Body fluids that do not transmit HIV
Tears, saliva, urine, stool
2 highest risk factors for risk of HIV transmission without anti-retroviral therapy
1) Maternal-fetal 30% 2) Receptive anal intercourse 3%. Note that aside from mode of transmission, stage of transmitter is also important (acute HIV is more infectious w/higher viral loads)
Differential for atypical lymphocytes on CBC
HIV, EBV, CMV, Lymphoma
How long does it take for an ELISA HIV screening test + western blot take to be positive?
6-8 weeks after exposure
Common signs and symptoms of HIV infection
Fever, rash, sore throat, lymphadenopathy, thrombocytopenia and leukopenia.
Who should be screened for HIV?
ITP, pancytopenia, leukopenia, unexplained nephropathy, shingles in young person, syphilis, acute viral hepatitis (A, B, C), refractory CAP, Tb, transfusion prior to 1985, recurrent giardia/salmonella/shigella, AIDS related cancer, dermatitis, psoriasis
What viral antigens are typically assessed on western blot?
p24, gp41, gp120 and gp160. There must be 2 positive bands to have a positive test.
1st line for HIV diagnosis
HIV RNA PCR
Stages of HIV infection
PHI (primary HIV infection), AHI (asymptomatic HIV infection), SHI (symptomatic HIV infection)
Common opportunistic infections
PCP, CMV, toxoplasmosis, Mycobacterium avium-intracellulare
Common oncogenic viruses seen in AIDS
Lymphoma, cervical carcinoma, Kaposi’s sarcoma
CD4 < 200 w/TMP-SMX
CD4 < 100 w/TMP-SMX
CD4 < 50
Rule of 3’s for percutaneous virus exposure
HBV 30% (HBIG and vaccine), HCV 3% (no prevention), HIV .3% (ARTs within 2 hours)
Increased risk for HIV transmission in occupational exposures
Hollow needle that was deep in tissue, in blood vessels and has visible blood in a patient with PHI, symptomatic HIV or AIDS status.