what are the glycoproteins on HIV envelope?
- together make GP 160
what type of virus is HIV?
- 2single stranded RNA
what are the ways of transmission of HIV?
- sexual: concurrent STI
- blood: IVDU, blood product
- vertical: delivery or breast feed
how is vertical transmission of HIV prevented?
- 1. HAART to pregnant woman
- 2. C-section to control blood contact at delivery
- 3. stop breast feeding
give 7 features of primary HIV infection presentation?
- rash: blanching erythematous
- meningitis, other neuro: GB, transverse myelitis, mononeuritis
what is the spectrum of AIDS? give 3 categories
- neoplastic: KS, lymphoma, viral oncogenesis, castleman's disease
- HIV direct effect: enteropathy, dementia, nephropathy
name the bacterial infections in AIDS and what they cause
- strep pneumo: pneumonia, meningitis, sepsis
- Non-typhoidal salmonella: sepsis
name the mycobacterial infections in AIDS and what they cause
- M.Tb: pulmonary, meningitis, disseminated lymphadenitis
- M. Avium intracellulare: disseminated lymphadenitis, GI infection
name the fungal infections in AIDS and what they cause
- Pneumocystis jiroveci (PCP): pneumonia
- candidiasis: upper GI infection
- cryptococcus neoformans (soil): fever, meningitis, skin lesion
name the different herpes virus infections in AIDS and what they cause
- HSV1: oral ulcers - cold sores. all way through mucosal layers, meningoencephalitis
- HSV2: genital ulcers
- VZV: recurrent chickenpox and shingles (multidermatomal)
- EBV: lymphoma
- CMV: fever, retinitis, gastroenteritis,
- HHV6: hairy leukoplakia
- HHV8: Kaposi's sarcoma, Castleman's disease
name the protozoan infections in AIDS and what they cause
- toxoplasma gondii: cerebral abscess, retinitis, disseminated (inadequ prep food)
- leishmania: fever, hepatosplenomegaly, lymphadenopathy (bite of a sandfly)
what is slim's disease and what are the main causes of it in HIV?
- infective diarrhoea: CMV, MAI, cryptosporidiosis, microsporidiosis
- neoplastic: lymphoma, KS
- catabolic state
- HIV: enteropathy
what are the causes of lymphadenopathy in HIV?
- infection: mTb, MAI, leishmania, histoplasmosis
- Neoplastic: lymphoma, KS, castleman's
- HIV: immune activation
what are the different skin diseases in HIV?
- seborrheic dermatitis
- molluscum contagiosum
- psoriasis bad
- bacterial folliculitis
- cryptococcal disease
what are the GI tract diseases in HIV?
- CMV ulcers
- hairy leukoplakia
- KS in mouth
- HSV oral ulcers
name 2 ano genital disorders in HIV
- HSV2 genital ulcers
- papilloma virus causing perianal warts
what are the different respiratory diseases in HIV?
- pneumocystis jiroveci (PCP)
- Streptococcus pneumonia
- chronic sinusitis
- KS in airways
- lymphadenopathy due to TB or lymphoma
what are the near diseases of HIV?
- cerebral abscess
- atrophy and dementia
- peri ventricular lymphoma
- meningitis: Strep pneumo, HSV, TB
- cryptococcal meningitis
- CMV retinitis
- toxoplasma retinitis
- progressive multi leukoencephalopathy: plaques of demyelination
what are the haematological diseases in HIV?
- lymphoma (EBV)
how is consent obtained for a HIV test?
- 1. no obligation
- 2. rationale: if pick up can treat earlier and prevent from getting worse
- 3. simple blood test
- 4. confidentiality
if a pt is unable to give consent but HIV is suspected, what happens?
- confidentiality: do not ask family/partner
- pts best interest
what are the 2 main types of tests for HIV?
- serology: anti-gp120, p24 antigen
- molecular: RNA HIV viral load, proviral DNA