ACQUIRED IMMUNODEFICIENCY SYNDROME (A I D S) is the final and most serious stage of HIV disease, is a chronic viral infection.

ion. affects the immune system and causes OPPORTUNISTIC infections in the body; Discovered lasts 1981;

High-Risk Groups for Transmission: Homosexual or bisexuals Transfusion and blood products recipients (before 1985) Heterosexual contacts of HIV-positive individuals Newborn babies of mothers who are HIV positive

Causative Agent: Human Immunodeficiency Virus (HIV-1 and HIV-2) IP: 1 - 3 MONTHS to detect the presence of antibodies in the blood; 2 months 20 years from HIV to AIDS; Mode of Transmission: Sexual intercourse Sharing of needles Blood transfusion Direct or indirect contact with mucus membranes Vertical or perinatal transmission

Signs and Symptoms The symptoms of AIDS are primarily the result of infections that do not normally develop in individuals with healthy immune systems. These are called opportunistic infections. People with AIDS have had their immune system depleted by HIV and are very susceptible to these opportunistic infections. Common symptoms are y y y y y y fevers, sweats (particularly at night), swollen lymph glands, chills, weakness, weight loss.

OPPORTUNISTIC INFECTIONS Pneumocystic carinii pneumonia (PCP) PTB Kaposis sarcoma Cytomegalovirus retinitis can cause BLINDNESS!!! Oral candidiasis Protracted diarrhea Herpes infections

Diagnostic Examination: 1. 2. 3. 4. 5.
  

ELA or ELISA Enzyme link immunosorbent assay Particle agglutination (PA) test Western blot analysis confirmatory diagnostic test Immunofluorescent test Radio immuno-precipitation assay (RIPA) Many laboratories use fourth generation screening tests which detect anti-HIV antibody (IgG and IgM) and the HIV p24 antigen. The detection of HIV antibody or antigen in a patient previously known to be negative is evidence of HIV infection. Individuals whose first specimen indicates evidence of HIV infection will have a repeat test on a second blood sample to confirm the results.

Medical Management: ANTI-RETROVIRAL THERAPY to prolong life and prevent opportunistic infections; To increase CD4 T cells above 200.

ANTI RETROVIRAL AGENTS: 1. PROTEASE INHIBITORS Amprenavir Indinavir 2. Nucleoside reverse transcriptase inhibitors (NRTI) Zidovudine (AZT) 3. Non-nucleoside reverse transcriptase inhibitors (NNRTI) Efavirenze

Nursing Management: Monogamous relationship Practice SAFE sex Practice STANDARD PRECAUTION. HIV testing for STI-clients. Advise to treat sexual partner/s AIDS reverse isolation. Report cases to the DOH

Pathophysiology of AIDS/HIV

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Human beings produce antibodies against specific infections. When HIV infection takes place, anti-HIV antibodies are produced but they do not appear immediately. This is called the window effect. In some cases, antibodies to HIV become detectable 4 to 6 weeks after infection. When HIV is in circulation, it invades several types of cells the lymphocytes, macrophages, the Langerhans cells, and neurons within the CNS. HIV attacks the bodys immune system. The organism attaches to a protein molecule called CD4 which is found in the surface of T4cells. Once the virus enters the T4, it inserts its genetic materials into the T4 cells nucleus taking over the cell to replicate itself. Eventually the T4 cell dies after having been used to replicate HIV. The virus mutates rapidly making it more difficult for the bodys immune system to recognize the invaders. HIV infection progresses through several stages. The clinical course of HIV infection begins when a person becomes infected with HIVthrough: a. sexual contact with infected person b. injection of infected blood or blood products c. Perinatal or vertical transmission.

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