AIDS PDF

# HIV prisidelen.ca (tomanes) * HIV creates DNA from RNA. * Retronrus that is attacking CD4 T helper cells. CD4 T helper cells are like the Sarvnts of immunity cells, taking over a cell and then sits without activity as the virus replicates and multiply. * It could be 6 weeks to several months fo...

# HIV prisidelen.ca (tomanes) * HIV creates DNA from RNA. * Retronrus that is attacking CD4 T helper cells. CD4 T helper cells are like the Sarvnts of immunity cells, taking over a cell and then sits without activity as the virus replicates and multiply. * It could be 6 weeks to several months for cells to create antibodies because while HIV cells are replicating our body doesn't know yet to fight, and by the time our body identifies this, the virus cell has replicated and taken over. * CD4 lab value * 500 - 1200 normal * when CD4 drops to 400 HIV was now progressed * to AIDS. * transmission/viral load is highest at beginning of virus and at the end (once it was progressed to AIDS) without drug therapy. # HIV transmission X = Y - Semen is highest for infection. ANAL SEX is highest then vaginal sex, then anal sex. * Transmission through blood * Transmission through parental, across placenta or breast milk. # HIV symptoms ## Flu Like Symptoms * In first 4-6 weeks * Sore throat * Fever * Night Sweats * CD4 count stays above 500 at this stage * CD4 cells are beginning to be attacked, body was not yet to identified. ## Acute Phase # Chronic Phase * CD4 count Stay above 500 but continue * Once flu like symptoms resolve, they typically do not come back unless sick. # AIDS Phase 3 * CD4 count below 200 which means AIDS. * Once diagnosed with AIDS, you almost always have it. * Or... Opportunistic Infection * e.g. TB! * Because rettim sick will throw red flags and renew immune system. * Pt: 252 # Opportunistic Infection -TB -Fungal pneumonia in lung (15-80%) -Wasting syndrome -Herpes (HSV) or Varicella (VZV) -Candidiasis -Kaposi's sarcoma - face lesions, purple blotches # HIV treatment * HIV treatment should focus on HIV itself. * If we can lower viral load and CD4 cells then we have more to fight off opportunistic infection. # Screening and Testing * 3 months after exposure is recommended. * Nucleic acid test (NAT) (Customer) * (testiny actual RNA) (soon as 6 weeks after exposure bic of terting RNA not antibodies) * Rapid testing (usually 20 minutes of screening time) * (test antibodies) (ex. ora quick still requires 3 month after exposed). * ELISA & Western Blot (may give false negative if tested too early) - HIV test before exposure time (false negative). - HIV test at health fai (follow up to confirm) - HIV test at doctor office (start treatment) - HIV test after exposure time? (false). # Drug and treatment * Adams 6th Edition: pg. 553 * fusion inhibitors * reverse transcriptase inhibitors * integrase inhibitors * protease inhibitors ## Drug treatment * General NRTI plus another class bic they are well tolerated. * Usually takes at least 3 months to have affects and decrease viral load. ## Drug therapy - ART * Nucleoside Reverse transcriptase inhibitors (NRTI) * ex. Zidovudine * CBC, Platelets, WBC bic (bone marrow suppression) * Hepatic toxicity - so get a liver function test ## Drug Therapy - PREP * Prophylactic treatment * Must be HIV preventative. * This is offered as a preventative to those with non risk of getting HIV, e.g. HIV partner. * 99% lower risk. * Takes 7 days for effect, or safe for "pre-exposure". * OK to take while pregnant. * Drug name: intravada, trovodi. ## PEP * POST Exposure Prophylactic Medication * As early as 2 hours but has to be started within 72 hours of potential exposure * I.e. needle stick with HIV Et. * 28 days of medication regimen to be effective. * 3 month post exposure testing to see if actually exposed, i.e. DX disease if needed. ## Q & A - Sexual Assault - PEP - Needle snaring - PREP - Known user - PREP - Needle stick - PEP - HIV partner - PREP * PEP to know exposure to HIV. * If suppressed Undetectable viral load then baby is not exposed to HIV in pregnancy - still use PREP. ## Nursing Role - Education - Prevention - Assessment - Psychosocial support - Avoid Bias. - Standard precaution - Exposure - Confidentiality - Nutrition ## HIV symptoms - Body aches (1-3 days) - Fever night sweats - Thrum and esophageal discomfort - Atingia - Nausea - Coughing HOT! * Zidovudine - NRTI