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32 Cards in this Set
- Front
- Back
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acute illness in 50-90% patients with HIV presents with
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mild fever and sore throat; some have myalgias, lethargy, pharyngitis, arthralgias, lymphadenopathy, and maculopapular rash of trunk; lasts 3-14 days, complete recovery is rule
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ELISA for HIV
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>99% sensitivity, not completely specific
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Western blot for HIV
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sensitive and specific, but much more expensive; used as confirmatory test
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p24 antigen
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viral core protein produced by gag gene; presence denotes active viral replication
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HIV DNA PCR is used when
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infants born to HIV infected moms; maternal antibodies could complicate serologic diagnostic tests
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exposures in healthcare to HIV infected blood that lead to infection
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1 in 300
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when does the probability of AIDS-related opportunistic infections rise sharply
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CD4+ T cell count below 200 cells/mm^3; also level of viral load-may be more important than CD4+ count
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what complaints from a previously healthy adult should raise the possibility of HIV infection
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excessively dry skin, pruritus, seborrheic dermatitis with eczema folliculitis or psoriasis
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Kaposi saroma characterisitcs
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blue-violet palpable, nonpruritic, painless lesions
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common early manifestations of HIV infection (also identify ppl at greater risk of soon dvlp AIDS)
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recurrent mucocutaneous candidiasis, extensive oral aphthous ulcerations (canker sores)
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Hairy leukoplakia
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plaques of thickened mucosa on tongue and elsewhere in mouth; caused by EBV
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standard assessments to decide when to start antiretroviral therapy
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CD4+ <350 cells/mm^3; viral burden of 55,000; AIDS-defining illness
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when should HIV pos infants be considered for prophylaxis
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CD4+ <1500
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P jiroveci
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more frequent opportunistic infection associated with AIDS; 25-60%; fever, cough, SOB
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esophageal infections with AIDS
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usually candidiasis; can be from herpes viruses, herpes simplex, and CMV
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herpes simplex in AIDS
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recurrent skin infections, espcially perirectally
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CMV and AIDS
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disseminated disease with viremia; colon involvement-severe abdominal pain and diarrhea; eye infection-blurred vision, possible blindness
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AIDS and diarrheal causes
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CMV, other viruses; enteric gram-ned (salmonella, shigella); mycobacterial (avium); intestinal parasites (giardia, isospora, cryptosporidium, microsporidia); malignancies; HIV itself
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pneumonia in AIDS
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P jiroveci; pneumococci, Haemophilus influenzae, enteric gram-neg rods; TB
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Mycobacterium avium and AIDS
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MAC organism; can cause pneumonia, more commonly disseminated disease in lymphoreticular organs and GI tract
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symptoms of MAC
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fever, night sweats, weight loss, enlarged liver or spleen, diarrhea; similar to fungal infection symtoms (histoplasmosis, coccidiomycosis)
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fever and headache in AIDS patient should make you suspect
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cryptococcus neoformans-typically causes meningitis
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Toxoplasma gondii and AIDS
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multifocal infection in brain
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JC virus and AIDS
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progressive and fatal encephalopathy (progressive multifocal leukoencephalopathy or PML)
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HIV nephropathy
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proteinuria, nephrotic syndrome, and kidney failure-may respond to antiretroviral therapy
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wasting syndrome in AIDS
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profound weight loss and concomitant loss of muscle mass; pathogenesis unclear, grave prognosis
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what is Kaposi sarcoma associated with
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human herpes virus 8
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most common neurological problems in AIDS caused by
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HIV itself
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percentage of infants who aquire HIV if mother HIV positive
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13-40%; can be <2% if mom treated during last two trimesters and delivery with antiretrovirals
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what drugs target the retroviral-specific DNA polymerase
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nucleoside alalogs like zidovudine, didanosine, and nonnucleoside reverse transcriptase inhibiots like efavirenz and nevirapine
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fusion inhibitor
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enfuvirtide; bloc viral adherence to target cells
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HIV integrase
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enzyme essential for integration of provirus into host chromosomeal DNA
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