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HIV Human Immunodeficiency Virus Mind Map 2 - Coggle Diagram
HIV
Human Immunodeficiency Virus
Mind Map 2
Types of HIV?
HIV-1
worldwide distribution
HIV-2
Localised in Western Africa
What infections can HIV patient's develop?
Treated with medical management (below)
Patients can develop
opportunistic infections
PML
Focal demyelination of white matter
Rare
Treatment = reversing immunosupresion
Herpes Zoster
Cutaneous rash affecting head, trunk, extremities
Can lead to vasculitis, myelitis, multifocal leukoen
Tuberculosis
TB is leading cause of death among people with TB
Oral & Oesophageal Candidiasis
Oral yeast infection
Can be a predictive staging marker for progression to AIDS
Kaposi Sarcoma
Benign vascular tumour
Affects skin, mucous membranes of GI, lymph nodes, lungs
PJP
Fungus: pneumocystis jiroveci
Taxoplasmosis of the Brain
Protozoan Toxoplasma gondii = neurological manifestations
Parasites form tissue cysts that affect brain, myocardium, skeletal muscle, eyes
What is the medical treatment/management of HIV?
PREVENTION
Pre-Exposure Prophylaxis (PrEP)
Aim to reduce risk of people contracting HIV
Reduce risk of sexual transmission by 90% and IV drug use by 70%
prescribed for people as medium or high risk
EXPOSURE
Post-Exposure Prophylaxis (PEP)
Prophylactic dose of Antiretroviral Therapy (ART) given after potential exposure to HIV
Aim to prevent infection prior to virus being able to replicate
PEP is only effective 72hours from time of exposure
1 pill per day for 28 days
TREATMENT
Antiretroviral Therapy (ART)
Long term management of HIV
Aim to suppress viral replication, preserve immunological function, decrease mortality, improve QOL
One pill per day
How does ART work?
Suppression of viral load inhibits virus spreading
--> regeneration of CD4+ T-helper lymphocytes
--> restoration of immune function
Suppressing viral load to undetectable level reduced transmission of HIV in heterosexual vaginal intercourse by 96%
Long Term Side Effects?
Increased risk of MI
Increased risk of insulin res. diabetes
Dyslipidaemia, chronic renal disease, depression, suicide
HIV related neuro-cog disorders
Decreased bone density
What is
AIDS?
HIV is different to AIDS
AIDS is advanced stage of HIV infection
Classification:
CD4+ T-Cell count falls below 200cells/mm3
body no longer able to ward off opportunistic infections
-- > developing one or more HIV related opportunistic infections
With medical management AIDS is curable
HIV requires life long management
How is HIV transmitted?
Sexual transmission
Parental transmission
Blood and blood products
Mother to child transmission
Occupational exposure (eg needlestick injury)
Body fluids
Body Fluids that CAN transmit:
Blood
Semen
Vaginal and cervical secretions
Breast milk
Body Fluids that CAN'T transmit:
Tears
Sweat
Urine/faeces
Saliva
How is HIV diagnosed and staged?
2 main clinical markers are used in measurement of HIV
CD4+ T-Cell Count
Number of CD4+ helper lymphocytes
Represents destruction of immune function and susceptibility to infection
Virus destroys CD4+ cells and weakens immune system
CD4+ T-Cell count reduces as person is more infected
Plasma Viral Load
Number of copies of HIV virus in blood plasma
Measure of viral replication and potential to transmit HIV
Lower the number, less virus in system
Undetectable viral load is below 20-75 copies/mL
Rehabilitation Concepts
for HIV patients
Life expectancy similar duration to general population
HIV no longer considered terminal illness
HIV presentation occurs with opportunistic infection
Need to understand
Episodic Disability Framework
(disability across longer course of disease, with fluctuation in function and wellness)
Episodic Disability Framework
Symptom & Impairments
Difficulties carrying out ADLS
Challenges to social interaction
Uncertainty (of infection, relationships, mortality etc)
Contextual factors
Belief Systems
Stigma & Spirituality
What is
Physio's
role in management of HIV?
Follow evidence bases and practice guidelines for managing co-morbidities
Help manage chronic disease risk factors eg:
smoking, physical inactivity, poor diet, decreased access to health services
Each infection is treated individually as can have multiple systems affected:
Neuro, digestive, cardio, muscular, respiratory
Prescribe aerobic and resistance based exercises tailored to individual goals
Encourage self-management and physical activity as per government guidelines
Holistic care linking with Disability Framework
Opportunities for improvement in PT Management
Offering
pre-habilitation
(due to cascade effect of HIV)
community based
maximising well-being, QOL
prevention of impairments
addressing social participation restrictions
maintenance of current functional and social status
decrease hospitalisations and promote self-care
Once it's transmitted?
Within 2-4 weeks of exposure 50-90% have acute, short lived-viral illness
fever, fatigue, myalgia, headache, rash
Seroconversion
phase
6-8 weeks, antibodies are developed and viral load will drop
*post-seroconversion
is when people will have positive HIV test
Clinical Latency
Battle between virus and immune system can last several years
variable in length
infected person may be symptom free and unaware of HIV status