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Eronlyn C. Rivera November 11,2024 Caregiving NC II Case: AIDS/HIV Pattern:.

INTRODUCTION HIV - stands for Human Immunodeficiency Virus that causes AIDS. it attacks the immune system that gives our bodies the ability to fight infections. it destroys a type of WHITE BLOOD CELLS specifically CD4 T cells or Helper T cells that fight diseases. AIDS - It stands for Acquired Immunodeficiency Syndrome and it is a FINAL STAGE of HIV. it means that the virus has weakened the immune system to the point at which the body has difficult time fighting the infections..

people have been warned about HIV and AIDS for over 30 years now. AIDS has already killed millions of people, millions more continue to become infected with HIV and there's NO CURE. some still don't know exactly what HIV and AIDS actually are. HIV/AIDS is a virus. VIRUSES infect the cells of living organisms and replicate within those cells. A virus can damage the cells it replicates in, which is one of the thing that can make an infected individual become ill..

Different viruses attack different parts of the body - the skin, lungs etc. What makes HIV so dangerous is that it attacks the immune system itself - the very thing that would normally get rid of the virus. CD4 T cells are the blood cells that HIV attacks. They are also called T4 cells or "helper T cells. also, HIV has a number of trick that help it to evade the body defenses including very rapid MUTATION..

Once HIV has taken hold, the immune system can never fully get rid of it. People can become infected with HIV from other people who already have it, and when they are infected they can then go on to infect other people. As HIV damages the immune system, the CD4 T cells count drops. A normal CD4 count is from 500 to 1,500 cells/mm3 of blood. People usually develop symptoms when their CD4 count drops below 350. More serious complications occur when the CD4 count drops to 200. When the count is below 200, the person is said to have AIDS..

DEFINITION. AIDS.

What Is HIV? HIV (HUMAN IMMUNODEFICIENCY VIRUS) is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases. HIV targets the body’s white blood cells called CD4 T Cells, weakening the immune system. This makes it easier to get sick with diseases like tuberculosis, infections and some cancers. HIV is spread from the body fluids of an infected person, such as blood, breast milk, semen and vaginal fluids. If left untreated, HIV can lead to the disease AIDS (acquired immunodeficiency syndrome). What is AIDS?.

AIDS (ACQUIRED IMMUNODEFICIENCY SYNDROME) is the late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus. People with AIDS have very low counts of certain white blood cells. They may have additional illnesses that indicate that they have progressed to AIDS. Without treatment, HIV infections progress to AIDS in about 10 years..

HISTORY Scientists believe that HIV originally came from a virus particular to chimpanzees in West Africa during the 1930s, and originally transmitted to humans through the transfer of blood through hunting. Over the decades, the virus spread through Africa, and to other parts of the world..

However, it wasn’t until the early 1980s, when rare types of pneumonia, cancer, and other illnesses were being reported to doctors that the world became aware of HIV and AIDS..

Pathophysiology of HIV Infection. HIV attaches to and penetrates host T cells via CD4+ molecules and chemokine receptors (see figure Simplified HIV Life Cycle). After attachment, HIV RNA and several HIV-encoded enzymes are released into the host cell..

Viral replication requires that reverse transcriptase (an RNA-dependent DNA polymerase) copy HIV RNA, producing proviral DNA; this copying mechanism is prone to errors, resulting in frequent mutations and, thus, new HIV genotypes. These mutations facilitate the generation of HIV that can resist control by the host’s immune system and by antiretroviral drugs..

.. Proviral DNA enters the host cell’s nucleus and is integrated into the host DNA in a process that involves integrase, another HIV enzyme. With each cell division, the integrated proviral DNA is duplicated along with the host DNA. Subsequently, the proviral HIV DNA can be transcribed to HIV RNA and translated to HIV proteins, such as the envelope glycoproteins 41 and 120. These HIV proteins are assembled into HIV virions at the host cell inner membrane and budded from the cell surface within an envelop of modified human cell membrane. Each host cell may produce thousands of virions..

.. After budding, protease, another HIV enzyme, cleaves viral proteins, converting the immature virion into a mature, infectious virion. Infected CD4+ lymphocytes produce > 98% of plasma HIV virions. A subset of infected CD4+ lymphocytes constitutes a reservoir of HIV that can reactivate (eg, if antiviral treatment is stopped)..

.. In moderate to heavy HIV infection, about 108 to 109 virions are created and removed daily. The HIV average half-life in plasma is about 36 hours, about 24 hours intracellularly, and about 6 hours as an extracellular virus. Every day, roughly 30% of the total HIV burden in an infected individual is turned over. Also, 5 to 7% of CD4 cells turn over daily, and the entire pool of CD4 cells turns over every 2 days (1). Hence, end-stage HIV infection (AIDS) results from a continuous and consistent replication of HIV, leading to the virus and immune-mediated killing of CD4 lymphocytes. Further, the high volume of HIV replication and high frequency of transcription errors by HIV reverse transcriptase result in many mutations, increasing the chance of producing strains resistant to host immunity and drugs..

.. Infection with another type of retrovirus, human T-lymphotropic virus 1 (HTLV-1), is less common but can also cause serious disease..

.. Treatment and Rehabilitation There are two types of HIV treatment: PILLS and SHOTS. Pills are recommended for people just starting HIV treatment. There are many FDA-approved single pill and combination medicines available. HIV treatment shots are long-acting injections given once a month or once every other month, depending on your treatment plan..

.. The primary treatment for HIV is antiretroviral therapy (ART), which is a combination of HIV medicines that people take daily or by schedule. ART can help people with HIV live long, healthy lives by: Reducing viral load: ART prevents HIV from multiplying, which reduces the amount of HIV in the body. When the viral load is undetectable, HIV is too low in the blood to be detected by a test. People with an undetectable viral load are unlikely to transmit HIV to others through sex.

.. Strengthening the immune system: ART helps the immune system get stronger, which helps fight other infections. Preventing AIDS: ART prevents HIV from advancing to AIDS. People with HIV should start taking ART as soon as possible after diagnosis. ART is recommended for everyone with HIV, regardless of how long they've had HIV or how healthy they are..

.. ART is usually a mix of two or more medicines from several classes. This approach has the best chance of lowering the amount of HIV in the blood. There are many ART options that mix more than one HIV medicine into a single pill, taken once daily. Each class of medicines blocks the virus in different ways. Treatment involves mixing medicines from different classes to: ● Account for medicine resistance, called viral genotype. ● Keep from creating new medicine-resistant strains of HIV. ● Suppress the virus in the blood as much as possible..

.. MEDICATION The classes of anti-HIV medicines include the following: Non-nucleoside reverse transcriptase inhibitors (NNRTIs) turn off a protein needed by HIV to make copies of itself. Examples include efavirenz, rilpivirine (Edurant) and doravirine (Pifeltro). Nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs) are faulty versions of the building blocks that HIV needs to make copies of itself..

.. Examples include abacavir (Ziagen), tenofovir disoproxil fumarate (Viread), emtricitabine (Emtriva), lamivudine (Epivir) and zidovudine (Retrovir). Retrovir is no longer suggested for routine use in the U.S. because of high rates of toxic effects. Mixes of medicines also are available, such as emtricitabine-tenofovir disoproxil fumarate (Truvada) and emtricitabine-tenofovir alafenamide fumarate (Descovy)..

.. Protease inhibitors (PIs) make HIV protease inactive. HIV protease is another protein that HIV needs to make copies of itself. Examples include atazanavir (Reyataz), darunavir (Prezista) and lopinavir-ritonavir (Kaletra). Integrase inhibitors stop the action of a protein called integrase. HIV uses integrase to put its genetic material into CD4 T cells..

.. Examples include bictegravir sodium-emtricitabine-tenofovir alafenamide fumarate (Biktarvy), raltegravir (Isentress), dolutegravir (Tivicay) and cabotegravir (Vocabria) Entry or fusion inhibitors block HIV's entry into CD4 T cells. Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry). Newer medicines include ibalizumab-uiyk (Trogarzo) and fostemsavir (Rukobia). Some side effects of HIV medicines include: Nausea and vomiting, Diarrhea, Difficulty sleeping, Dry mouth, Headache, Rash, Dizziness, Fatigue, and Pain..

.. A healthcare professional will monitor a person's viral load and CD4 T cell counts to assess their response to treatment. PrEP is another medication that can help protect people at risk for HIV. PrEP medications include Truvada and Descovy, which are taken by mouth, and Apretude, which is taken by injection. PrEP, or pre-exposure prophylaxis, is medicine people at risk for HIV take to prevent getting HIV from sex or injection drug use. PrEP can stop HIV from taking hold and spreading throughout your body..

.. Why Take PrEP? PrEP is highly effective at preventing HIV when taken as indicated. PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed. Among people who inject drugs, it reduces the risk by at least 74% when taken as prescribed. PrEP is much less effective when it isn't taken consistently..

.. Is PrEP Right for You? PrEP may benefit you if you test negative for HIV and any of the following apply to you: you have had anal or vaginal sex in the past 6 months. have a sexual partner with HIV (especially if the partner has an unknown or detectable viral load), or have not consistently used a condom. have been diagnosed with an STD in the past 6 months. you inject drugs and have an injection partner with HIV, or share needles, syringes, or other injection equipment..

.. you’ve been prescribed PEP (post-exposure prophylaxis) and you report continued risk behavior or have used multiple courses of PEP You may choose to take PrEP even if the behaviors above don’t apply to you. Talk to your health care provider. If you have a partner with HIV and are considering getting pregnant, talk to your doctor about PrEP. PrEP may be an option to help protect you and your baby from getting HIV while you try to get pregnant, during pregnancy, or while breastfeeding..

.. What Drugs Are Approved for PrEP? PrEP can be pills or shots. There are two pills approved for daily use as PrEP. They are combinations of two anti-HIV drugs in a single pill: Truvada® (emtricitabine/tenofovir disoproxil fumarate) is for all people at risk for HIV through sex or injection drug use. Generic versionsExit Disclaimer are also available..

.. Descovy® (emtricitabine/tenofovir alafenamide) is for sexually active men and transgender women at risk of getting HIV. Descovy® is not for people assigned female at birth who are at risk for HIV through receptive vaginal sex. A long-acting injectable form of PrEP has also been approved by the FDA: Apretude® (cabotegravir) is for people at risk for HIV through sex who weigh at least 77 pounds (35 kg). It’s an injection given by your health care provider every other month instead of daily oral pills..

.. Is PrEP Safe? PrEP is safe. No significant health effects have been seen in people who are HIV-negative and have taken PrEP for up to 5 years. Some people taking PrEP may have side effects, like nausea, diarrhea, headache, fatigue, and stomach pain. These side effects are usually not serious and go away over time. If you are taking PrEP, tell your health care provider if you have any side effect that bothers you or that does not go away..

.. And be aware: PrEP protects you against HIV but not against other sexually transmitted infections (STIs) or other types of infections. Combining PrEP with condoms will reduce your risk of getting other STIs. There's no cure for HIV/AIDS. Once you have the infection, your body can't get rid of it..

.. History of HIV 1981: The first cases of severe immunodeficiencies were reported to the CDC(Centers for Disease Control and Prevention). 1982: The CDC used the term AIDS, or acquired immune deficiency syndrome, for the first time. 1983: Luc Montagnier French Virologist at the Pasteur Institute discovered the virus that causes AIDS. 1986: The virus causing AIDS was officially named HIV, or human immunodeficiency virus. 1987: The FDA approved Zidovudine (ZDV) also known as Azidothymidine (AZT), the first antiretroviral drug used to.

.. treat HIV. The sale of male condoms for preventing HIV was also authorized by the FDA. Princess Diana publicly shook hands with someone living with HIV. 1991: The red ribbon became the symbol of HIV/AIDS support and awareness. Basketball player Magic Johnson told the public he had HIV. 1996: Highly active antiretroviral therapy (HAART) hit the market, boosting the life expectancy of someone with HIV by 15 years. 2007: Timothy Ray Brown, known as the “Berlin patient,” got a bone marrow transplant to treat his leukemia. A few months later, doctors could no longer detect HIV in his blood despite no longer being on ART(Antiretroviral Therapy). He is the first.

.. person thought to be “cured” of cancer. (Though, there is no proven cure for HIV.) 2010: A study found evidence that pre-exposure prophylaxis (PrEP) works. Researchers found that taking a daily dose of antiretrovirals not only helped those with HIV but also protected people without HIV from getting the virus. 2012: The FDA approved the first at-home HIV test and the drug Truvada, a once-daily PrEP pill. 2021: The FDA approved cabotegravir and rilpivirine (Cabenuva), the first long-acting shot used as a complete HIV treatment regimen. The PrEP extended-release injectable cabotegravir suspension (Apretude) also got FDA approval.

.. * Vaginal fluids * Breast milk. CAUSES The virus is spread (transmitted) person-to-person through certain body fluids: * Blood * Semen and preseminal fluid * Rectal fluids HIV can be spread if these fluids come in contact with: * Mucous membranes (inside of the mouth, penis, vagina, rectum) * Damaged tissue (tissue that has been cut or scraped) * The blood stream by injection.

.. HIV cannot be spread through sweat, saliva, or urine. In the United States, HIV is mainly spread: * Through vaginal or anal sex without using a condom with someone who has HIV who is not taking medicines to prevent or treat HIV * Through needle sharing or other equipment used to inject drugs with someone who has HIV.

.. Less often, HIV is spread: * From mother to child. A pregnant woman can spread the virus to her fetus through their shared blood circulation, or a nursing mother can pass it to her baby through her breast milk. Testing and treatment of HIV-positive mothers has helped lower the number of babies getting HIV. * Through needle sticks or other sharp objects that are contaminated with HIV (mainly health care workers)..

.. The virus is NOT spread by: * Casual contact, such as hugging or closed-mouth kissing * Mosquitoes or pets * Participating in sports * Touching items that were touched by a person infected with the virus * Eating food handled by a person with HIV.

.. Risk factors for getting HIV include: Having unprotected anal or vaginal sex. Receptive anal sex is the riskiest. Having multiple partners also increases the risk. Note: Using a new condom correctly every time you have sex greatly helps lower this risk. Using drugs and sharing needles or syringes. Having a sexual partner with HIV who is not taking HIV medicines. Having a sexually-transmitted disease (STD).

.. SIGNS AND SYMPTOMS Early signs related to acute HIV infection (when a person is first infected) can be similar to the flu or other viral illnesses. They include: Fever and muscle pains Headache Sore throat Night sweats Mouth sores, including yeast infection (thrush) Swollen lymph glands Diarrhea.

.. Many people have no symptoms when they are first infected with HIV. Acute HIV infection (Stage 1) progresses over a few weeks to months to become chronic or asymptomatic HIV infection (Stage 2) (no symptoms). This stage can last 10 years or longer. During this period, the person might have no reason to suspect they have HIV, but they can spread the virus to others. If they are not treated, almost all people infected with HIV will develop AIDS (Stage 3). Some people develop AIDS within a few years of infection. Others remain completely healthy after 10 or even 20 years (called long-term no progressors)..

.. People with AIDS have had their immune system damaged by HIV. They are at very high risk of getting infections that are uncommon in people with a healthy immune system. These infections are called opportunistic infections and can affect any part of the body. These can be caused by: Bacteria Viruses Fungi Protozoa.

.. People with AIDS are also at higher risk for certain cancers, especially lymphomas and a skin cancer called Kaposi sarcoma. Symptoms depend on the particular infection and which part of the body is infected. Lung infections are common in AIDS and often cause cough, fever, and shortness of breath..

.. Intestinal infections are also common and can cause: Diarrhea Abdominal pain Other common symptoms in people with HIV infection and AIDS include: Weight loss Fever Sweats.

.. TERMINOLOGIES HIV - Human Immunodeficiency Virus AIDS - Acquired Immunodeficiency Syndrome ART - AntiRetroviral Therapy HAART - Highly Active AntiRetroviral Therapy CD4 COUNT - The number of CD4 cells you have in your blood PEP - Post-Exposure Prophylaxis PrEP - Pre-Exposure Prophylaxis Viral Load - The amount of HIV in the blood.

.. Viral Load Test - A test that can tell if a person has HIV NAT Nucleic Acid Test Pathogen - any organism that causes disease Seroconversion - the process in which the immune system produces antibodies to attack an invading virus. Concordant - This term refers to a couple in which both partners have HIV..

.. Thank you !!! The End Eronlyn C. Rivera Caregiving NC II.