HIV Infectious disease case study PDF

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Case study/Essay written about HIV and the basics of the infectious disease process and how far HIV treatments have evolved....

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1 Human Immunodeficiency Virus

Disease Process of Human Immunodeficiency Virus Ashley Anglin Nepthalie Branvil Morgan Colon NUR206, Fortis Institute

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We hear the term HIV often, but do you really know what it means? HIV is the abbreviated form of the virus known as Human Immunodeficiency Virus. We know that this is the virus that leads to AIDS, which is the syndrome that the virus can creates after a period of time. But for this paper, we are going to focus on HIV itself and what causes it, how it is transmitted, and some clinical signs and symptoms.

Human Immunodeficiency Viruses are two species of Lentivirus, which are a subgroup of retrovirus that infect humans. Without treatment, average survival time after infection with HIV is estimated to be 9-11 years, depending on the subtype. There are two sub-types, HIV-1 and HIV-2. HIV-1 is actually more virulent and more infective than HIV-2. It is also the cause of more infections. “It infects vital cells in our immune system, such as helper T cells, macrophages, and dendritic cells.” (HIV.gov, 2021)

The only way to know if you have HIV is through a blood test. It is very important that if you have been exposed or suspect you are infected, that you become aware of your status. HIV treatments have came a very long way and can prevent full blown AIDS from occurring and these prescribed medications can lower your viral load to becoming undetectable, which also means untransmittable, which is the coolest thing ever. But let’s slow down a bit, and talk about some signs and symptoms of HIV before we jump into the modes of transmission. Usually within 4 weeks of infection, your body will have a response that results in a flu-like illness. That means the usual viral symptoms: chills, fever, muscle aches, rash, sweats, swollen nodes, and fatigue. There are a few people who don’t have such a pronounced response to the virus and skip this step or don’t notice it. These symptoms are similar to many other illnesses so it is easy to go

3 undiagnosed. In stage 2, the virus is still multiplying, but at low levels. This is the chronic stage, and people often do not have symptoms or feel sick. Sometimes, without treatment, it is possible to be in this stage for 10 years without treatment, but this differs person to person and some people get sicker much faster. We aren’t going to really cover AIDS in this paper, but briefly I will touch on what happens when HIV turns into full-blown AIDS. There will be weight loss, fever, night sweats, extreme fatigue, diarrhea, mouth sores, skin splotches, memory loss, diarrhea, and prolonged swelling of lymph nodes. The goal is to prevent AIDS and keep the viral load undetectable. With modern medicine, this is possible today. Let’s stop getting ahead of ourselves and talk about modes of transmission.

HIV is usually transmitted sexually through vaginal or anal sex, sharing needles, and vertical transmission can occur (mom to baby). It is important to note that anal sex is the riskiest type of sex for transmission and being the receptive partner is more risky as well. The rectum is very thin, and allows HIV to enter the body. Vaginal sex is less risky, but it is a means of transmission and either partner can get the virus during vaginal sex. Mother to child transmission is lower than it once was thanks to advances in modern medicine. All pregnant women are tested early on during pregnancy. Sharing dirty needles is a risky business one shouldn’t get into. Oral sex rarely can cause infections, and there are a few cases of workplace infections (needlestick injury) that could have been prevented. HIV is transmitted in bodily fluids: semen, blood, preseminal fluid, rectal fluids, vaginal secretions, and breast milk. You cannot get HIV through saliva, sweat, or tears, or touching someone who is infected. Over the years, medicine has evolved and people with this virus can live full lives as long as they are compliant with their medications. It is amazing to see the progress we have made over the last few decades. There is now prophylactic therapy medication (prep) for high-risk individuals, and people who are med

4 compliant can be non-transmittable, which means that that as long as their viral load is low enough, they cannot transmit it to their partner. We will talk about that more in the treatment section.

HIV as we know ultimately weakens the immune system. Making someone much more likely to develop infections, diseases, and even certain types of cancers. There are many complications that can develop from HIV. One of the most critical complications when it comes to HIV is a development to AIDS. The way nurses can monitor the development of HIV to AIDS is by checking the CD4 count. A CD4 count of 200 or less will diagnose a person with full blown AIDS. A diagnosis of AIDS means your immune system has been severely damaged. Other common infections/complications of HIV include: Pneumocystis pneumonia (PCP) is a fungal infection, this is the most common cause of pneumonia in people infected with HIV. Candidiasis infection related to HIV causes inflammation and a thick white coating on the mouth, tongue, esophagus, or vagina. Tuberculosis (TB) is most common in resource limited nations in people with HIV. Cytomegalovirus is a herpes virus; a weak immune system can make the virus resurface causing damage to organs. Cryptococcal meningitis common central nervous system infection associated with HIV. Last but not least is toxoplasmosis, potentially deadly infection that is a parasite that is spread by cats. Thankfully in today’s world, there are many modern treatments for HIV. Treatment can depend on a few things: patients medication compliance, age, and patient’s literacy level. There is currently no cure for HIV/AIDS. ART therapy is the gold standard treatment for HIV/AIDS. ART stands for antiretroviral therapy, ART is a combination of three or more medications from many different drug classes. The combination of these drugs has the best chance at lowering the load of HIV in the blood. ARTs main goals: drug resistance, avoid creating new drug resistant

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strains of HIV, and to maximize suppression of virus in the blood. The typical ART drug cocktail is two drugs from one class, plus a third drug from a second class. HIV prevention is key to keeping a healthy and properly functioning immune system. The best measures for prevention of HIV is to use condoms for sex, never share needles, always get a new needle, use PREP if exposed, consider male circumcision, treat STIs, and stay away from IV drug use. Correct prevention can lower the prevalence of HIV and further complications.

HIV/AIDS surveillance/tracked collects, analyzes, and disseminates information about new and existing cases of HIV infection. The ultimate surveillance goal is a nationwide system that combines information on HIV infection (CDC). It communicates information regarding HIV and AIDS, such as the number of HIV diagnoses and population rates, the number of people living with HIV, and the number of people receiving HIV medical treatment. This program is a browser-based program developed by the Centers for Disease Control and Prevention that helps health departments with reporting, data management, analysis, and data transfer to the CDC. The Human Immunodeficiency Virus (HIV) can influence any individual in any case of gender, age, race, ethnicity, sexual orientation, or communities where they live. Populations who is vulnerable to HIV include men who have sex with men (homosexuality), IV drug users, homeless adolescent (most homeless adolescent exchange sex for food, clothing, and shelter which put them at high risk of getting the HIV virus, infants and children (most pediatric AIDS cases were acquired perinatally), women (certain strains of HIV can infect women more easily through sexual intercourse), and people of color (Hispanics and African Americans have higher rates of AIDS which are linked to socioeconomic conditions and distrust to health care system) (Center for Disease Control). Acquired Immunodeficiency Syndrome is a life-

6 threatening condition that occurs when the body's immune system is severely damaged by the Human Immunodeficiency Virus (CDC). According to CDC, since 1996, when highly active antiretroviral therapy (HAART) became available; access, adherence, and response to HAART affect whether or when HIV progresses to AIDS. HIV virus has become a manageable medical condition that will empower people to lead a long and healthy life.

7 References:

:HIV.govDate last updated: June 05, 2020. (2021, April 8). What are hiv and aids? HIV.gov. https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids. Mayo Foundation for Medical Education and Research. (2020, February 13). Hiv/aids. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc20373524. Centers for Disease Control and Prevention. (2021, June 1). About hiv/aids. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/whatishiv.html.

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