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acquired immune deficiency (HIV and AIDS) (prevention:
condoms
pre-…
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HIV-1 transmitted in body fluids (blood, seminal fluid, vaginal secretions amniotic fluid and breast milk) MOST occur after exposure during delivery. NOT TRANSMITTED THROUGH CASUAL CONTACT!
retrovirus carries genetic material in RNA not DNA
HIGHER AMOUNTS OF HIV and infected cells in body fluid associated with the probability that the exposure will result in infection.
HIV2 course of illness slower and most in w.africa. HIV1 more common in other regions.
(RT-PCR)to detect HIV in seronegtvie ppl before antibodies are measurable. and confirm positive EIA result. and screen neonates.
SE: of all treatments- hepatotoxicity, nephrotoxicity, osteopenia, increased risk of Cardiovascular disease, myocardial infarction.
- antiretroviral agents:
- nucleoside reverse transcriptase inhibitors (NRTI)
- NON- NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS
- PROTEASE INHIBITORS
- FUSION INHIBITOR
- INTEGRASE INHIBITOR (INSTI)
- CCRS antagonist
- antiretroviral agents: may cause fat redistribution syndrome(lipodystrophy) fat loss in the face, arms, and legs and butt. (lypohypertrophy): visceral fat , breast, buffalo hump, facial wasting,
metabolic alterations: dyslipidemia, insulin resistance,
assess using (assessment of body change distress) questionnaire assess subjective report of patient.
complications:
immune reconstitution inflammatory syndrome: IRIS
- rapid restoration of organism specific immune responses to infections. causes deterioration of treated inf or new infection.
- occurs in first months of ART Tx. (3months)
- characterized: fever, resp/ or abdominal symptoms, worsening of the clinical manifestations of infection.
- treated with anti-inflammatory agents: cortisone.
- paradoxical tuberculosis associated immune reconstitution inflammatory syndrome (TB- IRIS): arises during successful ART in patient with HIV-TB also receiving TB Tx.
- can occur in the first weeks ART tx.