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Flashcards in HIV Deck (28)
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What is a T(CD4)-cell

- Important for immune system
- Protection from infections and cancers
- 2 main groups
○ Killer
§ 'x ray vision'
§ Circulate body and look for abnormal cells / germs
○ Helper
§ Messenger
§ Initiate activity of other immune cells
§ Generate antibodies
- Cut out one arm of this immune response = more at risk


what was the early names of HIV when it was first being discovered

> gay cancer
> "slim"
> gay pneumonia
> gay related immune deficiency (GRID)
> gay compromise syndrome
> community acquired compromise syndrome


what is the causative agent of AIDS

human immunodeficiency virus


what was the problem with the first test for HIV-1 antibodies

> very sensitive
> high false positive rate
> lots were given the wrong diagnosis and there was no way to prove if this was right or not


what is HIV PrEP

> a pill that can stop the person taking it from getting HIV
> it is for HIV negative people who are at high risk of getting HIV (continually having high risk sexual encounters)
> extremely effective at preventing HIV when taken as directed


how is HIV transmitted

- unprotected sex
- drug addicts
- blood transfusion
- pregnancy
- non sterile instruments


how is HIV not transmitted

- touching
- through food
- with a kiss
- insect bites
- in the pool


where did HIV come from

- ingestion / exposure to blood from animals
- zoonoses (derived from animals)


how many people live with HIV / AIDS globally

- 37.9 million


what are the 2 main HIV viruses

> HIV 1
- the one that caused the pandemic
- categorised into 3 groups
= major
= new
= other

> HIV 2


how is the HIV virus able to survive outside the body

- lipid envelope


what is glycoproteins role in HIV viruses

important in replication


what is the HIV life cycle

- HIV releases genetic material into CD4 cell
- reverse transcriptase copies RNA-DNA
- viral DNA inserted in cell DNA
- many copies of the viral RNA and proteins made
- new viral particles assemble and bud from the cell


what is the virus half life

5.7 hours


how many virons are found per ml of blood in an infected person



define AIDS

the presence of one of 25 conditions indicative of severe immunosuppression


HIV infection in an individual with a CD4+ cell count <200 cells per cubic mm of blood

AIDS is therefore the end point of an infection that is continuous, progressive and pathogenic


what are clinical features of AIDS

> lymphadenopathy and fever
- insidious onset
- may be accompanied by weight loss and malaise

> opportunistic infections
- pneumocystis carinii pneumonia
- cerebral toxoplasmosis
- cryptococcal meningitis
- candidosis
- herpes virus infections
- diarrhoeal disease

> malignancies
- kaposi's sarcoma
- non-hodgkin's lymphoma

> wasting
- common in africa

> AIDS-related dementia
- decrease in cognitive and / or motor functions


what is done in testing to diagnose HIV

> first generation test = antibody test
- sensitive
- only detected infection 6-12 weeks so tested before this meant the infection was missed

> viral detection antigen detection
- better than antibodies
- done within 2 weeks


what are alternative tests that dont involve blood

> rapid tests
> oral fluid tests
> dried blood spot (DBS)


what is the advantages and disadvantages of doing a dried blood spot test

good for research
not always great for diagnostic


what are the advantages and disadvantages of rapid tests and oral fluid tests

not too sensitive
needs to be confirmed


how is dental care impacted for patient's with HIV

have poorer oral health
greater dental care needs - painful oral lesions are common in HIV patients
experience high levels of HIV related stigma and discriminations


what are the oral lesions associated with HIV

> group 1
lesions strongly associated with HIV infection
= candidosis
= hairy leukoplakia
= kaposi's sarcoma
= non hodgkin lymphoma
= periodontal disease

> group 2
lesions less commonly associated with HIV infection

> group 3
lesions seen in HIV infection


what role do dentists play in HIV diagnosis

> several key HIV indicators are encountered by the dental professional
> play a role in early diagnosis to improve health outcomes and provide opportunities to prevent further transmission events
> may be able to offer chairside HIV screening to patient during dental appointments


what does the duty of candour legislation state / include

dentists must notify patients if they have been put at risk of a number of conditions due to failure to deliver satisfactory service
(need to ask how the patient wants to be notified before they are notified - this is difficult)
> need to notify the patient within 2 days
> must be the GDP delivering the service to notify the patietn


what is the risk of HIV transmission

mucosal: 1/1000
percutaneous: 1/300


what is the risk of getting HIV from a needle stick injury

1 in 37,500


how is the risk of HIV transmission further reduced

> source on cART with undetectable viral load
(undetectable viral load means the HIV is untransmissible)
> follow up and management with PEP