Clinical HIV AIDS PDF

Clinical HIV AIDS Nishita Patel, MD, FACP HIV basics  HIV stands for human immunodeficiency virus.  AIDS stands for acquired immunodeficiency syndrome  HIV attacks and destroys the CD4 cells of the immune system.   HIV is spread by certain body fluids from a person...

Clinical HIV AIDS Nishita Patel, MD, FACP HIV basics  HIV stands for human immunodeficiency virus.  AIDS stands for acquired immunodeficiency syndrome  HIV attacks and destroys the CD4 cells of the immune system.   HIV is spread by certain body fluids from a person who has HIV. These body fluids include:  blood  semen  spinal fluid  vaginal fluids HIV  rectal fluids  breast milk transmission  In the United States, HIV is spread mainly by:  Sexual contact: Homosexual or heterosexual  Contact with HIV infected blood(shared needle, occupational exposure).  Spread from mother to her child during pregnancy, childbirth, or breastfeeding Founder Virus and HIV Infection  This image shows multiple HIV particles approaching the mucosal surface, but only one virus sustaining replication.  This virus, shown as the purple virus, is known as the 'founder virus'.  Following the founder virus infection, the initial local replication of HIV crates homogenous population of virions. The stages of HIV infection  The three stages of HIV infection are:  (1) acute HIV infection  (2) chronic HIV infection  (3) acquired immunodeficiency syndrome (AIDS) Acute HIV infection  Defined as 2 to 6 weeks after infection with HIV.  Clinical presentation is vague with  fever, lymphadenopathy, pharyngitis and diffuse maculopapular rash.  Pathogenesis:  Rapid multiplication and spreads throughout the body.  Destruction of the CD4 cells.  The level of HIV in the blood is very high, which greatly increases the risk of HIV transmission.  Starting HIV meds at this stage provide significant health benefits.  The "seroconversion window period" : The eclipse phase: The interval following hiv acquisition and the The time after hiv acquisition when no first detection of anti-hiv antibodies (IgG/IgM diagnostic test is capable of reliably detect hiv. hiv immunoassays). The duration of the eclipse phase is typically The average seroconversion window period is about 10 days. approximately 23-25 days Rule out HIV after exposure  A negative test 12 weeks after the exposure is reliable for ruling out HIV infection from this exposure 12 Chronic HIV infection Acute HIV infection subsides in few weeks If untreated, then it enters Chronic HIV infection If CD4 count drops