TERMS RELATED TO HIV /AIDS
WINDOW PERIOD
Time period between initial HIV infection and the development of a measurable
immunological response to the infection
WASTING SYNDROME
It is defined as 10 percent weight loss accompanied by 30 days of fever or diarrhea
It include severe weight loss of appetite.
PNEUMOCYSTIS PNEUMONIA
It is serious infection that causes inflammation and fluid buildup in the lungs caused
by fungus called pneumocystis.
KAPOSI SYNDROME
A cancer that causes lesions to grow in the skin, soft tissues, internal organs, mucous
membrane of nose and throat.
ENCEPHLOPATHY
A term used for brain disease that alter the brain function and structure, causes are
tumors, infections.
PYOMYOSITIS
It is a rare muscle bacterial infection, includes fever, pain, tenderness, abscess
formation.
ULCERATIVE STOMATITIS
It is an immune mediated disorder characterized by oral erosions and ulcers.
• IMMUNE SYSTEM
Immune system protects and defends the body from infections. White blood cells are the
most important part, which fight and destroys bacteria, fungi, viruses that enter the body.
DEFINITION OF HIV/AIDS
H=HUMAN
I=IMMUNODEFICIENCY
V=VIRUS
WHAT IS AIDS
A=AQUIRED
I=IMMUNE
D=DEFICIENCY
S=SYNDROME
INTRODUCTION
AIDS is the ultimate clinical consequence of HIV. it is a retrovirus that primarily effect the
vital organs of human immune system such ads CD4 cells if the number of CD4 cells is
below 200 then immunity is lost.
DEFINITION AND HIV AND AIDS
HIV is a virus that attack cells that helps the body to fight infection making a person more
vulnerable to other infections and diseases.
AIDS is the last stage of HIV infection that occurs when the immune system of the body is
badly disturbed because of virus.
DIFFERNCE BETWEEN HIV AND AIDS
HIV AIDS
1) It stands for human 1) it stands for acquired
Immunodeficiency virus. Immunodeficiency syndrome.
2) It is a virus. 2) It is a condition.
3) Virus invades the immunity 3) it is later stage of infection
System. Caused by HIV.
ETIOLOGY
Unprotected sex
Sharing needles
Occupational exposure
Infected blood
During pregnancy
HOW HIV IS TRANSMITTED
• SEXUAL TRANSMISSION
• MOTHER TO BABY
• INJECTING EQUIPMENT SHARING
HOW HIV IS NOT TRANMITTED
Kissing
Hugging
Swimming
Sharing
Cooking
Insect bites
WHY ARE WOMEN AT HIGHER RISK FOR INFECTION
Large amount of mucosal surface rea in the vagina.
When they are young –because of an immature genital contact.
When they have STI.
RISK FACTOR
Transplant procedures
Occupational
Tattoo
IDU (INJECTION DRUG USERS)
Poverty
PATHOPHYSIOLOGY
Due to etiological factor
Invasion of the virus
The distribution of HIV in the body
Parasites in the different human cells
Dysfunction of human Immune function
Emergence of AIDS symptoms
Human mortalities
HIV LIFE COMPLEX
ATTACHMENT
UNCOATING
DNA SYNTHESIS
INTEGRATION
TRANSCRIPTION
TRANSLATION
CLEAVAGE
BUDDING
CLINICAL MENIFESTATIONS
Clinical stage 1
Clinical stage 2
Clinical stage 3
Clinical stage 4
CLINICAL STAGE 1
Asymptomatic, lymphadenopathy
CLINICAL STAGE 2
Unexplained weight loss, recurrent respiratory tract infection,
Recurrent oral ulceration, dermatitis, fungal nail infection.
CLINICAL STAGE 3
Unexplained severe weight loss, chronic diarrhea, persistent fever,
Oral candidiasis, pulmonary tuberculosis, bacterial infection,
Ulcerative stomatitis, unexplained anemia
CLINICAL STAGE 4
Wasting syndrome, pneumocystis pneumonia, extra pulmonary tuberculosis, KAPOSI
SARCOMA, HIV encephalopathy, meningitis,
Cervical carcinoma, nephropathy and cardiomyopathy.
DIAGOSTIC EVALUATION
HIV ANTIBODY TEST
HIV ANTIGEN TEST
HIV ANTIBODY TEST
1. ELISA TEST (enzyme-linked immunosorbent assay)
It is the test to detect antibodies to HIV ANTIGEN in the patient blood using plates
If positive, the ELISA test is repeated because false positive can occur
If the ELISA test is again positive, the western blot test is done to detect the presence of
antibodies
2. WESTERN BLOT
This test includes separation of blood proteins and detect the specific called HIV
ANTIBODIES that indicates an HIV infection. It is used to confirm a positive ELISA, and
combine tests are 99.9% accurate.
HIV ANTIGEN TEST
1. P24 ANTIGEN
This test detect the protein of presence of the p24 protein of HIV
2. DNA PCR [polymerase chain reaction]
The DNA PCR Test looks for HIV DNA in white blood cells. PCR is sensitive enough to
detect HIV
OTHER LABORTATORY TESTS
Total leukocyte and lymphocyte count
Ig G and Ig A level
T cell subset assays
CBC
Platelet count
Lymph node biopsy.
COMPLICATIONS
i. AIDS wasting syndrome
ii. HIV associated neurocognitive disorders
iii. Cancer
iv. Opportunistic infections
TREATMENT [pharmacological management]
[HAART THERAPY]
The classes of antiviral drugs include;-
1) NON NUCLEOSIDE REVERSE TRANSCRIPTASE
Doravirine, Rilpivirine
2) NUCLEOSIDE AND NUCLETIDE REVERSE TRANSCRIPTASE
INHIBITORS
Tenofovir, zidovudine
3) PROTEASE INHIBITORS
Lopanavir
4) FUSION INHIBITORS
Enfuvirtide
5) INTEGRASE INHIBITORS
Dolutegravir
NON PHARAMACOLOGICAL MANAGEMENT
• Patient education
• Lifestyle modifications
• Take rest diet rich in proteins and vitamins
• Smoking cessation
• Alcohol cessation
• Regular exercise or yoga
NURSING ASSESSMENT
a. History collections
b. Review patient present complications
c. Assess patient knowledge about HIV
d. Evaluate nutritional pattern
e. Assess respiratory rate, general health status
f. Check for lesions , ask for bowel pattern
g. Check orientation.
NURSING DIAGNOSIS
• Ineffective breathing pattern related to opportunistic infection
• Acute pain related to infection, neuropathies
• Hyperthermia related to infection
• Risk of infection related to immunodeficiency
• Imbalanced nutrition related to side effect of treatment
• Diarrhea related to treatment side effect
• Confusion related to adverse effect of medicines
• Fatigue related to HIV infection
• Fear of infection progression related to having HIV
• Disturbed body image related to body changes
• Hopelessness related to chronic illness
PREVENTION
o Use treatment as prevention
o Education
o immunizations
o Immigration regulations
o Use condom
o Use of clean needle
o Supportive car
o Use standard precautions
Hand hygiene
Protective equipment gloves, mask, gown
Patient placement
Avoid sharing clothes
WHAT NURSE CAN DO
1) Counsel on safe sex practices
2) Healthy life style practices
• Food nutrition
• Oral hygiene
• Personal hygiene
• Food hygiene
• Exercise
3) Educate on HIV disease progression
4) Family planning options
5) Regular follow up
6) Explain the proper method of disposal of used condom (male or female).
7) Participate in awareness campaigns
BIBLOIGRAPHY
1) Hinkle J.L., Cheever K. H., Brunner and Siddhartha’s textbook of medical surgical
nursing. 14 edition, Wolters Kluwer publishers, page no. 483-487.
2) Seltzer S.C. Bare B.G., Hinkle J.L., Cheever K. H. Brunner and Siddhartha’s textbook
of medical surgical nursing 11 edition. Lippincott Williams and Wilkins publishers,
page no 845-848
