HIV Epidemiology and Transmission

Stages of HIV Disease: Select all that apply

• HIV progresses through stages: acute infection, asymptomatic infection, symptomatic infection, and AIDS
• Average time from HIV to death is about 12 years with treatment, down to 5 years without treatment
• Comorbidities like malnutrition, tuberculosis (TB), and malaria shorten survival rates

Historical Context of HIV/AIDS: Select all that apply

• First AIDS case in the U.S. was June 1981, identified by the CDC
• 'Acquired immune deficiency syndrome' was coined due to severe immune compromise
• HIV antibody test in 1985 allowed identification of HIV-positive individuals

Classification Systems: Select all that apply

• The CDC established a classification system in 1986, categorizing individuals into symptoms and HIV status in four groups
• Adult classification is based on CD4+ lymphocyte count and AIDS-defining conditions
• WHO has system allowing movement between stages based on treatment response, not in CDC system

Global Impact of HIV/AIDS: Select all that apply

• In 2020, 37.7 million people were living with HIV globally
• HIV prevalence varies, with resource-limited countries facing higher rates of infection and mortality

Challenges in Vaccine Development: Select all that apply

• Absence of an effective HIV vaccine is due to the virus's ability to mutate rapidly, complicating the vaccine design Research is focused on understanding the virus's structure and immune evasion strategies

Risk Mitigation Strategies: Select all that apply

• Until a vaccine is available, strategies include promoting safe sex and intravenous drug use harm reduction
• Public health campaigns emphasize condom use and tests to manage and prevent spread

Overview of HIV Transmission: Select all that apply

• HIV affects all demographics like orientation, race, ethnicity, gender, and age
• Primary transmission mode is sexual contact; IV drug use is also a significant risk factor
• Sharing injection equipment spreads HIV

Global Statistics and Trends: Select all that apply

• In 2020, WHO reported about 1.5 million new HIV infections, indicating a slow decline since 1997
• The decline in new cases is attributed to enhanced prevention strategies and increased access to treatment
• Deaths due to HIV decreased to 680,000 in 2020, reflecting improved care and treatment options

HIV in the United States: Select all that apply

• CDC estimates about 2 million adults and children have been infected since epidemic began, with 600,000 deaths
• About 1.1 million individuals are living with HIV in the U.S., with 15% unaware of their status
• Highest rates of new infections in 2019 were among gay men, accounting for 66% of new cases

Demographic Disparities: Select all that apply

• African American men, particularly those who have sex with men, represent the most affected racial group
• CDC reported the highest rates of new infections among African American men, highlighting significant health disparities
• Between 2015 and 2019 in the U.S., HIV infections decreased by 8%

Geographic Distribution of HIV: Select all that apply

• The District of Columbia, Georgia, and Florida have high HIV incidence rates
• Understanding geographic trends is crucial for targeted public health interventions and resource allocation

Sexual Transmission: Select all that apply

• Sexual contact is the most common route of HIV transmission, emphasizeing safe sex practices
• Condoms and testing are critical preventive measures

IV Drug Use and HIV: Select all that apply

• IV drug use remains a significant risk factor, particularly shared needles
• Harm reduction strategies like needle exchange programs are essential in preventing spread among drug users

Blood Transfusions and Occupational Exposure: Select all that apply

• Blood transfusions are a rare source of HIV transmission, with only one case since 2002
• Occupational exposure accounts for a small percentage (0.36%) of HIV infections, primarily among healthcare workers

Perinatal Transmission: Select all that apply

• Pregnant or breastfeeding individuals with HIV can transmit the virus to their children
• The risk of perinatal transmission can be reduced with antiretroviral therapy Access to prenatal care and adherence to treatment are vital in preventing perinatal transmission

Prevention Strategies: Select all that apply

• Comprehensive prevention strategies: education, access to testing, and treatment for HIV-positive individuals
• Pre-exposure prophylaxis (PrEP) is an effective method to prevent HIV in high-risk populations

Functions of the Immune System: Select all that apply

• The immune system serves as defense mechanism against infectious agents like bacteria, viruses, and parasites
• The immune system identifies/eliminates abnormal and cancerous cells
• The immune system reacts to foreign objects ranging from transplanted organs to splinters

Components of the Immune System: Select all that apply

• The immune system is composed of various cells, including T lymphocytes (T cells), B lymphocytes (B cells), and macrophages
• CD4+ T helper cells are crucial for orchestrating the immune response by releasing cytokines that activate other immune cells
• Cytokines are signaling proteins that mediate and regulate immunity, inflammation, and hematopoiesis

Mechanism of HIV Infection: Select all that apply

• HIV primarily targets CD4+ T cells, leading to their destruction and compromising the immune response
• The virus replicates within the CD4+ cells, causing chronic and persistent cell death

Stages of HIV Disease: Select all that apply

• HIV infection progresses to the stages of acute infection, clinical latency, and AIDS
• During the acute phase, individuals may experience flu-like symptoms as the virus rapidly replicates
• In the clinical latency stage, the virus is still active

Consequences of Untreated HIV Infection: Select all that apply

• Untreated HIV can lead to a decline in CD4+ cell counts, resulting in AIDS
• Individuals with AIDS are at high risk for opportunistic infections
• Common OI: Pneumocystis pneumonia, tuberculosis, and certain cancers such as Kaposi's sarcoma.

Role of CD4+ T Cells: Select all that apply

• CD4+ T cells are essential for the immune response, as they help activate B cells
• CD4+ T cells stimulate killer T cells to destroy infected cells
• The loss of CD4+ T cells leads to a weakened immune system
• Monitoring CD4+ cell counts is crucial in managing HIV infection and assessing immune function

Cytokine Release and Immune Activation: Select all that apply

• Upon recognizing an antigen from an infected cell, CD4+ T cells release cytokines that stimulate other immune cells
• This activation is critical for mounting an effective immune response against pathogens
• HIV disrupts this process by targeting CD4+ cells, leading to a cascade of immune dysfunction

Viral Transmission Mechanism: Select all that apply

• HIV is transmitted through bodily fluids, primarily via sexual contact and shared needles
• HIV is transmitted from mother to child during childbirth or breastfeeding
• The virus targets CD4+ T lymphocytes
• Initial infection triggers an inflammatory response, attracting immune cells to the site of infection

Entry and Integration of HIV into Host Cells: Select all that apply

• HIV attaches to CD4+ receptors and co-receptors (CCR5 or CXCR4) on the surface of CD4+ cells
• Viral RNA is reverse transcribed into DNA by the enzyme reverse transcriptase
• Newly formed viral DNA integrates into the host cell's DNA within the nucleus

Replication and Release of New Viruses: Select all that apply

• Integrated HIV DNA directs the host cell to produce viral proteins
• New HIV particles are assembled and bud off from the host cell, leading to the destruction of the CD4+ lymphocyte as it releases the new viruses
• This leads to a rapid increase in viral load and a decrease in CD4+ lymphocyte count

Symptoms and Immune Response: Select all that apply

• During the acute phase, individuals may experience flu-like symptoms such as low-grade fever, fatigue, swollen lymph nodes, and aches.
• The acute phase typically occurs within 2-4 weeks post-infection, marking a critical period for diagnosis and intervention

Seroconversion Process: Select all that apply

• Seroconversion refers to the period when the immune system begins producing antibodies against HIV
• This process usually occurs within 3-12 weeks after infection
• The presence of antibodies indicates that the body is responding to the infection, but the individual remains infectious

Implications of Acute Infection: Select all that apply

• The rapid increase in viral load during acute infection poses a high risk of transmission to others
• Understanding the acute phase is crucial for public health strategies aimed at HIV transmission rates
• Early diagnosis and treatment can improve long-term health outcomes for individuals living with HIV

Clinical and Epidemiological Considerations: Select all that apply

• CD4+ lymphocyte count and viral load are key indicators of HIV progression and treatment efficacy
• Regular monitoring helps in assessing the immune system's health and the effectiveness of ART
• A decline in CD4+ count and an increase in viral load indicate disease progression and the need for treatment adjustments

Treatment and Management Strategies: Select all that apply

• Antiretroviral therapy (ART) aims to reduce viral load to undetectable levels
• Early ART initiation can lead to better health outcomes and lower transmission rates

Public Health Implications: Select all that apply

• Understanding HIV dynamics is vital for developing effective prevention strategies
• Education and awareness campaigns can help reduce stigma and promote testing and treatment
• Global efforts are needed to address disparities in HIV care and prevention in regions

Asymptomatic Chronic Infection: Select all that apply

• The immune system can not eliminate, but exerts control over HIV
• CD4+ T-cell increase, viral load decreases
• Viral load increases, CD4+ counts slowly decline, could take 10 years to become symptomatic

Symptomatic Chronic Infection: Select all that apply

• Decrease in CD4+ count and an increase in viral replication diminishes ability to control viral replication
• People experience: respiratory infections, lymphadenopathy, skin issues, and weight loss
• average time to AIDS is 2 years

Immune System Control Mechanisms: Select all that apply

• Mechanisms to control HIV include production of antibodies and the activation of CD4+ T cells
• The balance between viral replication and immune response is critical in the asymptomatic phase
• Understanding these dynamics is essential for developing therapeutic strategies

Viral Load and CD4+ Count Dynamics: Select all that apply

• amount of HIV in the blood/indicdates health of immune system
• As one increase, other typically decreases
• Monitors progression, and efficacy
• Regular testing can help prevent progression to ADIS

Clinical Implications and Management: Select all that apply

• Early detection improves life
• Early ART delays symptomatic stage
• Safe practices and regular testing can help reduce rates
• Support is crucial

Long-term Outcomes and Prognosis: Select all that apply

• Prognosis improved with treatment
• Suppressed viral load helps individuals live a normal life
• Untreated individuals face risks with associated complications
• Critical for health providers to understand timeframe for symptomatic infections

Definition and Diagnosis of AIDS: Select all that apply

• AIDS (Acquired Immune Deficiency Syndrome) is diagnosed when the CD4+ T-cell count falls below 200 cells/mcL
• The presence of one or more AIDS-defining illnesses also qualifies for an AIDS diagnosis
• CD4+ T-cells depletion leads to increased susceptibility to infections

Mechanism of Immune System Failure: Select all that apply

• As the CD4+ count decreases, the immune system's ability to combat infections diminishes significantly
• Opportunistic infections can exploit the weakened immune system, leading to severe health complications
• Dormant infections may reactivate exacerbating the patient's condition

HIV Infection and Immune Response: Select all that apply

• HIV (Human Immunodeficiency Virus) primarily targets CD4+ T-cells, leading to their gradual depletion
• The immune response initially controls the virus, but over time, the virus replicates and overwhelms the immune system
• Treatment adherence and genetics influence progression

Target Organs Affected by HIV: Select all that apply

• HIV-associated nephropathy may affect the renal system
• neuropathies and pain
• Central nervous system involvement can result in cognitive impairments(cryptococcal meningitis)

Clinical Progression and Staging: Select all that apply

• HIV is categorized into stages: acute infection, clinical latency, and AIDS
• Regular monitoring of CD4+ counts and viral load is essential for preventing progression to AIDS

Impaired Immune Function: Select all that apply

• Progressive decline of immune
• Opportunistic
• Important to understand progression

Common Signs and Symptoms: Select all that apply

• Fever: persistent fever may indicate an opportunistic infection
• Cough: respiratory infections
• Weakness: General weakness may result from chronic infections or effects of antiretroviral therapy
• Nausea/Vomiting: Can be caused by Infections, medications, or metabolic disturbance

Indicators of Deteriorations: Select all that apply

• Symptoms requiring immediate attention
• New cough: A sudden onset may indicate a new respiratory infection
• Night sweats: Is a sign of lymphoma

Overview of HIV Screening Recommendations: Select all that apply

• All of those aged 15 to 65
• Risk infection
• Pregnant
• Inform patients about testing process

Risk-Based Screening: Select all that apply

• Behaviors
• Ensure treatment
• Emphasized importance of screening

HIV Tests: Select all that apply

• Diagnos antibodies
• Rapid yield results
• detect p24 reduction of window

Viral Load and CD4: Select all that apply

• Critical for diagnosing
• Counts for the forst 2 years then annually
• Assessed at 3-4 months

Screenings: Select all that apply

• Opportunistic
• Higher rick of screening
• Low counts are critical
• Regular monitoring for diseases

ART: Select all that apply

• Prophylaxis
• For people 200 cells to prevent: Pneumocystis
• CD4 count of 50 ells
• Can be discontinued

Monitoring and Adherence: Select all that apply

• Regular monitoring CD4 count
• 95 is adherence to prevent resistant
• Missed doses educate patience
• Prepare for therapy

HIV Care Continuum: Select all that apply

• In U.S., 87% of people know status; 25% are suppressed
• Continuum has stages
• Aids in health outcomes
• Understand improvement

Assessment Interventions: Select all that apply

• Assessment of vitals
• Track weight trends
• Monitor CD4 couhnt and viral loads
• Evaluate TB

Action Intervention: Select all that apply

• Universal precautions
• Administer ARY
• 3 Encourage diet
• refer mental health

This lesson covers HIV epidemiology, transmission routes, and prevention measures. It emphasizes understanding key factors influencing HIV infection rates and geographic distribution for effective public health strategies.