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HIV/AIDS discussion in micro
Where did HIV come from? Benign simian infection evolved into
human infection in the early 30s in southwest Africa
Considered a chronic disease now Causes a depletion of CD4 cells
(lymphocyte receptor) Inserts genetic material on host DNA
creating a permanent infection
Strains of HIV There are many strains of HIV – can be
infected by 1+ viruses and get superinfection
Can pass on drug resistant strains AIDS defined: CD4 count <200/mm3,
Candidiasis (thrush), invasive cervical cancer, HIV dementia or wasting, Kaposi’s sarcoma, infections like mycobacterium
Kaposi’s
Kaposi’s Always purple
Like the leg w/ assoc. edema
CD4 Type of WBC that carries CD4 surface
marker and helps the body fight infection. Also known as Tcells or T helper cells. These cells incorporate the HIV RNA
About 140 viral replication cycles occur each year 10.3 X10^9 virions are produced each day
Transmission Heterosexuals on the rise
1985- 1.9%; 1997- 35% Higher risk in uncircumcised due to warm moist
environ. Of foreskin In Baltimore, 31% of IDU are HIV+ and 48% of all
new HIV cases were IDU in 2001 Blood transfusions – 1:450,000 false negative
blood tests Perinatal transmission – 1.2% of all AIDS cases Organ transplant – 10 since 1985 screening began
7 from same donor
transmission Household contact: 8 total; 4 child to
child, 3 patient to care giver, 1 parent to child
Deep kissing: 1 total; man with gingivitis kissing a female
One case of two females sharing a sex toy Health care worker to patient: 7 total; 6
from Florida dentist, 1 orthopedic surgeon
Statistics - globally People living with HIV – 39.4 mill New HIV infections in 2004 – 4.9mill Deaths due to AIDS in 2004 – 3.1mill About 14,000 new HIV infections/day in
2004 95% in low and middle income countries 50% are 15-24 year olds
In US highest age group is 25-44 yoa Fastest rate of increase is Black and South states
In Maryland, % of AIDS cases by location: Suburban Washington 32%, Suburban Baltimore 35%
Stats cont. Baltimore – 3rd highest AIDS rate in
2001 after New York and Miami with 50/100,000
Diagnosis to death with no treatment is 10-12 years
Acute HIV infection Syndrome after initial infection – 2-4
weeks after exposure, consists of fever, adenopathy, pharyngitis, rash, m/c Symptoms means more rapid
progression Seroconversion – 3 weeks after
transmission >95% of patients seroconvert within 5.8 mo.
Occupational exposure of 2001 57 seroconversions
46 percutaneous exposures 23 nurses
Infectious body fluid: blood, semen, vaginal secretions
Not infectious unless bloody: feces, urine, snot, spit, sweat, tears, vomit
Drug therapy Goal: increase CD4, decrease viral
load, prevent secondary infection Drug failures after 1 year: Baltimore
63% Why – drug side –effects such as head
ache, GI intolerance, peripheral neuropathy, lipodystrophy
Lipodystrophy – central fat accumulation, periphera wasting, lipoma
lipoma
lipodystrophy
Long term drug side effects Osteopenia, AVN, myopathy
(weakness), polymyositis, peripheral neuropathy (burning, aching or numb)– need vit D and Calcium