Hiv Slides

Front 1

HIV infection is caused by

Back 1

•A parasite looking for a way into a cell, take over the cell, and makes more copies of itself.

Front 2

CD4 cell
function

Back 2

Directs immune system defenses and regulates the activity

Front 3

HIV
Life cycle

Back 3

Gradually the CD4+ cell counts fall
viral numbers (viral load) rises client eventually dies of opportunistic infections or cancer.

Front 4

Transmission of HIV

Back 4

•Transmitted by body fluids containing HIV or infected CD4 lymphocytes
–Blood, seminal fluid, vaginal secretions, amniotic fluid, and breast milk
–Sexual: genital, anal or oral sexual contact
–Most prenatal infections occur during delivery

Front 5

HIV
Assessment

Back 5

•Age, gender, occupation, and residence
•Current illness
•Chronology of infections and problems since diagnosis
•Donated blood ?
•Rec’d blood products? When ?
•STDs ?
•Any Major Infections ? TB? Hepatitis?
•Manifestations ? SOB, fever, night sweats fatigue, N/V, weight loss, diarrhea, visual changes, H/A, memory loss confusion, rashes, skin lesions.
•Opportunistic Infections?

Front 6

Dx of AIDS is made by

Back 6

HIV + and have a CD4+ cell count < 200cells/mm or an opportunistic infection.

Front 7

Primary Infection

Back 7

•Acute HIV infection/acute HIV syndrome
•Part of CDC category A
–Review Table 52-1, CDC Classification System
•Symptoms: none to flu-like syndrome
•Window period: lack of HIV antibodies
•Period of rapid viral replication and dissemination through the body
•Viral set point: balance between amount of HIV and the immune response

Front 8

HIV Asymptomatic

Back 8

•CDC category A
•More than 500 CD4+ T lymphpocytes/mm3
•Upon reaching the viral set point, chronic asymptomatic state begins
•Body has sufficient immune response to defend against pathogens. Patient feels well and has few if any symptoms.
•8 -10 years can pass before major HIV related complication develops.

Front 9

HIV Symptomatic

Back 9

•CDC category B
•200 to 499 CD4+ lymphpocytes/mm3
•CD4 T cells gradually fall
•The patient develops symptoms or conditions related to the HIV infection that are not classified as category C conditions
•Patients who are once treated for a category B condition are considered category B

Front 10

AIDS

Back 10

•CDC category C
•Less than 200 CD4+ lymphocytes/mm3
–A person is said to have AIDS.
•As levels drop below 100 cells/mm3, the immune system is significantly impaired
•Development of listed conditions–

Front 11

Manifestations of AIDSRespiratory

Back 11

•Pneumocystis carinii pneumonia (PCP)
–Most common infection
–Initial symptoms may be nonspecific and may include nonproductive cough, fever chills, dyspnea, and chest pain
–If untreated, progresses to pulmonary impairment and respiratory failure
–Treatment: TMP-SMZ or pentamidine; prophylactic TMP-SMZ
•Mycobacterium avium complex (MAC)
–Also found in the GI track, lymph nodes and bone marrow.
•Tuberculosis

Front 12

Manifestation of AIDSGI

Back 12

•Oral candidiasis
–Creamy white patches in the oral cavity. If left untreated, progresses to involve the esophagus and stomach.
–Treatment with Mycelex troches or nystatin and ketoconazole
•Diarrhea related to HIV infection or enteric pathogens
–Octreotide acetate for severe chronic diarrhea
–Fluid & electrolyte imbalances, perianal skin excoriation, weakness, inability to perform activities of daily living.

Front 13

•Wasting syndrome

Back 13

–10% weight loss and chronic diarrhea or chronic weakness and fever with absence of other cause
–Protein energy malnutrition. Hypermetabolic state –excessive calories burned and lean body mass is lost.
–Anorexia, diarrhea, GI malabsorption, and lack of nutrition may contribute
–Similar to that seen in sepsis or trauma and can lead to organ failure.

Front 14

Manifestations of AIDSOncologic
•Kaposi's sarcoma

Back 14

–Most common HIV related malignancy.
–Cutaneous lesions but may involve multiple organ systems
–Lesions cause discomfort, disfigurement, ulceration, and potential for infection

Front 15

Manifestations of AIDSOncologic
•B Cell Lymphomas

Back 15

–Second most common malignancy.
–AIDS related lymphomas tend to develop outside the lymph nodes, most commonly in the brain, bone marrow, and GI tract.
–Aggressive growth and resistance to treatment.
–Includes multiple sites of organ involvement
–Treatment is less successful in people with AIDS due to severe hematologic toxicity and complications that can occur from treatment.

Front 16

Manifestations of AIDSNeurologic
•HIV Encephalopathy (Chart 52-8)

Back 16

–Progressive decline in cognitive, behavioral, and motor functions.
–Probably directly related to the HIV infection
•Cryptococcus Neoformans
–Fungal infection. Cryptococcal meningitis characterized by fever, H/A, malaise, stiff neck, N/V, mental status changes, seizures.
•Progressive Multifocal Leukoencephalopathy
–Occurs in about 3% of AIDS patients
–Mental confusion rapidly progressing to include blindness, aphasia, muscle weakness, partial or complete paralysis, and death.
•Other Neurologic Disorders including peripheral neuropathy associated with pain and numbness in the extremities, weakness, diminished deep tendon reflexes, orthostatic hypotension, and impotence.
•Depressio