HIV (powerpoint)

Overview of HIV

  • Definition: HIV (Human Immunodeficiency Virus) is a retrovirus that primarily infects CD4+ T-cells, a type of white blood cell crucial for the immune system.
  • Transmission: HIV is transmitted through blood, body fluids, and breast milk. Less common sources include amniotic fluid, urine, saliva, feces, tears, and cerebrospinal fluid.

Stages of HIV Infection

  1. Primary HIV Infection

    • Symptoms appear 2 to 4 weeks post-infection, resembling flu-like illness.
    • Increased HIV viral load and decreased CD4+ lymphocyte count.
    • More than 500 CD4+ T-cells/mm³ may be present.

  2. Chronic Asymptomatic Infection

    • Clients can remain asymptomatic for over 10 years.
    • HIV antibodies are present, indicating HIV positive status.
    • As virus replicates, viral load increases, and CD4+ count decreases to between 200 and 499 CD4+ T-cells/mm³.

  3. Acquired Immunodeficiency Syndrome (AIDS)

    • The final stage of HIV infection with significant immune system loss.
    • Life-threatening opportunistic infections (e.g., pneumonia, tuberculosis) occur.
    • CD4+ count drops below 200 cells/mm³, leading to a high risk of death without treatment (3 to 5 years).

Risk Factors for HIV

  • Unprotected sexual practices.
  • Multiple sexual partners.
  • Occupational exposure (healthcare).
  • Perinatal transmission.
  • Blood transfusions (rare in the U.S.).
  • IV drug use with contaminated needles.

Diagnostic Indicators

  • Antibody Assays: Positive within 3 weeks to 3 months post-infection.
  • Testing Methods:
    • Enzyme-linked immunosorbent assay (ELISA)
    • Western blot assay (confirmatory)
  • CD4+ Count:
    • Normal range: 750 cells/mm³; below 200 indicates a high risk of disease progression.

Clinical Manifestations of HIV/AIDS

General Symptoms
  • Fever, chills
  • Anorexia, weight loss
  • Lymphadenopathy
  • Night sweats, fatigue
  • Skin lesions, weakness
Opportunistic Infections and Related Symptoms
Immunologic
  • Low white blood cell counts (CD4 < 200/mm³)
  • Presence of opportunistic infections
Integumentary
  • Skin lesions, poor wound healing, night sweats
Respiratory
  • Symptoms: cough, shortness of breath
  • Common infections: Pneumocystis carinii pneumonia, tuberculosis.
Gastrointestinal
  • Diarrhea, weight loss, nausea/vomiting
Central Nervous System
  • Symptoms: confusion, headache, visual changes
  • Severe cases may lead to AIDS dementia complex.

Health Promotion and Treatment Strategies

  • Health Education:

    • Safe sex practices and infection control measures.
    • Nutrition and well-balanced diet.

  • Antiretroviral Therapy (HAART):

    • Goals:
      • Decrease viral load.
      • Maintain or increase CD4 T-cell counts.
      • Delay symptoms and opportunistic infections.

  • Drug Classes:

    • NRTIs (e.g., zidovudine, lamivudine)
    • NNRTIs (e.g., efavirenz, nevirapine)
    • PIs (e.g., atazanavir, saquinavir)
    • Integrase inhibitors (e.g., raltegravir)
    • Entry inhibitors (e.g., enfuvirtide)

Nursing Process in HIV/AIDS Care

Assessment
  • Monitor physical and psychosocial status.
  • Check nutritional status and immune function.
  • Assess respiratory and neurologic status.
Diagnosis
  • Common nursing diagnoses:
    • Impaired skin integrity
    • Risk for infection
    • Activity intolerance
    • Disturbed thought processes
Planning
  • Goals include maintenance of skin integrity, improved nutritional status, and absence of complications.
Interventions
  • Regular skin assessment, dietary management, and education on disease management.
  • Facilitate social integration and support systems.

Co-Infection Considerations

  • Screening for co-infections such as hepatitis C is crucial in patients with HIV, especially among IV drug users.
  • Challenges in treatment include potential drug interactions and managing overlapping toxicities.

Conclusion

  • Understanding the comprehensive management of HIV/AIDS, including stages, symptoms, risk factors, and treatment regimens, is essential for effective patient care.