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HIV/AIDS (Young gay men, kaposi's sarcoma (vasc), PCP (pneumonia),…
HIV/AIDS
Young gay men, kaposi's sarcoma (vasc), PCP (pneumonia), GRIDS, HTLVIII, LAV, HIV
Transmit: sex, IV, blood, pregnancy, breastfeeding
Retrovirus, reverse transcriptase, type 1 & 2 (indistinguishable)
Targeted: CD4, macrophages, dendritic (1st in contact)
HIV enters macrophages & CD4 by glycoproteins on surface receptors, viral envelope fuses w membrane, release HIV, rep, low CD4
Incubation (asymptomatic, 3 wks), acute infection (1 month, fever, lymphadenopathy, neuro), latency (weeks-years, infectious), AIDS
CD4 uninfected 1000 cells/mm3 vs <200 AIDS
Group 1 lesions strongly associated w HIV: candidiasis, kaposi's sarcoma, NUG, hairy leukoplasia, non-hodgkin's lymphoma
Group 2 less common: TB, HSV, HPV, VZV
Group 3: e coli, trigem neuralgia
Candidiasis: pseudomembranous, erythematous, hyperplastic, angular chelitis
Hairy leukoplasia: EBV, lat tongue, asymptomatic
PD: linear gingival erythema, NUG, NUP
Anti-retroviral tx: HAART, combo, viral cell rep, decr viral load, incr CD4, decr oral lesions
NNRTIs, NRTIs (retrovir - viral rep), PIs (prezista), entry inhibitor, integrase inhibitor, 2+ meds, 1+ classes
Incr HIV viral load & candida
Decr CD4 & PD
Decr CD4 & candidiasis
Incr HIV & leukoplasia
CD4 <200 & VL >2000 oral lesions
WHO stage 1 (no disease), 2 (angular chelitis, candidiasis), 3 (leukoplasia, ANUG, HSV, kaposi's sarcoma), 4 (non hodgkin's lymphoma)