AIDS Research (Acquired Immune Deficiency Syndrome)

• Caused by human immunodeficiency virus
• When the T4/CD4 cell count falls below 200/mL opportunistic infections are greatest because the immune system is severely depressed
• Incubation Period estimates range from ½ to 10 years and may be longer
• The antibodies produced by the body are generally first be detected in the blood in 2 weeks to 3 months or longer after infection


AIDS Clinical Findings

1. Subjective:

– Anorexia, fatigue, dyspnea, chills, sore throat

2. Objective:

– Positive for HIV antibody: ELISA and Western Blot
– Positive for HIV itself: Polymerase chain reaction
– Decreased CD4/T4 cells
– Night sweats
– Enlarged lymph nodes
– Wasting syndrome: wt loss exceeding 10% baseline weight, chronic diarrhea for more than 30 days, chronic weakness and constant fever
– HIV encephalopathy: memory loss, lack of coordination, partial paralysis, mental deterioration


HIV is present in…

• Blood
• Semen
• Vaginal secretions
• Blood-tinged saliva
• Tears
• Breast milk
• CSF
• The virus is not viable outside the body


AIDS: Classification System

• T4/CD4 categories

1. Category 1: less than or equal to 500 cells /mL
2. Category 2: 200 to 499 cells/ mL
3. Category 3: less than 200 cells/ mL

• Clinical Categories

1. Category A: asymptomatic HIV
2. Category B: presence of opportunistic infection/s
3. Category C: presence of all opportunistic conditions


AIDS OPPORTUNISTIC INFECTIONS

1. Protozoal:
– PCP, toxoplasmosis

2. Fungal:
– Candidiasis, histoplasmosis

3. Bacterial:
– Mycobacterium avium-intracellulare complex
–Mycobacterium tuberculosis

4. Viral:
– Herpes, varicella-zoster, cytomegalovirus

5. Malignancies:
–Kaposi’s sarcoma, B-cell lymphomas, non-Hodgkin’s lymphoma


AIDS: Therapeutic Interventions

– No cure, prevention is the key
– For PCP: trimethorprim sulfamethoxazole (Bactrim), pentamide
– For TB: isoniazid, rifampin, ethambutol
– For Fungal infections: nystatin, amphotericin B, ketoconazole


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