lines not affect?
Affect or remove bacterial biofilms from the inside of dental water lines
153
What other methods must be used to prevent and treat dental water biofilm?
Self-contained water systems with inline water filters and anti-retraction devices to prevent backflow.
154
What are the methods to protect a clinician in a dental office?
Use PPE, check and maintain personal immunizations, education and training in the signs, symptoms and transmission of infectious agents, postexposure management for sharps injuries.
155
What methods are used to protect a patient in a dental office?
Use protective eyewear to prevent direct spatter and aerosols to face and eyes.
156
How do DHCP and dental facilities maintain and review infection control protocols?
Utilize official guidelines from the centers for disease control and prevention (CDC), state public health agencies, and the Occupational Safety and Health Administration (OSHA).
157
What is the procedure when dealing with a patient with an active HHV lesion?
Postpone appointment if patient has an active vesicular lesion, explain the contagious nature of the disease, educate patient to limit personal contact, and stress the importance of meticulous hygiene.
158
Which stage of HHV is the most transmissible to other patients and clinicians?
Prodromal stage.
159
What can cause autoinoculation of HHV during a dental appointment?
Instrumentation that can splash viruses to the patient's eye or extend the lesion to the nose.
160
What can irritation to HHV lesions do?
Prolong the course and increase severity of infection.
161
What is HHV-1 also known as?
HSV-1.
162
What percentage of people worldwide are estimated to be affected by HHV-1?
Between 50% and 90%.
163
How does primary infection of HSV-1 manifest?
As primary herpetic gingivostomatitis, usually occurring in children.
164
Are many cases of primary infection with HSV-1 asymptomatic?
Yes, many cases are asymptomatic or mild.
165
What are the most frequent manifestations of HSV-1?
Gingivostomatitis and pharyngitis.
166
What are other symptoms or manifestations of HSV-1 aside from gingivostomatitis?
Fever, malaise, widespread oral ulcers, severe pain, and lymphadenopathy for 2-7 days.
167
Where does latent infection of HSV-1 occur?
In the trigeminal nerve ganglion.
168
How does recurrent infection of HSV-1 manifest?
As herpes labialis, herpetic whitlow, and ocular herpes.
169
Where is herpes labialis commonly found?
At the vermillion border of the lower lip.
170
What are the characteristics of herpes labialis?
Prodromal symptoms occur 6 to 24 hours before the lesion appears, followed by a group of vesicles that coalesce, rupture, and crust over. Healing may take up to 10 days.
171
What causes herpetic whitlow?
HSV-1 or HSV-2 entering skin abrasions around a fingernail.
172
What may chronic herpetic whitlow indicate?
It may be a manifestation of HIV infection.
173
What causes ocular/ophthalmic herpes?
A primary or recurrent infection of HSV-1 or HSV-2.
174
What can ocular/ophthalmic herpes lead to?
Blindness.
175
How is ocular/ophthalmic herpes transmitted?
From splashing saliva or fluid from a vesicular lesion directly into an unprotected eye.
176
How can ocular/ophthalmic herpes transmission be prevented in a dental facility?
By using standard precautions, including eye protection for both clinician and patient.
177
What is HHV-2 also known as?
HSV-2.
178
What is a complication of HHV-2 infection during childbirth?
Neonatal herpes.
179
What may obstetricians recommend to women with active genital herpes to avoid transmission to the infant?
Delivery by cesarean section.
180
Can antiviral therapy suppress HSV-2 lesions?
False. Antiviral therapy can suppress HSV-2 lesions.
181
What is HHV-3 also known as?
Varicella-zoster virus (VZV).
182
What does primary infection of VZV cause?
Varicella (chicken pox) infection.
183
How is VZV primarily transmitted?
Via respiratory aerosols and direct or indirect skin contact with discharge from vesicles.
184
Is VZV life-threatening to certain populations?
True.
185
When are the two doses of the varicella vaccine recommended?
The first dose at 12-15 months old and the second between 4 and 6 years old.
186
What does VZV reactivation cause?
Herpes zoster (shingles) infection.
187
How does shingles manifest?
As a painful vesicular rash lasting from 2 to 4 weeks.
188
What are risk factors for zoster?
Increasing age, HIV infection, physical trauma, cancer, and immunosuppressive medications.
189
Who should receive the shingles vaccine?
All adults aged 50 years and older.
190
What is HHV-4 also known as?
Epstein-Barr virus (EBV).
191
What does primary infection with EBV cause?
Infectious mononucleosis.
192
Who is EBV common among?
Teenagers and young adults.
193
How is EBV commonly spread?
Through saliva, sexual contact, organ transplants, and blood transfusions.
194
How can EBV be prevented?
By minimizing contact with saliva and practicing standard precautions.
195
What does EBV manifest as in those with HIV?
Oral hairy leukoplakia.
196
What is HHV-5 also known as?
Cytomegalovirus (CMV).
197
How is CMV transmitted?
Through direct contact with infected body fluids.
198
Who develops the most severe CMV disease?
Infants infected in utero and immunocompromised patients.
199
What are HHV-6A and HHV-6B considered?
Distinct viral species.
200
What is HHV-6A acquired after?
HHV-6B infection as an asymptomatic primary infection.
201
Is HHV-6A a possible risk factor in accelerating HIV infection?
True.
202
What does primary infection with HHV-6B cause?
Roseola infantum.
203
Where has HHV-6B been found?
In endodontic abscesses and in the adenoids and tonsils of children.
204
What is HHV-7 often found with?
HHV-6.
205
Is HHV-7 implicated in a range of diseases?
Yes.
206
Is it true that some persons infected with HHV-7 are asymptomatic?
True.
207
What is HHV-8 also known as?
Kaposi's sarcoma-associated herpesvirus.
208
Can primary infection of HHV-8 be asymptomatic?
True.
209
Does HIV increase the risk of HHV-8 infection?
True.
210
How many numbered viruses are considered to be human papillomaviruses (HPVs)?
Over 200.
211
Are most HPV infections asymptomatic?
Yes, they are mostly asymptomatic.
212
Do some HPV infections persist and are oncogenic?
True.
213
What do most types of HPV infect?
Epithelial tissues of the skin.
214
What are low-risk HPV types 6 and 11 considered?
Non-oncogenic.
215
What do types 6 and 11 HPV infections cause?
Recurrent respiratory papillomatosis and anogenital warts.
216
What are oropharyngeal lesions caused by types 6 and 11 HPV infections?
Benign squamous cell papillomas.
217
What are high-risk HPV types known to cause?
Cervical, vaginal, penile, anal, rectal, and oropharyngeal cancers.
218
Where do HPV-16-associated oropharyngeal cancers typically develop?
Near the base of the tongue and in the tonsils.
219
Who does the CDC recommend HPV vaccination for?
All children aged 11-12 years and everyone through age 26 years.
220
What does HIV attack in the body?
CD4 T lymphocyte cells (T-cells).
221
What signals the last stage of HIV infection?
A weakened immune system under attack from opportunistic infections.
222
Is there currently an effective cure for HIV?
No effective cure currently exists.
223
What are the two types of HIV?
HIV-1 and HIV-2.
224
Which type of HIV causes the majority of infections?
HIV-1.
225
Is HIV-1 more infectious than HIV-2?
Yes.
226
Where is HIV-2 generally confined to?
West Africa.
227
How is HIV transmitted?
By direct contact with infected bodily fluids.
228
What increases the likelihood of transmitting HIV?
A high viral load.
229
What are common modes of HIV transmission?
Parenteral and sexual contact.
230
What are less common modes of HIV transmission?
Deep open-mouthed kissing, oral sex, and contact with broken skin.
231
How is HIV not transmitted?
By saliva, sweat, tears, insect bites, or social contact.
232
What laboratory tests determine HIV infection?
Nucleic acid tests (NATs), antigen/antibody tests, and antibody tests.
233
What does the Home Access HIV-1 Test System® involve?
A finger stick to obtain a blood sample that is sent anonymously to a licensed lab.
234
What laboratory tests are used to determine HIV infection?
Nucleic acid tests (NATs), antigen/antibody tests, and antibody tests.
235
What does the Home Access HIV-1 Test System® involve?
A finger stick to obtain a blood sample sent anonymously to a licensed lab. Results can be obtained as fast as the next day.
236
What does the OraQuick In-Home HIV Test® involve?
Obtaining a swab of oral fluids and using the kit to perform the test at home. Results are available in 20 minutes; however, 1 in 12 tests may yield false negatives.
237
What do CD4 T lymphocyte and viral load counts estimate?
The health of the immune system and a person's risk of serious illness from opportunistic infections (OIs).
238
What do the tests mentioned provide data for?
They evaluate over time but do not indicate the health of the person, how they feel, or predict the future course of disease.
239
What does the CD4 T lymphocyte count measure?
The number of CD4 T lymphocytes in 1 mm of blood, providing data to evaluate the HIV-compromised immune system, progression of infection, and efficacy of HIV medications.
240
What is a normal CD4 T lymphocyte count in a non-HIV-infected adult?
500-1,500 cells/mm of blood.
241
What percentage of white blood cells do CD4* T-cells represent in a non-HIV-infected adult?
32-68% considered normal.
242
What does a CD4 T lymphocyte count below 200 cells/mm or below 14% indicate?
A person is at risk for opportunistic infections.
243
What does the viral load count measure?
The amount of HIV in 1 mm of blood, providing data to evaluate potential damage to the immune system, efficacy of HIV medications, and drug resistance.
244
What is viral suppression?
When the viral load count is below 200 copies of HIV/mm and the virus can be suppressed to the point where it becomes undetectable.
245
What is required to achieve viral suppression?
ART drugs must be taken by strict regimen.
246
What is Stage 1 of HIV?
Acute HIV infection.
247
What symptoms may occur within 2-4 weeks after HIV infection?
Flu-like symptoms lasting a few weeks; some may be asymptomatic.
248
What is the viral load like during the first two to four weeks after HIV infection?
Very high, and the person is highly infectious.
249
Are there AIDS-defining OIs present during Stage 1 of HIV infection?
True.
250
What is the CD4 T lymphocyte count during stage 1 of HIV?
≥500 cells/mm or ≥29%.
251
What is Stage 2 of HIV?
Clinical latency; also known as asymptomatic or chronic infection.
252
How long can clinical latency last?
10 years or longer, although some infections will progress to stage 3 faster.
253
What can HIV medications do for an infected person?
Maintain them at stage 2 for decades.
254
What is the status of HIV at stage 2?
At stage 2 of HIV, HIV is active, replicating at a slow rate, and is still transmissible. However, those with a low viral load are less likely to transmit the virus.
255
Are AIDS-defining Ols present during the second stage of HIV?
No, AIDS-defining Ols are not present during the second stage of HIV.
## Footnote
True
256
What are the CD4 T lymphocyte counts at stage 2 of HIV?
At stage 2, CD4 T lymphocyte counts are 200-499 cells/mm³ or 14-28%.
257
What is stage 3 of HIV?
Stage 3 of HIV is AIDS.
258
What are the CD4 T lymphocyte counts at stage 3 of HIV?
At stage 3 of HIV, CD4 T lymphocyte counts are below 200 cells/mm³ or <15%.
259
What is necessary for an AIDS diagnosis at stage 3 of HIV?
The emergence of Ols is necessary for an AIDS diagnosis.
260
How is the immune system during stage 3 of HIV?
The immune system during stage 3 of HIV is damaged and poorly functioning, which allows Ols to emerge and progress unchecked by the immune system.
261
What is the viral load during AIDS?
The viral load during AIDS is very high and without treatment, people may only survive 3 years.
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What are the symptoms of AIDS?
Symptoms of AIDS include fever, sweats, chills, swollen lymph nodes, weight loss, muscle wasting, and weakness.
263
How many different HIV-associated oral lesions are there?
There are 24 different HIV-associated oral lesions.
264
Has ART changed the prevalence and pattern of HIV-related oral manifestations?
Yes, ART drugs have changed the overall prevalence and pattern of HIV-related oral manifestations.
## Footnote
True
265
What are the consistently encountered HIV-associated oral lesions?
Consistently encountered HIV-associated oral lesions include:
- HIV-associated oropharyngeal candidiasis (HIV-OC)
- HIV-associated oral hairy leukoplakia
- Herpes simplex virus
- Kaposi's sarcoma: HHV-8 (most common)
- HIV-related oral ulcers
- Non-Hodgkin lymphoma: reactivation of latent EBV HHV-4
- Periodontal and gingival manifestations of HIV
- Linear gingival erythema (LGE)
- Necrotizing periodontal diseases (NPDs)
266
What are the less prevalent HIV-associated oral lesions?
Less prevalent HIV-associated oral lesions include:
- HHV-3 (herpes zoster; shingles)
- HHV-5 (CMV)
- HPV lesions
- Non-Candida fungal infections
- M. tuberculosis
- M. avium intracellulare infection
- Intramucosal hemorrhages
- Melanotic hyperpigmentation
- Salivary gland disease
267
What impact has ART drugs had on HIV-associated oral lesions?
ART has reduced the prevalence of HIV-associated oral lesions, with KS, candidiasis, LGE, and oral hairy leukoplakia being the most responsive.
268
What happens as the viral load declines with ART?
As the viral load declines and CD4 T lymphocyte counts improve with ART, there is a corresponding improvement in immune system function, which can prompt a strong inflammatory response resulting in immune reconstitution inflammatory syndrome (IRIS).
