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Signs and symptoms

- The signs and symptoms of HIV infection vary depending on the stage of infection and the presence of opportunistic infections or cancers.

- The stages of infection are acute primary infection, asymptomatic stage, symptomatic stage, and AIDS.

- Acute primary infection occurs within 2-4 weeks after exposure and lasts for 1-4 weeks.

  • It is characterized by flu-like symptoms, such as fever, headache, sore throat, rash, lymphadenopathy, myalgia, arthralgia, malaise, and night sweats.
  • It is also called acute retroviral syndrome (ARS) or seroconversion illness.
  • It is associated with a high viral load and a low CD4 count.
  • It is often unrecognized or misdiagnosed as a common viral infection.

- Asymptomatic stage occurs after the acute primary infection and lasts for up to 10-15 years without treatment.

  • It is characterized by no symptoms or mild symptoms, such as fatigue, weight loss, oral candidiasis, herpes zoster, or recurrent respiratory infections.
  • It is also called chronic HIV infection or latent HIV infection.
  • It is associated with a gradual decline in CD4 count and a gradual increase in viral load.
  • It is often undetected unless tested for HIV antibodies or antigens.

- Symptomatic stage occurs when the CD4 count falls below 500 cells/uL or when opportunistic infections or cancers develop.

  • It is characterized by persistent or severe symptoms, such as fever, diarrhea, wasting syndrome, oral hairy leukoplakia, Kaposi’s sarcoma, cervical cancer, lymphoma, tuberculosis, or pneumocystis pneumonia (PCP)
  • It is also called advanced HIV disease or AIDS-related complex (ARC)
  • It is associated with a rapid decline in CD4 count and a rapid increase in viral load
  • It is often diagnosed by clinical criteria or laboratory tests for opportunistic infections or cancers

- AIDS occurs when the CD4 count falls below 200 cells/uL or when certain opportunistic infections or cancers are present regardless of the CD4 count

  • It is characterized by life-threatening conditions that can affect any organ system in the body
  • It is also called end-stage HIV disease or full-blown AIDS
  • It is associated with a very low CD4 count and a very high viral load

- It is diagnosed by CDC criteria based on CD4 count and specific opportunistic infections or cancers .

  • Some of the opportunistic infections or cancers that define AIDS are :
    • Candidiasis of bronchi, trachea, lungs, or esophagus .
    • Coccidioidomycosis, disseminated or extrapulmonary .
    • Cryptococcosis, extrapulmonary .
    • Cryptosporidiosis, chronic intestinal (>1 month duration) .
    • Cytomegalovirus disease (other than liver, spleen, or nodes) .
    • Encephalopathy, HIV-related .
    • Herpes simplex: chronic ulcer(s) (>1 month duration) or bronchitis, pneumonitis, or esophagitis .
    • Histoplasmosis, disseminated or extrapulmonary .
    • Isosporiasis, chronic intestinal (>1 month duration)
    • Kaposi’s sarcoma
    • Lymphoma, Burkitt’s (or equivalent term)
    • Lymphoma, immunoblastic (or equivalent term)
    • Lymphoma, primary, of brain
    • Mycobacterium avium complex or Mycobacterium kansasii, disseminated or extrapulmonary
    • Mycobacterium tuberculosis of any site, pulmonary, disseminated, or extrapulmonary
    • Mycobacterium, other species or unidentified species, disseminated or extrapulmonary
    • Pneumocystis jirovecii pneumonia (PCP)
    • Pneumonia, recurrent
    • Progressive multifocal leukoencephalopathy (PML)
    • Salmonella septicemia, recurrent
    • Toxoplasmosis of brain
    • Wasting syndrome due to HIV

Questions on Signs and symptoms

Correct Answer is C

Explanation

Blood transfusion from an infected donor was a significant mode of HIV transmission in the past, but extensive screening of blood donations has made this mode of transmission extremely rare.

Correct Answer is ["B","E"]

Explanation

Pre-exposure prophylaxis (PrEP) for sexual partners can be effective in preventing HIV transmission, but it is not directly related to harm reduction for individuals who inject drugs. PrEP is a preventive measure for those at risk of contracting HIV through sexual activity.

Correct Answer is B

Explanation

This statement is incorrect. There is no cure for HIV, and relying solely on herbal remedies without taking antiretroviral medications would be ineffective and dangerous. Antiretroviral therapy (ART) is the standard treatment for managing HIV and preventing its progression to AIDS.

Correct Answer is C

Explanation

Nucleic acid tests (NAT) are not used to detect antibodies against HIV. Instead, NAT is used for early detection of the virus itself, not antibodies, and is typically employed in specific situations like testing donated blood or for early diagnosis during the window period before antibodies develop.

Correct Answer is A

Explanation

This statement is incorrect. The most common HIV-1 subtype worldwide is group M, specifically subtype C, which is predominant in sub-Saharan Africa and parts of Asia. The most common subtype in the US is subtype B.

Correct Answer is D

Explanation

This is the correct statement. HIV is primarily transmitted through contact with infected body fluids, such as blood, semen, vaginal fluids, and breast milk. Common modes of transmission include unprotected sexual intercourse, sharing of contaminated needles, and from mother to child during childbirth or breastfeeding.

Correct Answer is ["A","D"]

Explanation

Taking Pre-Exposure Prophylaxis (PrEP) is an effective biomedical intervention for HIV prevention. PrEP involves taking antiretroviral medications before potential exposure to HIV to reduce the risk of infection in high-risk individuals.

Correct Answer is ["A","B","C","D","E"]

Explanation

Being female can influence susceptibility to HIV infection due to biological and social factors. Women may have a higher risk of infection during unprotected heterosexual intercourse. Additionally, gender disparities in access to healthcare and prevention resources can also contribute to higher vulnerability.

Correct Answer is C

Explanation

AIDS is the final stage of HIV infection. At this stage, the immune system is severely compromised, and the individual is susceptible to various opportunistic infections and certain cancers. While the viral load remains high, the CD4 count is significantly low.

Correct Answer is ["A","C","E"]

Explanation

Without treatment, the asymptomatic stage can last for up to 10-15 years. However, the duration can vary widely from person to person.

Correct Answer is D

Explanation

This statement is incorrect. Antiretroviral therapy is a lifelong treatment for HIV infection, and its discontinuation should not be based solely on the CD4 count falling below 200 cells/uL. The client needs further education on the importance of continuous treatment to manage HIV effectively and prevent opportunistic infections.

Correct Answer is B

Explanation

This option is incorrect. NAT can detect HIV infection much earlier than 6 months after exposure.

Adherence to the prescribed regimen and schedule is crucial for the effectiveness of ART, but it is not the primary goal of ART itself.

The client's statement about Nucleoside reverse transcriptase inhibitors (NRTIs) is accurate. NRTIs are incorporated into the growing viral DNA chain, leading to chain termination and preventing further viral replication.

The number of opportunistic infections present is an important consideration when starting ART. Opportunistic infections are more likely to occur in individuals with low CD4 counts and can affect the choice of ART drugs and the need for prophylactic treatments.

ART can reduce the risk of transmission to others. When viral load is undetectable, the risk of transmitting HIV to sexual partners or through shared needles is greatly reduced.

<p>Educating the patient about HIV/AIDS transmission modes (Choice D) is crucial, but it can be addressed during the patient&#39;s hospital stay or subsequent visits, while the assessment for opportunistic infections requires immediate attention to ensure timely treatment.</p>

Performing male circumcision is not a nursing intervention for a client with HIV/AIDS. While male circumcision has shown to reduce the risk of HIV transmission in some studies, it is not a primary nursing intervention for managing HIV/AIDS.

"Supervised injection facilities aim to increase risky behaviors among drug users." This statement is incorrect. Supervised injection facilities provide a safe and controlled environment for drug users to consume drugs under medical supervision, reducing the risk of overdose and the transmission of

"Pre-exposure prophylaxis (PrEP) is used after HIV exposure." This statement is correct. PrEP is a biomedical intervention used before potential exposure to HIV to prevent infection. It involves taking antiretroviral medications regularly to reduce the risk of acquiring the virus.

Providing counseling, feedback, and reinforcement for adherence to medication is an essential nursing intervention during the implementation phase. Although it supports patient compliance with treatment, it is not the primary focus of the evaluation process.

<p>Male circumcision has been shown to reduce the risk of HIV transmission in heterosexual men. However, it is not a strategy to minimize the negative consequences of drug use, and its relevance is not applicable to this question.</p>

<p>Antiretroviral therapy does not directly promote human rights protection. However, access to appropriate medical care, including ART, is considered a human right for individuals with HIV/AIDS.</p>
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