Human Immunodeficiency Virus
Med Surg: Hematology
Pathophysiology & Causes
HIV is a virus that attacks the body's immune system
& if not treated, it can lead to AIDS
(Acquired Immunodeficiency Syndrome), which interferes
with the body's ability to fight infections. The virus can be
transmitted through contact with infected blood, semen
or vaginal fluids; commonly from unprotected sex, blood
transfusions, hypodermic needles & from mother to child
(during pregnancy).
Once exposed the virus replicates inside the body by
hijacking or taking over & killing the CD4+ cells (T helper
cells). These cells are vital in fighting off infections &
diseases. Since HIV cannot reproduce on its own, it
attaches itself to these T-helper cells & fuses together
with it becoming one. HIV belongs to a group of viruses
known as retroviruses, which carry their genetic material
in the form of ribonucleic acid(RNA) rather than
deoxyribonucleic acid (DNA).
Signs & Symptoms
Within a few weeks, flu-like symptoms appear:
• Fatigue
• Fever & night sweats
• Sore throat
• Weight loss
• Diarrhea
• Then asymptomatic (no signs / symptoms)
until it progresses to AIDS (late stage of HIV).
• AIDS s/s - Frequent infections as CD4+ cells decrease
(decreased immunity)
Diagnostic Procedures
• EIA: Antibodies are detected, resulting in positive results
and marking the end of the window period from initial
contraction.
• Western blot: Also detects antibodies to HIV; used to
confirm EIA
• Viral load: Measures HIV RNA in the plasma
• CD4/CD8: These are markers found on lymphocytes. HIV
kills CD4+ cells, which results in a significantly impaired
immune system
Education & Interventions
• Monitor for fever, cough, sore throat etc. could mean
deadly infection is setting in & CD4+ count is dropping
• Monitor declining hemodynamic measurements &
weight.
• Compliance with medication regimen (HAART therapy)
Stages of HIV to AIDS
• Stage 1 - HIV Primary Infection
Initially upon contracting HIV, there is a period during
which HIV tests appear as a false negative on the HIV
antibody blood test, although clients are infected &
highly infectious. Characterized by high levels of viral
replication with destruction & dramatic drops of CD4+
T-cells counts. Once viral load stabilized, there are no
signs & symptoms as the virus goes dormant until CD4+
levels drop below the 200 count.
• Stage 2 - AIDS
When CD4+ T-cells drop below 200 cells/mm3 the
client is considered to have AIDS.
Treatments: HAART Therapy
• HAART - Highly Active Antiretroviral Therapy
multiple drugs that act on different viral targets is
known as
• Zidovudine: is given to pregnant women to prevent HIV
crossing the placenta
Notes