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What is HIV?
How does the virus transmit?
- Is a Fragile Virus
- Contact with infected fluid-blood
- Semen
- Vagina Secretion
- Breast milk
- Sexual transmission
- Contact w/ blood & blood product
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HIV Viral Load?
- The numbers of virus in the plasma
- Is the important variable in transmission
- Large amount of the HIV can be found in the blood during the first 6 months of infection
- And again during the late stage of the disease
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Transmission Routes of HIV?
- Not spread casually
- Not transmitted through tear, saliva, urine, emesis, sputum, feces, or sweat
- Healthcare worker have a low risk of acquiring HIV at work even after a needle stick injury
- Most common mode: sexual contact
- Sharing of needles major means in large cities
- Needle stick expoxure: 0.3%-0.4%
- Perinatal transmission route of infection in children
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HIV disease?
- HIV: Human Immunodeficiency Virus
- Retrovirus: replicated in a backward manner RNA-DNA
- B-cell: initially make HIV antibodies (to stop the disease)
- T-4 (CD4) cell: T-helper cells-eventually the ability of HIV to destroy CD4+T cells exceed th ebody ability to replaces the cells
- T8 cell: T-suppressor cell-AIDS -CD4+ to CD8 ratio of 2:1 reverse with AIDS
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HIV Acute Infection Stage
Flu Like Symptoms which are? F, S, S, H, M, N, M &J, D, D, R
- Fever
- Swoolen Lympnodes
- Sore Throat
- Headache
- Malaise
- Nause
- Muscle and joint pain
- Diarrhea
- Diffuse Rash
- 1-3 week after initial infection-- and last for 1-2 weeks
- High level of HIV in the blood is noted
- CD4+T cells count FALLs temporarily
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EARLY CHRONIC HIV INFECTION
and asypmtomatic parts of the disease:
(fat, head, low glv, Ni, persis
- CD4+T lymphocyte count remains above 500cells/ul
- (normal or slightly decrease)
- Viral load is LOW
- Asymptomatic part of disease symptoms like:
- Fatigue
- Headache
- Low grade level fever
- Night sweats
- Persistent generalized Lympphadenopathy
These individual do not realize they are sick, and what impact does this have on the communicable of the disease
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INTERMEDIATE CHRONIC HIV INFECTION
and Most common infections: T,S,C,H,K,O
- CD4+T ceels count drops from 500-200 cells/ul
- Viral load RISES
- Symptomatic stage
- Symptoms from the early stage worsen
- Persisten fever
- Frenquent drenching night sweat
- Chronic Diarrhea
- Recurrent headache
- Severe Fatigue
- Most common infections:
- Thrush (oropharyngeal candidiasis)
- Shingles
- Persistent Candian infection
- Genital Herpes
- Kaposi's sarcoma
- Oral hairy leukoplakia EB virus indicateor of disease progression
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HIV Preventions?
- Education
- Culture Specific teaching intervention
- STANDARD PRECAUTIONS
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Late Chronic AIDS infection
- CD4+T below 200 cells/ul
- Development of an opportunistic infection (OI's):
- Fungal-pneumocytis carinii pneumonia (PCP)
- Bacteria-mycobacterium tuberculosis
- Development of an opportunistic cancers:
- Kaposi's sarcoma
- Lymphoma
- Wasting syndrome-loss of 10% of body weight
- Dementia develops
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What are four basic questions for NR to ask?
- Have You Ever?
- 1) had a blood transfusion or clotting factor?
- 2) shared drug-using equipment with an another person?
- 3) had a sexual experience in which your penis, vagina, rectum, or mouth came into contact w/another person' s PVRM ?
- 4) had a sexual transmitted disease?
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What lab finding may RN find with positive HIV?
- Positive HIV assay (EIA or ELISA)
- Detectable load levels by bDNA
- PCR decrease CD4+T lymphocyte
- Reversal of CD4: CD8 ratio (2:1)
- Decrease WBC count
- Lympopenia
- Anemia
- Thrombotopenia
- Electrolite imbalanced
- Abnormal liver function test
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Early Diagnose
Diagnostic test
- Pre and Posttest counseling
- (if the test is (+) do you have anyone to talk to?)
- ELISA test 2x, if positive then
- Western blot (standard test of HIV)
- Retest schedule
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What are Goals of Antiretroviral Drug Therapy?
- Decrease HIV RNA levels to less than 50 copies/ul
- (undetectable levels are preferred)
- Maintain or raise CD4+T cells count >200 cels/ul immune reconstitute
- Delay the develop of HIV related symptoms
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What is acute HIV intervention?
- Initial Response to diagnosis
- Antiviral therapy -3-20 pills/day
- Beepers
- Timers
- Pillboxers
- 2-4 weeks after the start on drug therapy (or change therapy)
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Antiretroviral drugs mechanism?
Work by affecting different points of the replication cycle
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Nonnucleoside Reverse Transcript Inhibitors (NNRTIs) mechanism?
- Inhibit the ability of the virus to make a DNA copy in replication
- Block the process to convert HIV RNA into HIV DNA
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NRTIs Mechanism?
Inhibits the abilty of the virus to reproduce production of the new HIV DNA incomplete
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Nucleotide Reverse Transcript Inhibitor mechanism?
Inhibit the action reverse transcriptase
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Protease Inhibitors (PIs) mechanism?
Interfere with the activity
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