HIV Flashcards
(19 cards)
Difference between HIV & AIDS?
HIV is being infected with human immunodeficiency virus.
AIDS is acquired immunodeficiency syndrome which occurs when HIV is not treated and so the person becomes immunocompromised.
What is HIV?
An RNA retrovirus which enters & destroys CD4 T-helper cells.
What occurs when you are first infected?
An initial seroconversion flu-like illness which is then asymptomatic until the condition progresses to immunodeficiency.
How is HIV spread?
Unprotected anal, vaginal or oral sexual activity
Vertical transmission.
Mucous membranes, blood or open wound exposure to infected blood or bodily fluid.
What are AIDS-defining illnesses?
Illnesses associated with end-stage HIV infection where the CD4 count has dropped to a level that allows for unusual opportunistic infections.
Examples of AIDS-defining illnesses?
Kaposi’s sarcoma.Pneumocystis jirovecii pneumonia. Cytomegalovirus.
How does the fourth generation laboratory test work?
Fourth generation laboratory test for HIV checks for antibodies to HIV and the p24 antigen.
It has a window period of 45 days meaning it can take up to 45 days after exposure to the virus for the test to turn positive. After 45 days, a negative result is reliable but before 45 days it is not.
How does point of care tests for HIV antibodies work?
Gives a result within minutes and have a 90 day window period.
How do you monitor HIV?
Testing the CD4 count- the lower the count, the worse the HIV is.
500-1200 cells/mm3 is the normal range.
Under 200 cells/mm3 puts pt at high risk of opportunistic infections.
What is the viral load?
Testing for HIV RNA per ml of blood.
Management?
A combination of antiretroviral therapy medications which is offered to everyone regardless of viral load or CD4 count.
What is the usual starting regime for antiretrovirals?
Two NRTIs (eg tenofovir plus emtricitabine) plus a third agent (eg bictegravir).
What is the aim of treatment?
To achieve a normal CD4 count and undetectable viral load.
What is given to protect against pneumocystis jirovecii pneumonia?
Prophylactic co-trimoxazole given to all pts with a CD4 count under 200/mm3.
How do you know what delivery a woman with HIV can have?
If viral load is under 50 copies/ml → normal vaginal delivery.
If viral load is over 50 copies/ml → consider a pre-labour caesarean section.
Over 400 copies/ml → pre labour caesarean section is recommended.
What is given during labour & delivery if viral load is unknown or above 1000 copies/ml?
IV zidovudine.
What prophylaxis is given to baby?
Low risk → zidovudine for 2-4 weeks.
High risk → zidovudine, lamivudine & nevirapine for 4 weeks.
What is post exposure prophylaxis?
Given after exposure to reduce the risk of transmission and has to be commenced within 72 hours.
It is a combination of ART therapy- emtricitabine/tenofovir and raltegravir for 28 days.
Can you breastfeed with HIV?
Can be transmitted during breast feeding.
Risk is reduced if mother’s viral load is undetectable, but not eliminated.
Safest option is to avoid breastfeeding.
