HIV Study Guide PDF

Okay, here is a comprehensive nursing student study guide based on the provided source, organized to follow the source\'s structure and with key information highlighted: **I. Introduction to HIV** - **History:** - Early cases date back to 1959, but the disease may have existed ear...

Okay, here is a comprehensive nursing student study guide based on the provided source, organized to follow the source\'s structure and with key information highlighted: **I. Introduction to HIV** - **History:** - Early cases date back to 1959, but the disease may have existed earlier. - The virus is estimated to have spread from its source around the 1930s. - It was recognized as a clinical syndrome in the early 1980s. - In 1987, the CDC reported cases of occupationally acquired HIV in healthcare providers, which led to the development of standard precautions for blood and body fluids. - **Early Observations** - **Pneumocystis jiroveci pneumonia (PCP)**, a fungal infection, was on the rise, leading to further studies. - Patients began to develop **Kaposi\'s sarcoma**, a rare skin cancer, mainly in men of Mediterranean descent. - Initially, the disease was observed in homosexual men with failing immune systems, but it was soon found to also affect people who used injection drugs, patients with hemophilia, and later heterosexual men and women. **II. Stages of HIV** - **Stage 1: Acute HIV Infection** - Occurs within 2 to 4 weeks of transmission. - Symptoms resemble influenza. - Patients are highly infectious due to elevated viral loads in blood and bodily fluids. - **Stage 2: Clinical Latency** - Patients are often asymptomatic. - Low levels of the virus are present in the blood. - **Stage 3: AIDS (Acquired Immunodeficiency Syndrome)** - The most severe stage of the infection. - Patients develop opportunistic infections due to damaged immune systems. - Viral loads are elevated, making patients very contagious. - **CD4 count drops to less than 200 cells/mm³**. - Symptoms include fever, chills, sweating, swollen lymph nodes, weight loss, and weakness. **III. Types of HIV** - **HIV-1:** - Found worldwide and the most prevalent strain in most places, including the United States, Europe, and Central Africa. - More virulent (toxic) than HIV-2. - Typically leads to profound immunodeficiency and high viral loads. - **HIV-2:** - Mostly confined to West Africa. - Thought to be linked to commercial sex trade and immigration. - Develops more slowly and has a lower transmission rate than HIV-1. - Resistant to some medications that treat HIV-1. - Often results in long-term non-progression. - Patients develop immunodeficiency more slowly but can still progress to AIDS with lower viral load levels than patients with HIV-1. - **Both HIV-1 and HIV-2:** - Spread in the same ways and have similar signs and symptoms. - Lead to opportunistic infections and progression to AIDS. **IV. Significance of the Problem** - **Statistics:** - Approximately 50,000 new HIV cases are diagnosed each year in the U.S.. - More than 1.1 million people in the U.S. are living with HIV. - The epidemic affects various racial, ethnic, geographic, and demographic populations including nonwhite people, women, heterosexuals, and people who use injection drugs. - People with HIV are living longer due to advancements in treatment. - **Mortality:** - The progression from HIV to AIDS has slowed due to treatment advancements, resulting in a decreased mortality rate. - In countries with inadequate access to healthcare, HIV infection remains a leading cause of death. **V. Transmission of HIV** - **Modes of Transmission** - HIV requires a host organism to survive and cannot live long outside the human body. - Transmitted through infected blood, semen, rectal secretions, cervicovaginal secretions, and breast milk. - Also found in pericardial, synovial, cerebrospinal, peritoneal, and amniotic fluids. - **Sexual intercourse** is the most common mode of transmission. - Exposure to contaminated blood through sharing injecting equipment. - Blood transfusions, though donors are tested, there is still a risk. - Occupational exposure for health care workers. - **Vertical transmission** from mother to fetus during pregnancy, delivery, or postpartum breastfeeding. - **Not Transmitted By:** - Casual contacts like hugging, dry kissing, or shaking hands. - Domestic animals or insects. - Coughing or sneezing. - Sharing objects such as pencils, keyboards, or telephones. - **Viral Load:** - The viral load peaks quickly after infection and during the later stages of the disease, increasing the likelihood of transmission. - HIV can be transmitted during the entire disease spectrum. - **Perinatal Transmission:** - Factors influencing vertical transmission include maternal HIV disease stage, CD4+ cell count, viral load, STIs, and maternal nutrition. - Approximately 25% of infected mothers transmit HIV to their infants in the US, but this is reduced to 1% with ART. - Interventions such as ART, formula feeding, and cesarean delivery reduce transmission rates. **VI. Pathophysiology** - **Retrovirus:** - HIV is a lentivirus or "slow" retrovirus with a long period before symptoms appear. - Requires host cells for replication. - The virus takes over the host cell to reproduce viral copies of itself. - **Acute Retroviral Syndrome:** - Viral replication occurs during the acute infection period, and the viral load peaks in millions of copies per milliliter of plasma. - Decline of virus occurs before the appearance of detectable antibodies. - **Seroconversion** (development of antibodies) occurs approximately 5 days to 3 months after exposure (usually within 1 to 3 weeks), accompanied by flu-like or mononucleosis-like symptoms. - Symptoms include fever, night sweats, pharyngitis, headache, malaise, arthralgias, myalgias, diarrhea, nausea, and a diffuse rash. - Symptoms may last for 1-2 weeks, but some may last for several months. - **Early Infection:** - The median time between HIV infection and AIDS is 10 to 14 years in an untreated individual. - Often called the asymptomatic phase because individuals feel healthy. - Vague symptoms may include fatigue, headaches, low-grade fever, and night sweats. - Due to non-specific symptoms, diagnosis may be delayed, leading to continued risky behaviors. - **Early Symptomatic Disease:** - Occurs when the CD4+ cell count drops below 500 cells/mm³. - Symptoms include persistent unexplained fevers, recurrent night sweats, chronic diarrhea, and headaches. - Physical exam may reveal persistent generalized lymphadenopathy (PGL), recurrent infections, and neurologic manifestations such as numbness, tingling, or weakness in extremities. - **AIDS:** - End-stage or terminal phase of HIV infection. - Diagnosed based on CDC criteria. - Occurs with severe immune suppression. - **CD4+ lymphocyte cell count decreases to \