Transcript HIV/AIDS- A Brief History

1. What is the most common mode of
HIV transmission?
2. How else is HIV transmitted?
3. What is the most common mode of
work related transmission?
p. 241
a)
Vaginal secretions
b)
Kissing
c)
Semen
d)
Urine and feces
e)
Breast milk
f)
Coughing, sneezing
g)
Using the same comb as person with HIV

What is the main receptor to
which the HIV virus must
bind in order to gain entry
into the host’s body?

Viruses cannot reproduce /replicate without a host,
what is the host, target cell for HIV?

What is the function of T-cells?

The normal CD4 cell count in an adult is ______?

What is the difference between
HIV and AIDS?

How long does it take for HIV to
become AIDS?

Flu-like symptoms
 Fatigue
 Sore throat
 Enlarged lymph nodes
 Headache
 Muscle and joint pain

Goes through stages
Which stage does this occur?
1.
Swollen lymph glands
a.
2.
Thrush
b.
3.
Muscle and joint pain
Low-grade fever
Oral hairy leukoplakia
Sore Throat
c.
4.
5.
6.
7.
8.
CD4+ T cells drop to 200 to
500 cells/μl
Localized infections
d.
Acute Stage
Early Chronic
Intermediate Chronic
Late Chronic/ AIDS
What is major problem rt diagnosis?

Diagnostic CDC criteria
 CD4+ T cell count below 200 cells/μl
 Specific opportunistic infection or cancer
 Wasting syndrome
 AIDS dementia complex (ADC)
 Must meet CDC criteria outlined in Table 1510 in textbook

Enzyme immunoassay (EIA) to detect serum
antibodies
 If test is negative – what do they do?
 If test is positive – what do they do?
 If re-test is positive – what do they do?

A confirming test (Western blot)
 If this test is positive – reported as +

Progression monitored by:
 CD4+ T cell counts
 viral load

Abnormal blood tests common
 Neutropenia, thrombocytopenia, and anemia


Measures amount of HIV
specific RNA,
Viral load correlates
strongly with stage of
disease

HIV RNA levels during
course of infection
 or at the time of
seroconversion= 5
million copies
 5 yrs= 25, 000 copies
 8 yrs= 300,000 copies

When should Therapy be Started?

Adherence to drug regimens is critical to prevent
 Disease progression
 Opportunistic disease
 Viral drug resistance

Non-nucleoside reverse transcriptase inhibitor
(NNRTIs) ex: efavirenz (sustiva)

Nucleoside/nucleotide reverse transcriptase
inhibitor (NRTIs/NtRT)
 ex: zidovudine (retrovir, AZT,
SDV), tenovir DF (viread, TDF)
Work by inhibiting viral replication

Protease inhibitors – disable protease, a protein
that HIV needs to make more copies of itself ex:
darunavir (prezista)

Entry/Fusion inhibitors – blocks HIV entry into cells
ex: enfuvirtide (FuzeonT-20)


Integrase inhibitors – disable integrase, a
protein that HIV uses to insert its viral genetic
material into that of the infected cell ex:
raltegravir (isentress)
Fixed dose combination – contain 2 or more
meds from 1 or more drug classes
ex.- efavirenz, tenofovir (atripla)

Common physical problems
 Depression
 Diarrhea
 Peripheral neuropathy
 Pain
 Nausea/vomiting
 Fatigue

Common metabolic disorders
 Lipodystrophy
 Hyperlipidemia
 Insulin resistance
 Bone disease
 Lactic acidosis
 Cardiovascular disease
If the side effects occur – what
would the nurse expect to happen
next?


What is the major problem encountered in treating
with ART primarily when one drug alone is being
used?

What to do about it?

How would the nurse know
that ART is effective?

Major goal: Prevention
 Four CDC strategies
 Use testing as routine health care
 Use rapid testing
 Work to modify risky behaviors
 Offer tests universally to pregnant women

What is important to teach to decrease the risk of
spread via:
 Sexual intercourse?
 Drug use?
 Perinatal transmission?

Ways to promote a healthy immune system
(slow disease progression)
 Nutritional support
 Moderation or elimination of alcohol,
tobacco, and drug use
 Mental health counseling
 Vaccines
 Rest, exercise, and stress reduction
 Avoid exposure to infectious agents
Source of Exposure
HIV %
 Needlesticks (open bore needle) or cuts
 0.3-0.4

Skin contact (intact)
Splashes in mucous membrane
 (eye, nose or mouth)


<0.1

0.1

The End