NUR 426 Complex Care- HIV Review Questions and Correct Answers
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Course
NUR 426
Institution
NUR 426
HIV 1 and HIV 2 HIV 1 -Common in US -Causes most HIV infections worldwide -More rapid progression to AIDS; more virulent
HIV 2 -Isolated in West Africa -Rare in the US -Slower rate of disease progression
HIV - RNA Virus -Called retroviruses because they replicate in "backward" manner going from R...
NUR 426 Complex Care- HIV Review
Questions and Correct Answers
HIV 1 and HIV 2 ✅HIV 1
-Common in US
-Causes most HIV infections worldwide
-More rapid progression to AIDS; more virulent
HIV 2
-Isolated in West Africa
-Rare in the US
-Slower rate of disease progression
HIV - RNA Virus ✅-Called retroviruses because they replicate in "backward" manner
going from RNA to DNA
-Replicates using CD4+ cells
-CD4+ T cell is the target cell for HIV entry
-CD4+ cells - send signals
Life cycle of HIV ✅Summary of 8 Steps
1. Virus Fuses with CD4 Cell receptor
2. HIV inserts its RNA into cell - reverse transcriptase
3. CD4 cell synthesizes HIV virus
4. Viruses are assembled and released
CD4 cell has been destroyed and is no longer functional
Transmission ✅-HIV can be transmitted thru contact with certain body fluids
-Blood, semen, vaginal secretions, and breast milk and amniotic fluid
-Organ transplants, HIV infected blood products (especially between 1978 and 1985)
-Sharing infected injection blood use equipment
-Sexual relations with infected individuals (both male and female)
-HIV is not spread thru casual contact
-Not spread by tears, saliva, urine, emesis, sputum, feces, sweat, bugs/mosquitos,
respiratory droplets or enteric routes
New Cases ✅Gay, bisexual, and other men who have sex with men (MSM) bear the
greatest burden by risk group accounting for 26,200 of the 38,000 new cases
Why Anal Sex is at a higher risk for HIV infection? ✅-Anal sex is 18 times riskier than
male-to-female vaginal intercourse.
o*Differences in Anal, Vaginal, Oral Cavities*
-Rectal layer - single layer of epithelial cells
-Vaginal and oral cavities - multiple layers of epithelial cells
, o*Rectal Mucosal fluid - higher concentrations of HIV virus than semen and blood.*
o*Receptive anal sex is a higher risk than Insertive anal sex*
-STI's increase the risk
-Foreskin Increases risk
Indications for HIV Screening ✅-CDC recommends all individuals between 13 -75
should be tested at least once.
-Sexually active gay and bisexual men consider testing every 3-6 months.
-*Test positive for STD's or Hepatitis*
-Unprotected vaginal, oral or anal sex with more than one sexual partner since last
screening
-Frequent testing is particularly important for men who have sex with men (MSM) *aged
13 to 24 years*
-Use IV drugs
-Exchange sex for money or drugs
-Have unprotected sex with someone in the above categories
-Have been sexually assaulted
-*Pregnant women - tested*
HIV Testing ✅-Window Period: 1-2 months post exposure may not give accurate
results if tested.
-*4th Generation HIV - 1/2 Antibody Antigen test (Blood Test)*
- Antigen *turns positive about day 13*
-*Antibody positive after 30 days ( 2-6 weeks)*
-Rapid HIV antibody test = 99% accurate
*What if that test is positive?*
-Further testing: HIV viral load test (HIV RNA) ordered as HIV Nucleic Acid Amplification
Test (NAAT or NAT), CD4+ count and genetic testing
*Ongoing Monitoring*:
-CD4+ (3 weeks, 3 months, 6 months) *Normal 800 - 1500 cells/mm3 of blood*
-Viral Load - every 6 months how much virus do you have in my ml of blood
How do you tell the patient? ✅Call the patient into the office, talk face to face, so we
can read the patients reaction, and provide support, discuss medication and schedule
follow up appointment
Stages of HIV Infection
Stage 0 and 1 ✅*Stage 0 - Early infection*
-40 - 80% develop symptoms of non specific viral illness (rash, fever, muscle/joint pain,
fatigue, sore throat, headache, swollen lymph nodes) for 1-2 weeks
-Highly contagious, includes Window period
*Stage 1 - Asymptomatic*
-Destruction of CD4 T cells > drops CD4 count (500 or greater)
-Other immune cells like CD8 increase killing of infecting virus
-Viral set point - equilibrium between HIV levels and immune response
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