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Flashcards in HIV Deck (23):

Kaposi’s sarcoma (HHV8 related)

Lymphoma (EBV-related non-Hodgkin’s lymphoma, Burkitt lymphoma, primary CNS lymphoma)

Cervical cancer (HPV-related)

Squamous cell carcinoma of the rectum (HPV-related)

Secondary malignancies related with HIV


Wasting syndrome
Renal disease

manifestations of HIV infection


characteristic codon mutations conferring resistance

genotypic resistance


ability of the virus to grow in vitro in the presence of different concentrations of antiretroviral

phenotypic resistance


lack of clinical or virologic benefit in an individual patient

clinical resistance


oropharyngeal infection
Candida albicans
White plaques that involve the soft and hard palate, tonsils, and esophagus
Diagnosed by exam and KOH smears

oral candidiasis


Appears as raised, white lesions on lateral aspect of the tongue
Caused by EBV and disposed by exam or biopsy

oral leukoplakia


oropharyngeal infection
HSV 1 and 2 cause small painful ulcers on an erythematous base
CMV causes larger, shallow ulcers
Aphthous stomatitis appear as ulcerations with an exudative base
Definitive diagnosis with culture/biopsy; EM for CMV

oral ulcers


Genital lesions can coalesce and form large ulcers that can become secondarily infected with bacteria
Infections may be complicated by radiculomyelitis and proctitis
Diagnosed by culture

HSV cutaneous infection


Recurrent dermatomal outbreaks as well as disseminated disease can occur
Diagnoses made by culture

VZV cutaneous infection


cutaneous infection
Small, flesh-colored, umbilicated lesions caused by a poxvirus

Molluscum contagiosum


cutaneous infection
Bartonella henselase and Bartonella quitana
Cutaneous (raised, violaceous) and visceral disease

bacillary angiomatosis


ocular infection
Progressive visual loss, floaters
Funduscopic exam reveals coalescing white exudates with surrounding hemorrhage and edema
Retinitis without treatment results in retinal detachment and visual loss

CMV retinitis


Recurrent bacterial infections due to strep pneumo, H. flu, S. aureus. Mycobacterial infections and fungal infections with Histoplasma, Coccidioides, Cryptococcus, and Aspergillus

pulmonary infections with HIV


Pneumocystic jiroveci
Fever, cough, progressively worsening dyspnea
Reduced O2 and CO2 levels, CXR shows diffuse interstitial infiltrates
Sputum, broncheolar lavage – specimens stained with silver stain
Prevention: being prophylaxis at CD4

Pneumocystic pneumonia


Primary and reactivation TB
M. kansasii is the most common NTB infection
Diagnosis with sputum or bronchiolar lavage stain and culture
Prevention: prophylaxis against MTB with isoniazid for all patients with positive PPD or close contacts of a patient with TB

Mycobacterial infections


Entire GI system – odynophagia, diarrhea, proctitis, fever, abdominal pain
Diagnosed by endoscopy/colonoscopy and biopsy/EM

Gastrointestinal CMV infection


Chronic diarrhea, occasionally acalculous cholecystitis
Diagnoses made by sending stool for ova and parasite staining

Gastrointestinal Cryptosporidium infection


Microsporidia, Giardia duodenalis/lamblia, Entamoeba histolytica

Gastrointestinal HIV infection


Cryptococcus, Toxoplasma, CMV, Progressive Multifocal Leukoencephalopathy (PML) caused by JC virus (polyomavirus)

CNS infections associated with HIV


Polyradiculopathy, ascending weakness, meningoencephalitis, flaccid paralysis
Diagnosis by CSF analysis, PCR, imaging

CNS CMV infection


Rapidly progressive, focal neurological deficits, caused by JC virus
Diagnosed by CSF JC virus PCR, imaging

CNS polyomavirus (PML) infection


Fever, sweats, weight loss, adenopathy, pancytopenia
Focal disease with isolated adenitis can occur
Diagnosis by blood cultures, lymph node and BM biopsy
Prevention: begin prophylaxis at CD4

Mycobacterium avium intracellulare