Dr. Graham HIV part 1 Flashcards
How long does it take for viral load to be positive on a PCR?
- 10 days the PCR will be positive for HIV RNA
Acute illness -> symptomatic disease
- often precedes positive ab test (15-25 days following the infection)
Eclipse phase of HIV infection
- time between infection and detectable HIV RNA (0-10 days following HIV transmission)
- no serological or blood test that will tell you that you have HIV
What is the window period of HIV infection?
- time b/t infection and detectable HIV abs (25 days following HIV transmission)
stage 3 HIV infection (AIDS)
- lab confirmation of HIV and CD4 count
Stage 1 HIV infection
- laboratory confirmation of HIV and CD4 count >500 cells/mm3 or CD4% >29%
Stage 2 HIV infection
- lab confirmation of HIV and CD4 count 200-499 cells/mm3 or CD4% 14-28
How many people are living with HIV in the US?
- 1.1 mill persons living with HIV in US
- 2.7-3.9 mill persons living with HCV in US
During the past 10 years, what has happened regarding the number of persons living with HIV in the U.S.?
the number has increased.
Why has the number of people living with AIDS increased in the U.S.?
- because of HAART, antiretroviral drugs that help keep the CD4 count up and extend HIV pt lifespans.
What % of HIV infected persons are unaware of their HIV status?
- 21% (1/5 people that have HIV unaware)
- this meds to an increased amount of HIV infections
What are the races/ethnicities that have the highest HIV rate in the US?
- Black and hispanics
Routine screening guidelines for HIV infection
- voluntary testing
- permission from pt required
- written consent shouldn’t be required
- prevention counseling not required in conjunction with screening
Goals of routine HIV screening?
-HIV screening -> HIV dx -> link to care -> improve survival and quality of life and prevent new HIV infections
Compare a normal molluscum contagious finding and non-normal finding?
- normal: just see a couple, common in daycare children
- not normal: way too many, growing on top of one another, or just out of control distribution
Other findings that may be normally seen in immunocompetent person but is out of control in HIV infected person?
- herpes simplex -> distal lesions -> ulcerate
- seborrheic dermatitis
- herpes zoster (shingles) -> see in a young pt or see hemorrhagic zoster, which covers 2-3 dermatomes
- kaposi’s sarcoma (really only seen in AIDS -> see all over skin, and palate
- oral hairy leukoplakia (not common in immunocompetent pts)
- out of control oral candidiasis
What is considered the cut-off for a positive tb skin test in an HIV-infected persons?
- greater than 5 mm of induration
- might be positive but doesn’t mean it is an active case of TB, could be latent
- Tx of latent TB?
- isoniazid x 9 months
- pyridoxine x 9 months
Major indication of prophylaxis tx for pneumocystis pneumonia?
CD4 less than 200 or oropharyngeal candidiasis
- tx: Bactrim
major indication of prophylaxis tx for Toxoplasma encephalitis?
- CD4 less than 100 and Toxoplasma IgG positive
- tx: bactrim
major indication of prophylaxis tx for disseminated Mycobaterium avium complex?
- CD4 less than 50 cells
tx: azithro
39 yo HIV pt presents with with 2 week hx of low grade fever, HA, and slight decline in mental status. CD4 count is 65 cells/mm3. What is this presentation consistent with?
- cryptococcal meningitis
- shows no signs of focal abnormalities or dementia (slight decline in mental status, but no dementia - pt is 39)
What will be positive in crytococcal meningitis?
- CSF cryptococcal antigen: positive in > 95% of cryptococcal meningitis cases
Preferred tx of cryptococcal meningitis?
- Amphotericin B + Fluctyosine
