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First case of AIDS
1981
What type of virus is HIV?
RNA virus
Retrovirus
Retroviridae family
Mode of transmission for HIV
Unprotected anal sex
Unprotected vagina sex
Mother to child during pregnancy or breast feeding
Sharing needles, syringes, other drug injections
HIV is not spread through
Saliva
Sweat
Tears
Casual contact
Airborne transmission
HIV life cycle
HIV attaches to CD4 cell
CCR5 receptors
CXCR4 receptors
Uncoats capsid proteins
Reverse transcriptase — Turns RNA into DNA —> mRNA
Starts making viral proteins
New viruses mature — lysis leaves cell
HIV integration
Incorporate with host genome
Makes tumor growth
3 phases of HIV
Primary infection
1—3 weeks after exposure
Fever, faigue, sore throat etc
Period of clinical latency
8—24 months
Clinically apparent disease
AIDS
Oral manifestations of HIV
Oral candidiasis
Hairy leukoplakia
Kaposi sarcoma
Non—hodgkin lymphoma
Linear gingival erythema
Necrotizing ulcerative periodontitis
HIV positive predictors
Hairy leukoplakia and oral candidiasis
HIV Diagnosis
HIV antibody testing
HIV antigen testing
HIV nucleic acid testing (NAT)
Purpose
Detect HIV early
Distinguish HIV—1 from HIV—2
Antiretroviral therapy (ART)
Given to positive HIV
Prevent transmission of virus, Lowers viral load, disease progression
Healthcare associate transmission of HIV
Risk is rare / low
Needlestick, mucous membrane splash, non—intact skin
Factors that would increase needlestick risk
Deep injury
Visible blood on instrument
Needle was in patient’s vein or artery
Patient has high viral load
If exposure happened
Wash wound with soap and water
Don’t use antiseptic or squeeze wound
Report the incident
Evaluate source patient to test for HIV, HBV, HCV
Evaluate worker (within 2 hrs) and start PEP (post exposure prophylaxis) ASAP within 72 hours for 4 weeks
Zidovudine reduced infection risk by 81%
Followup