TERMS RELATED TO HIV /AIDS

 WINDOW PERIOD
Time period between initial HIV infection and the development of a measurable
immunological response to the infection

 WASTING SYNDROME
It is defined as 10 percent weight loss accompanied by 30 days of fever or diarrhea
It include severe weight loss of appetite.

 PNEUMOCYSTIS PNEUMONIA
It is serious infection that causes inflammation and fluid buildup in the lungs caused
by fungus called pneumocystis.

 KAPOSI SYNDROME
A cancer that causes lesions to grow in the skin, soft tissues, internal organs, mucous
membrane of nose and throat.

 ENCEPHLOPATHY
A term used for brain disease that alter the brain function and structure, causes are
tumors, infections.

 PYOMYOSITIS
It is a rare muscle bacterial infection, includes fever, pain, tenderness, abscess
formation.

 ULCERATIVE STOMATITIS
It is an immune mediated disorder characterized by oral erosions and ulcers.

• IMMUNE SYSTEM
Immune system protects and defends the body from infections. White blood cells are the
most important part, which fight and destroys bacteria, fungi, viruses that enter the body.

DEFINITION OF HIV/AIDS
H=HUMAN
I=IMMUNODEFICIENCY
V=VIRUS
 WHAT IS AIDS
A=AQUIRED
I=IMMUNE
D=DEFICIENCY
S=SYNDROME
INTRODUCTION
AIDS is the ultimate clinical consequence of HIV. it is a retrovirus that primarily effect the
vital organs of human immune system such ads CD4 cells if the number of CD4 cells is
below 200 then immunity is lost.

DEFINITION AND HIV AND AIDS

HIV is a virus that attack cells that helps the body to fight infection making a person more
vulnerable to other infections and diseases.

AIDS is the last stage of HIV infection that occurs when the immune system of the body is
badly disturbed because of virus.

DIFFERNCE BETWEEN HIV AND AIDS

HIV
1) It stands for human
Immunodeficiency virus.
2) It is a virus.
3) Virus invades the immunity
System.
AIDS
1) it stands for acquired
Immunodeficiency syndrome.
2) It is a condition.
3) it is later stage of infection
Caused by HIV.

ETIOLOGY
 Unprotected sex
 Sharing needles
 Occupational exposure
 Infected blood
  During pregnancy

HOW HIV IS TRANSMITTED

• SEXUAL TRANSMISSION
• MOTHER TO BABY
• INJECTING EQUIPMENT SHARING

HOW HIV IS NOT TRANMITTED

 Kissing
 Hugging
 Swimming
 Sharing
 Cooking
 Insect bites

WHY ARE WOMEN AT HIGHER RISK FOR INFECTION

Large amount of mucosal surface rea in the vagina.
When they are young –because of an immature genital contact.
When they have STI.
RISK FACTOR

Transplant procedures
Occupational
Tattoo
IDU (INJECTION DRUG USERS)
Poverty
 PATHOPHYSIOLOGY

Due to etiological factor

Invasion of the virus

The distribution of HIV in the body

Parasites in the different human cells

Dysfunction of human Immune function

Emergence of AIDS symptoms

Human mortalities
 HIV LIFE COMPLEX

ATTACHMENT

UNCOATING

DNA SYNTHESIS

INTEGRATION

TRANSCRIPTION

TRANSLATION

CLEAVAGE

BUDDING

CLINICAL MENIFESTATIONS
Clinical stage 1
Clinical stage 2
Clinical stage 3
Clinical stage 4
CLINICAL STAGE 1
Asymptomatic, lymphadenopathy
CLINICAL STAGE 2
Unexplained weight loss, recurrent respiratory tract infection,
Recurrent oral ulceration, dermatitis, fungal nail infection.
CLINICAL STAGE 3
Unexplained severe weight loss, chronic diarrhea, persistent fever,
Oral candidiasis, pulmonary tuberculosis, bacterial infection,
Ulcerative stomatitis, unexplained anemia
CLINICAL STAGE 4
Wasting syndrome, pneumocystis pneumonia, extra pulmonary tuberculosis, KAPOSI
SARCOMA, HIV encephalopathy, meningitis,
Cervical carcinoma, nephropathy and cardiomyopathy.

DIAGOSTIC EVALUATION

HIV ANTIBODY TEST

HIV ANTIGEN TEST

HIV ANTIBODY TEST

1. ELISA TEST (enzyme-linked immunosorbent assay)

It is the test to detect antibodies to HIV ANTIGEN in the patient blood using plates
If positive, the ELISA test is repeated because false positive can occur
If the ELISA test is again positive, the western blot test is done to detect the presence of
antibodies
2. WESTERN BLOT

This test includes separation of blood proteins and detect the specific called HIV
ANTIBODIES that indicates an HIV infection. It is used to confirm a positive ELISA, and
combine tests are 99.9% accurate.
HIV ANTIGEN TEST
1. P24 ANTIGEN

This test detect the protein of presence of the p24 protein of HIV
2. DNA PCR [polymerase chain reaction]

The DNA PCR Test looks for HIV DNA in white blood cells. PCR is sensitive enough to
detect HIV

OTHER LABORTATORY TESTS

 Total leukocyte and lymphocyte count

 Ig G and Ig A level
 T cell subset assays
 CBC
 Platelet count
 Lymph node biopsy.

COMPLICATIONS

i. AIDS wasting syndrome

ii. HIV associated neurocognitive disorders
iii. Cancer
iv. Opportunistic infections

TREATMENT [pharmacological management]

[HAART THERAPY]
The classes of antiviral drugs include;-
1) NON NUCLEOSIDE REVERSE TRANSCRIPTASE
Doravirine, Rilpivirine
2) NUCLEOSIDE AND NUCLETIDE REVERSE TRANSCRIPTASE
INHIBITORS
Tenofovir, zidovudine
3) PROTEASE INHIBITORS
Lopanavir
4) FUSION INHIBITORS
Enfuvirtide
5) INTEGRASE INHIBITORS
Dolutegravir

NON PHARAMACOLOGICAL MANAGEMENT

• Patient education
• Lifestyle modifications
• Take rest diet rich in proteins and vitamins
• Smoking cessation
• Alcohol cessation
• Regular exercise or yoga

NURSING ASSESSMENT

a. History collections
b. Review patient present complications
c. Assess patient knowledge about HIV
d. Evaluate nutritional pattern
e. Assess respiratory rate, general health status
f. Check for lesions , ask for bowel pattern
g. Check orientation.

NURSING DIAGNOSIS

• Ineffective breathing pattern related to opportunistic infection

• Acute pain related to infection, neuropathies
• Hyperthermia related to infection
• Risk of infection related to immunodeficiency
• Imbalanced nutrition related to side effect of treatment
• Diarrhea related to treatment side effect
• Confusion related to adverse effect of medicines
• Fatigue related to HIV infection
• Fear of infection progression related to having HIV
• Disturbed body image related to body changes
• Hopelessness related to chronic illness

PREVENTION
 o Use treatment as prevention
o Education
o immunizations
o Immigration regulations
o Use condom
o Use of clean needle
o Supportive car
o Use standard precautions
Hand hygiene
Protective equipment gloves, mask, gown
Patient placement
Avoid sharing clothes

WHAT NURSE CAN DO

1) Counsel on safe sex practices

2) Healthy life style practices
• Food nutrition
• Oral hygiene
• Personal hygiene
• Food hygiene
• Exercise

3) Educate on HIV disease progression

4) Family planning options
5) Regular follow up
6) Explain the proper method of disposal of used condom (male or female).
7) Participate in awareness campaigns
BIBLOIGRAPHY
1) Hinkle J.L., Cheever K. H., Brunner and Siddhartha’s textbook of medical surgical
nursing. 14 edition, Wolters Kluwer publishers, page no. 483-487.

2) Seltzer S.C. Bare B.G., Hinkle J.L., Cheever K. H. Brunner and Siddhartha’s textbook
of medical surgical nursing 11 edition. Lippincott Williams and Wilkins publishers,
page no 845-848