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Questions and Answers
What is the primary consequence of immunodeficiency?
What is the primary consequence of immunodeficiency?
What does AIDS stand for?
What does AIDS stand for?
What is the first stage of HIV known as?
What is the first stage of HIV known as?
Which virus is considered the ancestor to HIV?
Which virus is considered the ancestor to HIV?
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During which stage are individuals with HIV most infectious?
During which stage are individuals with HIV most infectious?
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What is one of the main symptoms of AIDS?
What is one of the main symptoms of AIDS?
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What is a common outcome of the asymptomatic stage of HIV?
What is a common outcome of the asymptomatic stage of HIV?
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Which of the following is NOT a possible cause of immunodeficiency?
Which of the following is NOT a possible cause of immunodeficiency?
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What is the primary purpose of Pre-Exposure Prophylaxis (PrEP)?
What is the primary purpose of Pre-Exposure Prophylaxis (PrEP)?
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What is the recommended time frame for taking Post-Exposure Prophylaxis (PEP) after potential HIV exposure?
What is the recommended time frame for taking Post-Exposure Prophylaxis (PEP) after potential HIV exposure?
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What percentage of people living with HIV in the UK were estimated to be diagnosed in 2019?
What percentage of people living with HIV in the UK were estimated to be diagnosed in 2019?
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What is the significance of being virally suppressed for individuals diagnosed with HIV?
What is the significance of being virally suppressed for individuals diagnosed with HIV?
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Which of the following statements about the 2019 statistics on HIV in the UK is accurate?
Which of the following statements about the 2019 statistics on HIV in the UK is accurate?
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What is the highest risk factor for contracting HIV?
What is the highest risk factor for contracting HIV?
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Which of the following routes has the lowest chance of HIV transmission?
Which of the following routes has the lowest chance of HIV transmission?
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Which of the following is NOT a risk factor for contracting HIV?
Which of the following is NOT a risk factor for contracting HIV?
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What should you do immediately after experiencing a needle stick with potential HIV exposure?
What should you do immediately after experiencing a needle stick with potential HIV exposure?
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How soon must you access emergency anti-HIV medicine after potential exposure?
How soon must you access emergency anti-HIV medicine after potential exposure?
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What is the aim of antiretroviral medicines (ART) for treating HIV?
What is the aim of antiretroviral medicines (ART) for treating HIV?
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What does the viral load test measure?
What does the viral load test measure?
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What does U=U represent in the context of HIV?
What does U=U represent in the context of HIV?
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What is symptomatic HIV?
What is symptomatic HIV?
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Which of the following conditions is considered an AIDS-defining illness?
Which of the following conditions is considered an AIDS-defining illness?
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What is primarily affected by HIV as it progresses?
What is primarily affected by HIV as it progresses?
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Which of these is a common symptom of non-Hodgkin lymphoma?
Which of these is a common symptom of non-Hodgkin lymphoma?
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What type of infections might occur as a result of late-stage HIV?
What type of infections might occur as a result of late-stage HIV?
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Which organism is responsible for tuberculosis?
Which organism is responsible for tuberculosis?
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What is the primary function of the lymphatic system?
What is the primary function of the lymphatic system?
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What happens if someone lives with HIV without treatment for an extended period?
What happens if someone lives with HIV without treatment for an extended period?
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Which of the following is a common respiratory symptom associated with various illnesses?
Which of the following is a common respiratory symptom associated with various illnesses?
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What is the main underlying issue treated in hairy leukoplakia?
What is the main underlying issue treated in hairy leukoplakia?
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Which of the following is an example of a modifiable cancer risk?
Which of the following is an example of a modifiable cancer risk?
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How much higher is the rate of smoking among HIV positive individuals compared to the general population?
How much higher is the rate of smoking among HIV positive individuals compared to the general population?
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What is the most common way of transmitting HIV in the UK?
What is the most common way of transmitting HIV in the UK?
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What percentage of women with HIV were reported to have HPV infection compared to the general US population?
What percentage of women with HIV were reported to have HPV infection compared to the general US population?
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What is the recommended maximum alcohol consumption per week to lower cancer risk?
What is the recommended maximum alcohol consumption per week to lower cancer risk?
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Which of the following is a fluid that can transmit HIV?
Which of the following is a fluid that can transmit HIV?
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Which of the following should not be done when treating patients living with HIV?
Which of the following should not be done when treating patients living with HIV?
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What is one recommended action for patients living with HIV to maintain their health?
What is one recommended action for patients living with HIV to maintain their health?
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Which of the following is considered a standard infection control precaution?
Which of the following is considered a standard infection control precaution?
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Which of the following behaviors is encouraged for healthcare providers when seeing patients living with HIV?
Which of the following behaviors is encouraged for healthcare providers when seeing patients living with HIV?
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What is an inappropriate assumption to make about patients living with HIV?
What is an inappropriate assumption to make about patients living with HIV?
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What should healthcare providers avoid doing at the end of the day?
What should healthcare providers avoid doing at the end of the day?
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What positive lifestyle change is recommended for HIV patients regarding alcohol?
What positive lifestyle change is recommended for HIV patients regarding alcohol?
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What is a recommended health action for individuals living with HIV in relation to vaccinations?
What is a recommended health action for individuals living with HIV in relation to vaccinations?
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Study Notes
HIV, AIDS, and Immunodeficiency
- Immunodeficiency weakens the immune system, increasing susceptibility to infections, cancers, and other diseases a healthy system can fight off.
Intended Learning Outcomes
- Develop a broad knowledge base about HIV.
- Define HIV, AIDS, and immunodeficiency.
- Identify the stages of HIV infection.
- Explain the signs and symptoms of HIV and how they manifest.
What is Immunodeficiency?
- Immunodeficiency results in increased susceptibility to various infections, cancers, and other diseases typically fought off by a healthy immune system.
Types of Immunodeficiency
- Ataxia-telangiectasia
- Chediak-Higashi syndrome.
- Hypogammaglobulinemia
- Leukocyte adhesion defects
- AIDS
- Complement deficiencies
- DiGeorge syndrome
- HIV
- Job syndrome
- Combined immunodeficiency disease
The History of HIV
- In 1983, Luc Montagnier suspected HIV was a virus.
- He collaborated with Françoise Barré-Sinoussi to find retroviruses in cells from AIDS patients.
- The “hunter hypothesis” suggests HIV originated in chimpanzees (SIV). Humans contracted it through contact with infected chimpanzee blood.
What is AIDS?
- AIDS—acquired immunodeficiency syndrome—is a condition characterized by multiple life-threatening illnesses when the immune system is severely damaged by the HIV virus.
HIV Infection Stages
- Stage 1 (Seroconversion): Short illness (up to 6 weeks) after HIV infection; this is often a primary/acute HIV infection, which can be asymptomatic or influenza-like. Seroconversion is when a person is most infectious.
- Stage 2 (Asymptomatic): After seroconversion; person feels fine and doesn't show any symptoms; HIV is active infecting new cells, copying itself, and reducing the immune system's ability to fight off illness. This phase can last for years
- Stage 3 (Symptomatic): The longer the person goes without treatment, the higher their risk for infections the weakened immune system can't fight, as well as other direct effects from HIV.
- Stage 4 (Late-stage): A severely compromised immune system can lead to serious opportunistic infections and cancers, which mark the late-stage.
AIDS-Defining Illnesses
- Candidiasis (oesophagus, bronchi, trachea, or lungs[ not oral])
- Cervical cancer.
- Coccidioidomycosis
- Cryptococcosis
- Cryptosporidiosis
- Cytomegalovirus disease or CMV
- Cytomegalovirus retinitis (with loss of vision).
- Encephalopathy
- Herpes simplex
- Histoplasmosis
- Isosporiasis
- Kaposi sarcoma
- Lymphoma (Burkitt's, immunoblastic, or primary brain)
- Mycobacterium (avium complex, kansasii, other species)
- Pneumocystis pneumonia (PCP)
- Pneumonia
- Progressive multifocal leukoencephalopathy
- Salmonella septicemia
- Toxoplasmosis
- Wasting syndrome
Common AIDS-Defining Illnesses
- Non-Hodgkin lymphoma (cancer of the lymphatic system).
- Tuberculosis (TB) – caused by bacteria Mycobacterium tuberculosis.
- Cryptococcal meningitis (fungal infection caused by the cryptococcus neoformans fungus, which can cause brain infection).
- Cachexia (wasting syndrome).
- Kaposi's sarcoma (KS) – caused by Herpes Virus type 8 (HHV-8). This virus can cause cancer in the skin, mouth, or internal system in a weakened immune system and individuals with a genetic vulnerability.
- Candidiasis – usually a yeast (fungus) infection of the bronchi, trachea, lungs, or oesophageal. Oral pharyngeal candidiasis is the most common opportunistic infection with HIV
- Hairy leukoplakia – oral condition triggered by Epstein-Barr virus, in weakened immune systems, notably those from people living with HIV
HIV Transmission
- HIV is found in body fluids (semen, vaginal fluids, blood, breast milk)
- In the UK, the most common way to get HIV is through unprotected anal or vaginal sex.
- Oral sex carries a very low risk of transmission.
- HIV cannot be transmitted through sweat, urine, or saliva.
- Sharing contaminated needles, syringes, and medical instruments.
- Blood transfusions and tissue transplants (unsterile situations.)
- Needle stick injuries.
Risk Factors for Contracting HIV
- Having other sexually transmitted infections (STIs).
- Sharing contaminated needles, syringes, medical procedures (unsterile situations).
- Receiving unsafe injections, blood transfusions, tissue transplants.
- Needle stick injuries.
Diagnosing HIV
- Seek medical care as soon as possible if one thinks they have been exposed to HIV
- An HIV test is necessary to diagnose HIV.
Coming into Contact with HIV
- After possible exposure to HIV, have negative testing repeated at 6, 12, and 24 weeks post infection.
- If the tests turn positive, a specialist HIV clinic will likely be consulted for more tests and treatment options.
Treatment for HIV
- Antiretroviral medicines (ART) are used to treat HIV.
- ART medicines work by stopping the HIV virus from replicating within the body.
- Combination therapy; different medicines taken daily
- Aim of HIV treatment is U=U - undetectable viral load. This means treatment works to suppress the virus, preventing it from being infectious to others.
Viral Load
- Viral load is the amount of HIV in the blood.
- A viral load test measures how many HIV particles are in the blood sample.
- Result is given with copies per milliliter (e.g. 200 copies/mL)
- U=U (undetectable): <200 copies/mL (no HIV particles detectable)
- Low: 10,000 copies/mL
- High: >100,000 copies/mL
Pre-Exposure Prophylaxis (PrEP)
- PrEP medicine keeps people from getting HIV
- Taken regularly (one tablet daily) or as a 2+1+1.
- Truvada (specific medication)
Post-Exposure Prophylaxis (PEP)
- PEP medication is taken within 72 hours if there is an exposure to HIV.
- 28-day course of ARV drugs
- Recommended by WHO for both exposure situations, adult and childhood cases.
- Usually, one tablet of Truvada and two tablets of raltegravir.
Statistics on HIV in the UK
- There are an estimated 105,200 people living with HIV in the UK in 2019.
- 94% of individuals with HIV in the UK in 2019 have been diagnosed. 6% did not know they carried the virus.
Important Considerations for People Living with HIV
- Practice self-care (exercise, balanced meals, stop smoking, yearly flu jabs).
- Limit alcohol consumption.
- Maintain optimal oral hygiene.
What NOT to Do
- Book the patient at the end of the day.
- Place used items in a separate bag.
- Double glove or unnecessarily use excessive PPE for the patient
- Refuse to see a patient.
- Ridicule/insult the patient/team members.
- Make assumptions about the patient.
What TO Do
- Universal precautions/standard infection control precautions (SICPs)
- Positive welcoming attitude
- Respect and dignity must be shown to the patient as a care provider
UK Distribution Stats
- Most cases occurring in England (91.5%) followed by Scotland (5%), Wales (2.4%), and Northern Ireland (1.1%).
Ethnicity Distribution
- Majority of reported cases were white (54.6%), followed by Black African (28.7%).
Gender Distribution
- Larger portion of cases are male (69.1%); 30.9% of the sample group are female.
Mode of Transmission
- Sex between men (46.4%)
- Heterosexual contact (46.1%)
- Injecting drug use (1.9%)
- Unknown (2.7%)
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