Care of Client with HIV

• HIV

  Chronic condition
• Structure of HIV

  Constantly changing
• Disease that can occur if HIV is left untreated

  AIDS (Acquired Immunodeficiency Syndrome)
• Disease associated with immune system deficits


  • Pneumocystis Pneumonia
  • Kaposi Sarcoma
• Antiretroviral therapy (ART)


  • Slows down progression of HIV to AIDS
  • Multi drug therapy to decrease the chances of drug resistance & provide complete viral suppression
• Antiretroviral therapy


  Increasing life expectancy of those with HIV & AIDS
• Universal precautions


  • Gloves and goggles
• Fluids that can carry HIV infection

  • Blood & semen
• If someone found needles in the local community

  File a communicable report to local health department
• Populations most at risk for HIV


  • Behavioral IV drug use
  • Unprotected sex
  • Gay, bisexual, and other men who have sex with men
  • African Americans and Hispanics/Latinos
  • African Americans women 15x more likely to have an HIV infection than white women
• Retrovirus


  Carries genetic information in RNA
• Seroconversion


  Process of antibodies being produced following viral infection (fighting back)
• Cells primarily infected in viral infection

  Helper T (CD4)
• Must have viral load test to confirm HIV infection
• Initial manifestations of HIV


  Similar to flu
• Process after initial acute illness


  1. Prolonged asymptomatic period (8-10 years)

  2. Persistent generalized lymphadenopathy

  3. AIDS
• Lab value indicating viral infection

  CD4 T-cell count less than 200/mcL
• Untreated HIV patients most likely to transmit disease within first 3 months of exposure
• Cannot detect viral infection within first months of exposure with a CD4 test; Still have good CD4
• T4 (CD4) level


  Peaks in the late asymptomatic period
• Early transition of early AIDS

  6 months- 6 years
• Early manifestations for viral infection


  • Development of acute mononucleosis-type illness in days to weeks after contracting virus
  • Fever, sore throat, headache
  • Arthralgias(joint pain) and myalgias(muscle pain)
  • Rash and lymphadenopathy
  • Nausea, vomiting, abdominal cramping
  • Tired, lethargic
• Treated patients


  Undergo asymptomatic period
• Untreated patients


  Undergo early transmission
• Virus is still present and can be transmitted during the asymptomatic period
• Later manifestations of viral infection

  • General malaise & fatigue
  • Fever
  • Night sweats (Not HIV patients)
  • Severe involuntary weight loss
  • Persistent ski dryness & rash
  • Diarrhea
  • Hairy leukoplakia & candidiasis (thrush, anal constipation)
  • Gingival inflammation and ulceration
• Gingival inflammation and ulceration


  Trench mouth
• Conditions common in patients with AIDS


  • Generalized wasting
  • Kaposi's Sarcoma Lesions
  • Types of cancer all over body
• Progression from HIV to AIDS


  Neuro function decreases due to inflammatory, demyelinating, and degenerative changes
• Neurocognitive disorders associated with HIV


  • Fluctuating memory loss
  • Confusion
  • Difficulty concentrating
  • Lethargy
  • Diminished motor speed
• Opportunistic infections


  • Pneumocystis pneumonia (PcP)
  • Tuberculosis (TB)
  • Herpes virus infections, CMV, Disseminated herpes simplex, herpes zoster, sinusitis, parasitic infections, candida albicans infection, and pelvic inflammatory disease (PID)
• Secondary cancers associated with viral infections


  • Kaposi Sarcoma (KS)
  • Lymphomas
  • Cervical cancer
• Kaposi Sarcoma (KS)


  Tumor of endothelial cells lining small blood vessels
• Lymphomas


  Late manifestation, CNS a common site
• Cervical cancer


  Frequent in women and usually the cause of death
• More AIDS-Associated Diseases


  • Cardiovascular complications
  • Coronary heart disease
  • Hepatic complications
  • Liver disease, hepatitis B
  • HIV-associated nephropathy (HIVAN)
• Goals for those with viral infections


  • Early identification and determination of appropriate treatment
  • Promote health-maintenance activities
  • Prevent opportunistic infections (Seek doctor)
  • Treat disease complications
  • Provide emotional, psychosocial support
• Decrease the complications of viral infections


  ART medications (Antiretroviral Therapy)
• Who needs to be screened for viral infections


  • 15-65 years old; (yearly)
  • High risk persons; 3-12 months
  • All pregnant persons
• HIV testing requirements


  Patient must know that they are being tested for HIV; can opt out