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HIV/AIDS - Coggle Diagram
HIV/AIDS
Epidemiology
Homosexual (MSM) and culturally diverse heterosexual population from Sub-Saharan Africa are the two largest groups of people living with HIV
There is increasing HIV transmission in Eastern Europe and Middle East where homosexuality is less accepted and driven underground
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Of those diagnosed in the UK, 30% are women
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In general more men are infected than women - could be due to the fact HIV is spread very well by anal intercourse which is very prevalent in male to male sexual activity
Diagnosis
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If you see high protein but low albumin on bloods - sign of something occurring in blood (rule out HIV)
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Patient with fever, rash and non-specific symptoms - take a sexual history
Pathophysiology
These are released, and in turn infect new CD4 cells
As infection progresses, depletion or impaired function of CD4 cells leads to decreased immune function
The CD4 cells migrate to the lymphoid tissue where the virus replicates, producing billions of new virons
HIV is a retrovirus: it encodes reverse transcriptase, allowing DNA copies to be produced from viral RNA
HIV binds, via its GP120 envelope glycoprotein, to CD4 receptors on helper T cells, monocytes, and macrophages
Routes of acquisition
Mother to child transmission - can occur in utero although the majority of infections take place perinatally or via breast milk
Contaminated blood, blood products & organ donation - risk is minimal in developed countries since the introduction of screening
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Clinical Presentation
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Early symptomatic HIV
Associated with a rise in viral load and a fall in CD4 count and development of symptoms & signs due to direct HIV effects and immunosuppression
Examples of early symptomatic conditions:
- Fever, night sweats, diarrhoea, weight loss, minor opportunistic infections
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Treatment
Protease inhibitors - act competitively on HIV enzyme involved in production of function viral proteins and enzymes
Non-nucleoside reverse transcriptase inhibitors - bind directly to, and inhibit reverse transcriptase
Nuceloside reverse transcriptase inhibitors - inhibit the synthesis of DNA by reverse transcription and also act as DNA chain terminators
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