HIV

Question 0

What is the risk of transmission by sexual act?

Answer 0

Heterosexual 0.1%
Receptive anal 0.5%
Giver anal 0.05%

Question 1

How is HIV transmitted?

Answer 1

In developed countries

• homosexual
• IVDU or blood transmission

Developing

• heterosexual
• vertical

Question 2

RFs for HIV transmission?

Answer 2

Sexual
- unprotective receptive sex

Presence of ulcerated STIs

Viral load
Lack of circumcision

Question 3

Natural history of HIV?

Answer 3

Viral transmission 
Acute HIV
Seroconversion 4-10 weeks
Clinical latency, lymphadenopathy
Early symptoms
AIDS CD4< 200

Question 4

Acute HIV syndrome symptoms?

Answer 4

3-6 weeks after primary infection
Non-specific: lethargy, malaise, arthralgia, headache, anorexia

Infectious: opportunistic infection

Dermatological- mucocutaneous ulceration, psoariasis refractory to treatment

Neurological

Question 5

What are the aids defining illnesses?

Answer 5

Opportunist infections

• TB
• pneumocystis caribou pneumonia (fungus Rx cotrimatazole)
• oesophageal candidiasis
• cmv retinitis

NEOPLASTIC: kaposi sarcoma

Neurological

• HIV dementia
• progressive multifocal leukoencephalopathy (demyelination disease on)

Question 6

Investigations for HIV?

Answer 6

CBE EUC LFT CRP

• CD4+ count
• mild anaemia/thrombocytopenia is common
• deranged enzymes

Initial screen with HIV Elisa for HIV-1 and 2

• HIV 1 2 present in blood for 6 weeks after infection
• HIV p24 core antigen present in old 3 weeks after infection
• viral load not done because expensive and takes a week, p24 better

Western blot for confirmatory diagnosis
HIV drug resistance testing

Look for associated infections

Question 7

Rx?

Answer 7

DO NOT HAVE SEX

NON-PHARM

• educate
• contact tracing

PHARM
- antiretroviral when CD4 < 500