Spectrum of HIV Disease

Spectrum of HIV Disease
ACUTE STAGE
Flu like symptoms – 1 to 2 weeks
ASYMPTOMATIC PERIOD
No physical symptoms – 8 to 11 years
HIV ILLNESS
Night sweats, fatigue, diarrhea, fever, yeast infections, swollen
lymph nodes
AIDS
Opportunistic Infections, CD4<200
1
HIV TEST
HIV Antibody test
Looks for antibodies
Accuracy of the test
99.9%
Types of tests
Standard test – results will be known in 1 week
Rapid test – results will be known in 20 minutes
Test settings
Anonymous
Confidential
2
HIV Diagnosis (Testing)
Antibody tests
– EIA (or ELISA)
– Western Blot
– Rapid Tests
• OraQuick Advance *
• Unigold *
• Clearview Stat Pak & Stat Pak
Complete *
* These tests are “waived” under CLIA
HIV Diagnosis (Testing)
Other tests
– p24 antigen test
– Viral load tests
• Proviral DNA
• PCR RNA
– Home kits
HIV TEST
Informed Consent
12 yrs of age or older
Benefits of Testing……..
Where to test?
Private medical doctor
County clinic
Community-based organizations
www.hivla.org
5
California’s “Willful Exposure” Law (1998)/aka
“Recalcitrant Behavior”:
Willfully exposing another to HIV through unprotected sex
8 years of imprisonment
Intention to infect others with HIV through sex
To be prosecuted under the law, one would have to do ALL of the following:
Have anal or vaginal sex
Know that they are HIV +
Fail to disclose their HIV status
Fail to use a condom
Have a specific intent to infect another person
Actual knowledge of HIV infection without more evidence of “specific intent” is
insufficient for prosecution.
6
CONFIDENTIALITY LAWS
Disclosing a person’s HIV+ status to a third party without the
individual’s specific signed consent, is illegal;
Penalties and damages for unauthorized disclosure of HIV status
is a $5,000-$10,000 fine and/or jail sentence.
7
FEDERAL ANTI-DISCRIMINATION
LAWS
Rehabilitation Act of 1973 and American with Disabilities
Act (ADA) 1990
Prohibits discrimination against a person with a disability, including HIV disease or AIDS.
infection. infection.
This prohibits discrimination with regards to employment, public services, public
accommodations, and medical care.
Housing Discrimination
Care Discrimination
A doctor or dentist cannot refuse to treat an HIV+ person
California Anti-Discrimination Laws
Fair Employment and Housing Act (FEHA) and Unruh Civil Rights Act
8
PREVENTION
“It is not who we are but what we do that puts us at risk for HIV
infection”
Abstinence
Safer Sex
Male Condom (Activity)
Female Condom
Dental Dams
Needle use
Not Sharing Needles
Cleaning Needles (3x3x3 Method)
Needle Exchange
Harm reduction
9
PREVENTION
Universal Precautions
“Infection control measures that reduce the risk of transmission of
blood-born germs from patients to health care workers”

Wash hands thoroughly

Wear latex gloves

Use masks and eye protection

Wear a gown

Carefully handling and disposing of sharp instruments
during and after use.
10
PREVENTION
POST–EXPOSURE PROPHYLAXIS (PEP)
Exposure to HIV within the prior 72 hours
Approve for 13 yrs of age or older
For more information call 213-351-7699
PRE-EXPOSURE PROPHYLAXIS (PREP)
It refers to anti-HIV medication used daily or before
sexual encounters
Start prior to potential exposure
Prep should never be seen as the first line of defense against HIV
BREAST FEEDING
It is recommended that HIV+ women do not breastfeed
Infants.
11
TREATMENT
Goals of HIV/AIDS treatment;
 Reduce HIV-related morbidity and prolong survival,
 Improve quality of life,
 Restore the immune system,
 Suppress the viral load, and
 Prevent vertical HIV transmission (mother to child).
12

TREATMENT
What are Anti-retrovirals (ARVs) ?
Drugs that interrupt HIV replication & preserve immune system.
 When to start ARVs?:
 There are severe symptoms of HIV infection or
diagnosis of AIDS with a CD4 count of < 350 cells/mm3
 Patient has CD4 count less than 500 /mm3
 Recommended for pregnant women who otherwise do not meet
criteria to halt vertical transmission
 Regardless of CD4 count, treatment is recommended for all pregnant
patients, and patients with HIV-associated nephropathy (a kidney
disorder) or those who need treatment for hepatitis B.
 Treatment is considered optional for patients with CD4 counts over
500.
13
Current classes of Anti-HIV
medications
 Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
 Non-Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
 Protease Inhibitors
 Entry inhibitors
 Fusion inhibitors
 Integrase inhibitors
14
Who Pays For Treatment?
 HMO insurance
 Medi-Cal
 Medicare Part D
 ADAP
 Shared cost
15
Recent Advancements
 Immune based therapies
 Maturation inhibitors
 Multi-class Combination Products
 Gene Therapy
 Vaccine
16
Treatment as Prevention
• Science Magazine named 'HIV Treatment
as Prevention' as the breakthrough of 2011
• The HIV Prevention Trials Network (HPTN)
052 study of 1,700 sero-discordant
couples reported that ARVs reduced the
risk of heterosexual transmission by 96%.
17
Complementary Therapy
 General Health Maintenance
 Psychological Well-Being
 Spiritual Well-Being
 Social Well-Being
18
For More Information
Contact
 Jason Dawson, MPH
[email protected]
213-351-8043
Download
Related flashcards

Viral proteins

14 cards

Virologists

36 cards

Virology journals

11 cards

HIV/AIDS journals

12 cards

Create Flashcards