HIV and AIDS Flashcards
(34 cards)
Acquired Immune Deficiency Syndrome (AIDS)
Caused by the human immunodeficiency virus (HIV).
Human Immunodeficiency Virus (HIV)
- Affects the bodies ability to fight off infections and disease
- Ultimately results in death
- Effective interventions are now available
- Is one of the most important health threats of modern time
HIV Transmission
Transmitted from person to person through infected body fluids:
- Sexual contact
- Needle and syringe sharing
- Contaminated transfusions
- Transmission before and during birth
- Through breast feeding
HIV Retrovirus
Contains RNA, is transcribed to dual strand DNA and integrated into the host cell DNA to reproduce. Invades the CD4+ cells and causes progressive depletion of CD4+ cells, leads to immunodeficiency.
HIV CD4+ Cells
Principal agents involved in protection against infection.
Biomarkers Used to Assess HIV
- Viral load
- CD4+ count
4 Clinical Stages of HIV
- Acute HIV infection
- Clinical latency
- Symptomatic HIV
- Progression of HIV to AIDS
Acute HIV Infection
Time of transmission to the host until production of detectable antibodies. Half of individuals experience symptoms of fatigue, fever, malaise, or swollen lymph glands 2-4 weeks following infection. Nonspecific.
HIV Acute Stage
Virus replicates rapidly. If testing is done before seroconversion (production of detectable antibodies against the virus) occurs, will produce false negative results.
Clinical Latency or Asymptomatic HIV Infection
Further evidence of the disease may not occur for up to 10 years. Virus is still active and replicating.
Symptomatic HIV Infection
CD4+ cells fall below 500 cells/mm3. Signs and symptoms develop: fever, chronic diarrhea, weight loss, and fungal infections.
Progression to AIDS
CD4+ cells drop to less than 200 cells/mm3 or documentation of an AIDS defining condition with increased risk of opportunistic infections (OIs).
Opportunistic Infections (OIs)
Oral candidiasis, herpes simplex, hepatitis C, Kaposis sarcoma, lymphoma, pneumonia, toxoplasmosis of the brain, and TB.
HIV CD4+ Count
- Used to determine ART initiation
- Strongest predictor of disease progression
- Monitored every 3-4 months
HIV Antiretroviral Therapy Drugs (ART) Goals
- Achieve/maintain viral suppression
- Reduce HIV related morbidity and mortality
- Improve QOL
- Restore and preserve immune function
HIV Adverse Effects of ART
- Toxicities
- Metabolic complications
- Non adherence can lead to drug resistance
HIV 6 Mechanistic Classes of ART Drugs
- Nucleotide reverse transcriptase inhibitors (NRTIs)
- Non-nucleotide reverse transcriptase inhibitors (NNRTIs)
- Protease inhibitors (PI)
- Fusion inhibitors
- Chemokinase receptor 5 antagonists (CCR5)
- Integrase strand transfer inhibitors (INSTIs)
HIV ART Food and Drug Interactions
Pt needs to report ALL vitamins, supplements, medications and recreational substances they are using. Interactions can influence the efficiency of the drugs.
HIV Side Effects of ARTs
- Nausea
- Emesis
- Fatigue
- Insulin resistance
- Dyslipidemia
- Must be taken on a schedule
HIV Energy and Fluid Intake
- Difficult due to issues of wasting, obesity, HALS
- Asymptomatic HIV increases energy expenditure by 10%
- After OI, requirements increase by 20-50%
HIV Protein Requirements
- .8g/kg of body weight sufficient
- After an OI additional 10% intake in protein recommended due to increased protein turnover
- Renal insuff, cirrhosis, pancreatitis are present, adjust protein accordingly
HIV Fat Requirements
- General heart healthy guidelines
- Increase omega 3 intake
Micronutrients in HIV
Deficiencies common due to malabsorption, drug nutrient interactions, altered gut barrier function, gut infection and altered metabolism.
Micronutrients and HIV Infection
- Low levels of vitamin A, B12, and Zn associated with faster disease progression
- Higher intakes of vitamin C and B have been associated with increased CD4 counts and slower disease progression
- Vitamin A, Zn and selenium are low in response to infection
- Recommended balanced healthy diet with multivitamin meeting 100% of DRI
