HIV/AIDS: Symptoms, Testing, and Nursing

• HIV/AIDS: Viral infection, symptoms, testing, and antiretroviral therapy, varying with age, requiring nursing intervention.

Viral Infection

• HIV (Human Immunodeficiency Virus) is a virus that attacks the body's immune system, specifically the CD4 cells (T cells).
• AIDS (Acquired Immunodeficiency Syndrome) is the most advanced stage of HIV infection.
• HIV weakens the immune system, making individuals susceptible to opportunistic infections and cancers.
• HIV is primarily transmitted through certain body fluids: blood, semen, rectal fluids, vaginal fluids, and breast milk.
• Common routes of transmission include unprotected sex, sharing needles, syringes, or other drug injection equipment, and from mother to child during pregnancy, childbirth, or breastfeeding.
• HIV is not spread through air, water, saliva, sweat, tears, or casual contact.
• Without treatment, HIV can advance to AIDS in about 8-10 years.
• AIDS is diagnosed when the CD4 cell count drops below 200 cells per cubic millimeter of blood (200 cells/mm3) or if certain opportunistic infections occur.

Signs and Symptoms

• Initial HIV infection may cause a flu-like illness within 2-4 weeks after exposure. Symptoms can include:
  • Fever
  • Headache
  • Rash
  • Sore throat
  • Swollen lymph nodes
• These symptoms may last for a few days or several weeks.
• Many people with HIV do not experience any symptoms during the early stages.
• As the infection progresses and the immune system weakens, more severe symptoms can develop:
  • Rapid weight loss
  • Extreme fatigue
  • Recurring fever or night sweats
  • Swollen lymph nodes
  • Diarrhea lasting more than a week
  • Sores of the mouth, anus, or genitals
  • Pneumonia
  • Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
  • Memory loss, depression, and other neurological disorders.
• AIDS-related opportunistic infections can include:
  • Pneumocystis pneumonia (PCP)
  • Candidiasis (thrush)
  • Tuberculosis (TB)
  • Cytomegalovirus (CMV)
  • Toxoplasmosis
  • Cryptococcosis
• Certain cancers, such as Kaposi's sarcoma and lymphoma, are also more common in people with AIDS.

Testing

• HIV testing is crucial for early diagnosis and treatment.
• The only way to know if someone has HIV is to get tested.
• Several types of HIV tests are available:
  • Antibody tests: Detect antibodies the body produces to fight HIV. Can be done via blood or oral fluid.
  • Antigen/antibody tests: Detect both HIV antibodies and antigens (a part of the virus itself).
  • Nucleic acid tests (NATs): Look for the actual virus in the blood. More expensive and not used for routine screening.
• Testing is recommended for anyone who may have been exposed to HIV.
• Guidelines recommend that everyone between the ages of 13 and 64 get tested for HIV at least once.
• More frequent testing is recommended for individuals with risk factors, such as:
  • Unprotected sexual activity
  • Sharing needles
  • Having other sexually transmitted infections (STIs)
• If an initial screening test is positive, a follow-up test is needed to confirm the diagnosis.
• Home test kits are available, but a healthcare professional should confirm positive results.
• Early detection allows for prompt treatment, improving health outcomes and preventing further transmission.

Dependent on Age

• HIV/AIDS can affect people of all ages, but there are specific considerations depending on the age group:
  • Infants and children:
    • Typically acquire HIV from their mothers during pregnancy, childbirth, or breastfeeding.
    • May experience developmental delays, failure to thrive, and frequent infections.
    • Antiretroviral therapy (ART) is crucial for improving their health and survival.
  • Adolescents:
    • May acquire HIV through unprotected sex or injection drug use.
    • Should be educated about safe sex practices and HIV prevention.
    • Adherence to ART can be challenging in this age group.
  • Adults:
    • Most commonly acquire HIV through sexual contact or injection drug use.
    • Benefit from early diagnosis and treatment to prevent disease progression.
    • May experience age-related complications and comorbidities, influencing treatment decisions.
  • Older adults:
    • May be diagnosed later in the course of the infection due to lack of awareness.
    • May have other health conditions and medications.
    • ART can still be effective, but considerations for drug interactions and side effects are important.
• Age can influence the clinical presentation, treatment response, and long-term outcomes of HIV/AIDS.

Antiretroviral Therapy (ART)

• ART is the use of medications to treat HIV infection.
• It does not cure HIV, but it can control the virus so people with HIV can live longer, healthier lives.
• ART works by reducing the amount of HIV in the body (viral load).
• It keeps the immune system strong.
• It prevents HIV transmission.
• People on effective ART can achieve and maintain an undetectable viral load.
• Undetectable = Untransmittable (U=U), meaning they cannot transmit the virus to others through sexual contact.
• ART typically involves taking a combination of three or more drugs from different classes. Common classes include:
  • Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
  • Protease inhibitors (PIs)
  • Integrase inhibitors (INSTIs)
  • Fusion inhibitors
  • CCR5 antagonists
• Adherence to ART is essential for its effectiveness.
• Missing doses can lead to drug resistance and treatment failure.
• ART can have side effects, but many are manageable.
• Regular monitoring and follow-up with a healthcare provider are necessary to assess treatment response, manage side effects, and prevent complications.
• ART should be started as soon as possible after diagnosis.

Nursing Interventions

• Nursing interventions for HIV/AIDS focus on:
  • Assessment:
    • Monitor patient's vital signs.
    • Monitor CD4 count and viral load.
    • Assess for signs and symptoms of opportunistic infections.
    • Assess for adherence to ART.
    • Evaluate nutritional status.
    • Monitor mental health.
  • Prevention:
    • Educate individuals about HIV transmission and prevention.
    • Promote safe sex practices.
    • Encourage HIV testing.
    • Provide pre-exposure prophylaxis (PrEP) to individuals at high risk of infection.
    • Prevent mother-to-child transmission by providing ART to pregnant women with HIV.
    • Implement standard precautions to prevent nosocomial transmission in healthcare settings.
  • Medication Management:
    • Administer ART as prescribed.
    • Monitor for side effects.
    • Educate patients about the importance of adherence.
    • Provide strategies to improve adherence.
  • Symptom Management:
    • Manage symptoms such as fever, fatigue, pain, and diarrhea.
    • Provide supportive care for opportunistic infections.
    • Address psychosocial issues.
    • Offer emotional support and counseling.
  • Education:
    • Educate patients about HIV/AIDS, its transmission, prevention, and treatment.
    • Provide information about ART and adherence.
    • Teach patients how to recognize and manage symptoms.
    • Counsel patients on lifestyle modifications, such as nutrition and exercise.
  • Psychosocial Support:
    • Provide a supportive and non-judgmental environment.
    • Encourage patients to express their feelings and concerns.
    • Facilitate access to support groups and mental health services.
    • Address issues related to stigma, discrimination, and social isolation.
  • Coordination of Care:
    • Collaborate with a multidisciplinary team, including physicians, pharmacists, social workers, and case managers.
    • Ensure continuity of care.
    • Refer patients to appropriate resources and services.
• Nursing interventions should be tailored to the individual patient's needs and circumstances.

Learn about HIV (Human Immunodeficiency Virus) which attacks the body's immune system, leading to AIDS (Acquired Immunodeficiency Syndrome). Understand transmission routes (blood, semen) and the importance of nursing intervention. Discover symptoms, testing and treatment.