HIV/AIDS/vaccines
HIV Pathophysiology
-RNA retrovirus -unable to survive and replicate unless its in human cell -desttroys CD4 T cells
Normal CD4 count
800-1200
CD4 count below 200
AIDS, development of opportunistic infections
fungal infections
Candidiasis, cryptococcosis, histoplasmosis
viral infections
Cytomegalovirus (CMV), herpes simplex and zoster
Antiretroviral therapy (ART)
HAART, includes at least 3 meds, work in different ways to reduce viral load
indications for ART
HIV infected ppl, HIV pregnant pts, AIDS defining illness patients, HIV associated neuropathy pts, serodiscordant couples, HIV/hep B confection
HIV associated malignancies
Kaposi's sarcoma, lymphoma, squamous cell carcinoma
immunizations before international travel
MMR, typhoid, yellow fever, meningococcal, rabies, hep a and b, Japanese encephalitis
Protozoal infections
PCP, toxoplasmolysis, cryptosporidosis, leishmaniasis
bacterial infections
TB, septicemia, bac pneumonia
varicella seroconversion
acquisition of detectable antibody levels in the blood
vaccination
antigens stimulate immun e response butt typically does not produce disease
Stevens-Johnson Syndrome
dry,crusty rash and should be reported to the PCP
how can pregnant women w HIV transmit to child
during pregnancy, labor, delivery, breastfeeding
Toxoids
inactivated toxins that stimulate antitoxin formation but cant produce disease
Postexposure prophylaxis (PEP)
initiated within 72 hours of exposure and cont for 4 weeks
side effects of varicella
inj site reaction, fever, thrombocytopenia, ste vens Johnsons syndromes e
Recombinant subunit vaccines
insertion of some of the genetic material of a pathogen into another cell or organism, where the antigen is then produced in massive quantities
Live attenuated vaccines
live weakened microorganisms
C/I to varicella
moderate to severe illness,, untreated tb, pregnancy, hi dose steroids
serodiscordant couples
ongoing sexual partnerships between a HIV infected individual and an uninfected individual
community immunity
protection from disease that occurs if most of a population is immune to a pathogen, thereby protecting individuals who are not immune
ART treatment goals
reduce morbidity and mortality, prolong quality of life, preserve immune function, prevent HIV transmission, suppress plasma HIV viral load
Plasma HIV RNA (viral load)
reports number of copies of virus in body
conjugate vaccines
require a protein or toxoid from an unrelated organism to link to the outer coat of the disease-causing microorganism -can cause flaws positive results of strep pneumonia if administered right before obtaining culture
Adjuvant vaccine
substance sometimes used to inc vaccines immunogenicity and to prolong immune response -alumninun salt