Disease of the human Immune system caused by infection with human immunodeficiency virus
How is HIV transferred?
Contaminated blood transfusions, hypodermic needles, and from mother to child during pregnancy, deliver, or breastfeeding
ACUTE INFECTION OF HIV
- VIRUS PRODUCED IN THE BLOOD
- SYMPTOMS: FLU-LIKE
Clinical Latency of HIV
- HIV reproduces at low levels, but still active
- Symptoms: may/may not
- CD4 count drops below 200 cells/mm3
- Symptoms: without treatment, survival is 3 yrs
What race has the most # of AIDS diagnoses?
African American, Hispanic, White
What is the # 1 transmission of AIDS?
Male to Male sexual contact
Top # of Deaths in States?
CA, FL, TX, NY, GA
How many ppl living with AIDS?
Sources of HIV?
Blood, Semen, Vag secretion, Preg, Breast Milk, Years, CSF, Alveolar fluid, Saliva
What are the initial symptoms of HIV?
flu-like, loss of appetite, candidiasis, Kaposi’s Sarcoma, Oppurtunistic infections
What Defines AIDS?
- CD4 count <200 cells/mm^3
- increase in HIV p24 antigen
How can HIV NOT be spread? 5
- insect bites
- Aerosol exposure
- Body contact without body fluid exposure
Transmission Human bite?
Human Bite through skin
Are HIV patients aware they have the disease?
- Western Blot confirmation (antibody detection)
Are false positives common with HIV screening?
When does seroconversion happen?
Initial infection of AIDS:
8-12 years or greater
Average age of AIDS deathL
- 10-24 years
- 3 yrs if not treated
- NO LONGER IMMEDIATE DEATH SENTENCE
Oral HIV test OraSure:
- Oral mucosal transudate
- 99.7% accurate
- 72 hours
Most common HIV treatment:
combo of 1 non-nucleotide reverse transcriptase inhibitor and 2 nucleotide reverse transcriptase inhibitors
Opportunistic Infections with HIV:
- Atypical Mycobacteria
HIV related podiatric Conditions:Dermatologic
- -Onychomycosis / tinea pedis
- -Proximal white superficial onychomycosis
- -Mosaic plantar verucae
- -Itchy folliculitis
- -Severe psoriatic flares
- -Xerotic eczema
Vascualr with HIV
- increase chance of DVT
MS with HIV
- Non-specific arthritis
- Reiter’s syndrome
- Psoriatic arthritis
Neurologic HIV related:
- Motor neuropathy
- Spinal cord dysfunction
- Peripheral Sensory neuropathy
prevents packaging of viral proteins into infectious virions
Drugs for HIV:
- 1. Nucleoside Analogs
- 2. Non-nucleoside Analogs
- 3. Protease inhibitors:
- 4. Fusion Inhibitors (cell entry blockers)
- 5. Integrase inhibitor-Raltegravir
Block ssRNA—reverse transcriptase-> dsDNA
Prevents packaging of viral proteins into infectious virions
Cell entry blockers
Integrase inhibitor- Raltegravir
blocks integrating of the virus’s genetic material with the cell’s genetic material
Non-nucleoside Reverse Transcriptase Inhibitors:
- All have “vir”
- Ritonavir +Lopinavir(Kaletra)
CCR5 Entry Inhibitors:
- CCR5 receptor is one of the surface receptors that HIV atttaches too
- Maraviroc blocks the virus from attaching to this receptor preventing chemical exchange from the virus into the Host cell
- Used in combo with other antiretroviral drugs
- Trofile Test-used to test if the HIV virus targets CCR5 receptors
What is the most common sharp involved in percutaneous injuries?
Post Exposure Prophylaxis
- 4weeks treatment with a combination drug(3 or more antiretroviral drugs) several times a day
- Decreases the rate of infection approx. 79%
- Followed by baseline test, 6weeks, 12 weeks and 6 months
Hepatitis and healthcare workers: which is the most prevalent?
Acute Hep B incubation period:
- 60-90 days
- fatigue, nausea/vommitting, jaundice, itchy skin, joint/muscle pain, and dark urine (rarely death)
- 95% infections = full recovery and protective immunity
Chronic Hep B
- sam symptoms as Acute
- end: severe hepatitis, liver cirrhosis, liver cancer and death
- Death occurs from chronic liver disease in 15-25% of pts.
- Younger the patient, more likely to become a chronic carrier
Hep B and body fluids:
- High: blood, serum, wound exudate
- Moderate: semen, vaginal fluid, saliva
- Low: Urine, Feces, Sweat, Tears, Breast milk
- **Can survive as dried blood on a surfaces up to 2 weeks
Hep b transmission:
Risk of Transmission:
- 2-40% - Hepatitis B
- 0.3% - HIV
Hep b prevention:
Vaccination-Engerix B or Recombovax HB
- DTaP, hep B and inactive polio
- no preserative
Hep B vaccine:
immunity for life
Hep B treatment:
- Acute: no tx
- Chronic: Interferon and Antiretrovirals
- Respiratory disease caused by inhalation of Mycobacterium Tuberculosis
- Bacteria grows in the lungs (highly infectious)
- Can spread to kidney, spine and/or brain
% of HIV infected with TB?
1/3 HIV infected people co-infected
What is the leading cause of death for AIDS patients?
- Airborne droplets
- Skin disruption
- Productive cough, fever
- Weight loss, fatigue
- Night sweats
- Nail clubbing
- Barrel chest
- CHest X-ray
- *TB culture= gold standard
- 6-9 months