ms - hiv

Acquired immunodeficiency syndrome (AIDS)

is defined as the most severe form of a continuum of illnesses associated with human immunodeficiency virus (HIV) infection.

Immunodeficiency Disorders

impair the immune system’s ability to defend the body against foreign or abnormal cells that invade or attack it (such as bacteria, viruses, fungi, and cancer cells).

autoimmune disorder

Another problem is that up to 25% of people who have an immunodeficiency disorder also have an

autoimmune disorder

when the immune system attacks the body's own tissues.

retroviruses

HIV belongs to a group of viruses known as

ribonucleic acid (RNA)

These viruses carry their genetic material in the form of

CD4 (T) cell

Infection with HIV occurs when it enters the host ____ and causes this cell to replicate viral RNA and viral proteins, which in turn invade other CD4 cells.

• Primary infection

• . HIV asymptomatic (CDC Category A)

• HIV symptomatic (CDC Category B)

• AIDS (CDC Category C)

FOUR CATEGORIES OF INFECTED STATES HAVE BEEN DENOTED:

Primary infection (acute/recent HIV infection, acute HIV syndrome)

dramatic drops in CD4 T-cell counts, which are normally between 500 and 1,500 cells/mm3

HIV asymptomatic (CDC Category A)

more than 500 CD4 T lymphocytes/mm3)

HIV symptomatic (CDC Category B)

200 to 499 CD4 T lymphocytes/mm3)

AIDS (CDC Category C)

fewer than 200 CD4 T lymphocytes/mm3)

Pneumocystis pneumonia

the most common infection

Kaposi’s sarcoma (KS)

is the most common HIV-related malignancy

Kaposi’s sarcoma (KS)

involves the endothelial layer of blood and lymphatic vessels (exhibits a variable and aggressive course, ranging from localized cutaneous lesions to disseminated disease involving multiple organ systems).

B-cell lymphomas

are the second most common malignancy

B-cell lymphomas

• They tend to develop outside the lymph nodes, most commonly in the brain, bone marrow, and GI tract.

• These types of lymphomas are characteristically of a higher grade, indicating aggressive growth and resistance to treatment.

HIV-related peripheral neuropathy

y is common across the trajectory of HIV infection and may occur in a variety of patterns, with distal sensory polyneuropathy (DSPN) or distal symmetrical polyneuropathy the most frequently occurring type. DSPN can lead to significant pain and decreased function.

HIV encephalopathy

formerly referred to as AIDS dementia complex [ADC]

HIV encephalopathy

is a clinical syndrome that is characterized by a progressive decline in cognitive, behavioral, and motor functions

Cryptococcus neoformans

– a fungal infection

• Symptoms: fever, headache, malaise, stiff neck, nausea, vomiting, mental status changes, and seizures

Progressive multifocal leukoencephalopathy (PML)

a central nervous system demyelinating disorder

Enzyme immunoassay (EIA)

formerly enzyme-linked immunosorbent assay [ELISA]

Western blot assay

CONFIRMATORY TEST

• Enzyme immunoassay (EIA)

• Western blot assay

• Viral load tests such as target amplification methods

• OraSure saliva test

• OraQuick Rapid HIV-1 antibody test

Confirmation of HIV antibodies is done using:

highly active antiretroviral therapy (HAART)

Guidelines for the treatment of opportunistic infections should be consulted for the most current recommendations. Immune function should improve with initiation of ___, resulting in faster resolution of the opportunistic infection.

Trimethoprim-sulfamethoxazole (TMP-SMZ)

is the treatment of choice for PCP

Azithromycin (Zithromax) and clarithromycin (Biaxin)

are the preferred prophylactic agents of Mycobacterium Avium Complex

common variable immunodeficiency

Some primary immunodeficiency disorders (such as ___) are not recognized until adulthood.

Primary Immunodeficiency

• These disorders are usually present at birth and are genetic disorders that are usually hereditary.

• Typically become evident during infancy or childhood.

Secondary Immunodeficiency

These disorders generally develop later in life and often result from use of certain drugs or from another disorder, such as diabetes or human immunodeficiency virus (HIV) infection. T

Humoral (B-cell) Immunodeficiency

It refers to a wide variety of conditions which are characterized by insufficient or inability to effect humoral mediated immunity; increases the risk of recurrent pyogenic infections.

X-linked Agammaglobulinemia (Burton’s Agammaglobulinemia)

A condition resulting from arrest of B cell maturation during the early stages of development. a recessive trait that affects only males; have essentially undetectable levels of all serum immunoglobulin.

Selective IgA Deficiency

A primary immunodeficiency that is thought to result from a failure of terminal differentiation in IgA-positive B cells

Cellular (T-cell) Immunodeficiencies

It refers to a wide variety of conditions which are characterized by insufficient or inability to effect cell mediated immun

Digeorge Syndrome

A congenital condition that occur or develop before the 12th week of gestation, when the thymus gland, parathyroid gland and parts of the head, neck and heart are developing; infants born with this defect have partial/complete failure of development of the thymus and parathyroid gland.

Combined T-cell and B-cell Immunodeficiency

A wide range of conditions characterized by decreased or inability of the body to effect both humoral and cellular mediated immunity

Severe Combined Immunodeficiency Syndrome (SCIDS)

is caused by diverse genetic mutations that lead to absence of all immune function; opportunistic infections that usually lead to death by the age of 2.

Wiskott-Aldrich Syndrome

It is characterized by decreased serum levels of IgM and markedly elevated serum IgA and IgE concentrations; initially is mild but progressively deteriorates

Iatrogenic Deficiency

is a type of immunodeficiency resulting from medical treatment such as intake of immunosuppressive drugs, radiation therapy, etc.

Nutritional Deficiency

is a type immunodeficiency resulting from severe deficit in CHON and caloric intake

Secondary Immunodeficiency Disorders (SID)

are disorders that can result from prolonged (chronic) and/or serious disorders such as diabetes or cancer, drugs and rarely, radiation therapy.

Psoriasis

is a chronic, noninfectious, inflammatory disease of the skin in which the production of epidermal cells occurs faster than normal.

15 and 35 years

Psoriasis occur at any age but is most common between the ages of

exfoliative psoriatic state

may develop in which the disease progresses to involve the total body surface (erythrodermic psoriatic state).

 Psoralens and ultraviolet A (PUVA) therapy

may be used for severely debilitating psoriasis.

Ultraviolet B (UVB) light therapy

may be used to treat generalized plaque and may be combined with the topical cream, calcipotriene (Dovonex).

Psoriasis

is a chronic, noninfectious, inflammatory disease of the skin in whichtheproduction of epidermal cells occurs faster than normal. T

Plaque Psoriasis

It is also known as Psoriasis Vulgaris. This is the most commontype. About 8 to 10 people with psoriasis have this kind.

Guttate Psoriasis

This type often starts in children or young adults. It happens 2%of cases. This type of psoriasis may go away within a few weeks, even without treatment. Some cases, though, are more stubborn and require treatment.

Guttate Psoriasis

is small, pink-red spots on the skin. They often appear onthescalp, upper arms, trunk, and thighs.

Inverse Psoriasis

The common triggers are friction, sweating, and fungal infection.

Inverse Psoriasis

Patches of skin that are bright red, smooth, and shiny, but don't havescales and getting worse with sweating and rubbing. This typeusuallyfound in these locations: armpits, groin, under the breasts, and skinfoldsaround the genitals and buttocks.

Pustular Psoriasis

This kind of psoriasis is uncommon and mostly appears inadults. This type may show up on one area of the body, such as the hands and feet. Sometimesit covers most of the body, which is called "generalized" pustular psoriasis. Triggersinclude: topical medicine or systemic medicine especially steroids, suddenly stoppingsystemic drugs or strong topical steroids that you used over a large area of your body, getting too much ultraviolet (UV) light without using sunscreen, pregnancy, infection, stress, and exposure to certain chemical.

Pustular Psoriasis

o It causes pus-filled bumps (pustules) surrounded by red skin. Thesemaylook infectious, but are not.

o Fever, chills, nausea, tachycardia, muscle weakness.

Erythrodermic or Exfoliative Psoriasis

This type is the least common, but it's veryserious and affects most of the body. Triggers include: suddenly stoppingthesystemic psoriasis treatment, allergic drug reaction, severe sunburn, infection, medications such as lithium, antimalarial drugs, cortisone, or strong coal tar products. This may also happen if the psoriasisis hard to control.

• Widespread, fiery skin that appearsto be burned.

• Severe illness from protein and fluid loss, infection, pneumonia, or congestiveheart failure.

Nail Psoriasis

is evenmorecommon in people who have psoriatic arthritis, which affectsthe joints

Nail Psoriasis

o Pitting of your nails

o Tender, painful nails

o Separation of the nail from the bed

o Color changes(yellow-brown)

o Chalk-like material under your nails

Psoriatic Arthritis

It is a condition where the affected person have both psoriasis and arthritis. In 70% of cases, people have psoriasisfor about 10 years before getting psoriatic arthritis. About 90% of people with it also have nail changes.

Stevens–Johnson syndrome (SJS)

is an acute blistering disease of the skinandmucous membranes.

• Viral infections

• Immunocompromise

• Previous history of Stevens-Johnson syndrome

Risk factors for Stevens-Johnson syndrome may include: