Human Immunodeficiency Virus (HIV) Overview

Study Notes

Human Immunodeficiency Virus (HIV)

HIV causes acquired immunodeficiency, a condition weakened immune system, which can be triggered by medical treatments or infections.
Despite advancements in treatment, Acquired Immunodeficiency Syndrome (AIDS) remains a global health concern. Prevention, early detection, and ongoing treatment are paramount for patients, often referred to as PLWHA (People Living with HIV/AIDS)
Key transmission methods include unprotected sex and sharing injection drug equipment.
Vulnerable populations experience a disproportionate burden, e.g., marginalized groups and indigenous Canadians; men who have sex with men (MSM) are also at higher risk.

HIV Transmission

HIV transmission occurs through infected bodily fluids containing infected cells.
These fluids include blood and blood products, semen, vaginal secretions, amniotic fluid, and breast milk.
HIV is not spread through casual contact.

Prevention Strategies

Medical male circumcision and reproductive education are significant prevention measures.
Artificial insemination may also be considered in some cases.
Standard precautions, hand hygiene, and post-exposure prophylaxis (PEP) are crucial for healthcare providers to mitigate their risk.
PEP involves antiretroviral medications within 72 hours of potential exposure, typically lasting 28 days..

HIV Pathophysiology

HIV targets cells with CD4+ receptors, notably T lymphocytes (a type of white blood cell).

Stages of HIV Infection

HIV infection is classified into five stages (0, 1, 2, 3, unknown).
Stages 1, 2, and 3 are primarily determined by CD4+ T-lymphocytes count.
- Stage 0: Early infection, often identified through lab tests.
- Stage 1: Primary (acute HIV), the period between HIV infection and detectable antibodies. This stage is marked by a significant drop in CD4+ T-cells (typically 500-1500 cells/mm³).
- Stage 2: CD4+ T-lymphocyte count between 200 and 499 cells/mm³.
- Stage 3: CD4+ count drops below 200 cells/mm³, defined as AIDS for surveillance purposes.
- Unknown: Insufficient data on the CD4+ count.

Symptoms

Initial infection is often asymptomatic.
Common symptoms include respiratory problems (shortness of breath, cough, chest pain), loss of appetite, and diarrhea.
Opportunistic infections can lead to various symptoms, e.g oncologic manifestations (Kaposi sarcoma, lymphoma), neurological manifestations (cognitive impairment, neuropathy, encephalopathy), fungal infections (Cryptococcus neoformans), neurological issues (e.g. progressive multifocal leukoencephalopathy), and psychological issues (depression, apathy).
Skin conditions (e.g. Herpes zoster, seborrheic dermatitis), genital ulcers, and persistent vaginal yeast infections (candidiasis) can also occur.

Treatment of HIV and AIDS

Antiretroviral therapy (ART) aims to suppress HIV replication, improve health outcomes, and prevent transmission.
ART is recommended for all HIV-positive patients in Canada, regardless of viral load or CD4+ count.

Collaborative Problems/Potential Complications

Opportunistic infections are a frequent concern.
Immune weakening can contribute to wasting syndrome, fluid imbalances, and other complications.
Adverse drug reactions are also potential issues.
Body image changes can also be a concern.

Ethical Dilemmas

In Canada, individuals with HIV must disclose their status in sexual contexts with a "realistic possibility" of transmission.
No disclosure is necessary if the individual has a low/undetectable viral load and a condom is used.

Description

This quiz covers essential information about Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS), including their transmission, prevention strategies, and the impact on vulnerable populations. Test your knowledge on the critical aspects of HIV and its global health implications.