Secondary immunodeficiency (HIV)

Secondary immunodeficiency is caused by

illness that weakens immune system (HIV)

Human Immunodeficiency Virus (HIV)

Virus attacks CD4 T helper cells, leading to poor immune response

- HIGH infection risk

- progresses to AIDs

- NO cure

How is HIV spread?

Blood, semen, breast milk

vertical transmission

mother to baby

horizontal transmission

person to person (sex)

CD4 T-helper cell function

Coordinate immune response in both humoral and cell mediated immunity

NORMAL CD4 count

500-1500

HIV Patho

> Virus attaches to CD4 T helper cell

> converts RNA to DNA

> inserts viral DNA into host

> replicates infected cells

> CD4 cells die

> immune system failure

HIV has low ___ and high ___

LOW CD4 and HIGH viral load

CD4 count

<200

Viral load count

>5,000

HIV symptoms

Fever, swollen lymph nodes, weight loss, oral candidiasis, frequent infections

HIV infection categories (3)

a, b, c

Category A (mild symptoms)

Two or more symptoms of

- swollen lymph nodes, splenomegaly

- upper respiratory infections (sinusitis, otitis media)

Category B (moderate symptoms)

Bacterial meningitis, pneumonia, sepsis

Category C (AIDS)

Kaposi sarcoma

HIV treatment?

Antiretroviral therapy (ART)

ART includes which 3 drug combo?

2 NRTIs + 1 Protease inhibitor

Zidovudine - (NRTI) Nucleoside reverse transcriptase inhibitor

Prevents baby from getting HIV from mom

- stops conversion of RNA to DNA

- given during pregnancy and 6hrs after birth

1st line NRTI

How long to infuse zidovudine?

60 mins

Zidovudine side effects

paresthesia, agranulocytopenia, anemia

Taking Zidovudine

give every 12 hours, monitor CBC for anemia, STRICT adherence

Lopinavir/Ritonavir - (PIs) Protease inhibitor

inhibits protease enzyme and stops viral replication

TMP-SMX (Trimethoprim-Sulfamethoxazole)

Prevents Pneumocystis Pneumonia (PCP) during pregnancy

Goal of drug therapy

increase CD4 >500 and reduce viral load

Can HIV mom breastfeed?

NO