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MedSur
gExam 2PDF-Summar yBrunnerandSuddar
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s
Text
bookofMedi
cal
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gicalNursi
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imar
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sOfAdul
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Me
d-Su
rg.
Stu
dyGu
ideE
xam2
Ch
apt
er3
7-HI
V/AI
DS
KE
YTE RMS
EI
A( enzymei mmu noas say
):ab loodt estthatc and eterminethep re
senceof
ant
ibodiestoHIVi ntheb l
oodors al
iv
a;av a
riantofthistestiscall
ede n
zyme
l
inkedi mmu nosorbenta ssay(E LI
SA).Pos iti
ver esult
smu stb ev al
idat
ed,
usual
lywithWe st
e r
nb l
ottest.
HI
V-1:retr
ov i
rusis
olateda n
dr e
cog ni
zedast heetiol
ogica gentofHIVdiseas
e
HI
V-2:retr
ov i
rusi
de nt
if
iedin1986inp ati
entswi t
hAI DSinwe ster
nAf r
ic
a
opp
o r
tunist
icinfect
ion:il
lnes
sc ausedbyv ari
ousor gani
sms ,someofwh ich
usual
lydon otcaused i
seaseinp eopl
ewi t
hn orma li
mmu n esyst
ems
Kapos
i’
ss arcoma :
ma li
gnancythatinvol
vest heepithel
i
allayerofbloodand
l
ymp hat
icv ess
els
wast
ings y
n dro
me :i
n v
oluntar
ywe i
g htl
ossc onsis
tingofb othleanandfatbody
mass
Weste
rnb l
o tassay:abloodtestthatide
nti
fiesa n
tibodi
est oHIVa ndisusedto
conf
irmt heresul
tsofa nEIAorEL I
SAtest
Wh
atisHI Vinfect
iona ndAI DS
TheHI Va nt
ibodytest,ane nzymei mmu noassaybecame
avail
abl
ein1 984a l
lowi ngforearl
yd i
agnosisofthe
i
n f
ecti
onb ef
oreon se tofsympto ms.
Gay ,bisex
u al
,a n
dot h erme nwh oh av
es exwi thme n
r
e mainthep opul
ationmos taf
f ect
eda ndac c
ountfor
2%o fthepop u
lati
onb ut61%o fthenewi n
fecti
ons.
AIDS-rel
atedd eathsd ropp edby1 9 %g l
oball
yov erthe
peri
odfrom2 004to2 009alon
e ;and5 3%ofp r
egnant
wo menl i
vi
ngwi thHI Vh ada ccesst oantir
etr
ovi
ral
me di
cin
e stop reve ntt r
ansmissiono fHIVt ot h
e i
r
i
n f
ants
Howisi
ttran
s mit
ted
I
nfl
amma t
ionandbreaksi
ntheski
normucosar
esul
ti
nthe
i
ncr
easedp r
obabi
li
tyth
atanHIVexpos
urewi
l
lle
adto
i
nfe
cti
on .
(
HIV-
1)istran
smitt
edinbodyfl
ui
ds(b
lood,s
emi
nalf
lui
d,
, vagi
na l
secret
ions
,amn i
oti
cflui
d,an
db r
eastmil
k)t
hat
cont
a i
nfreevi
ri
onsa ndinf
ect
edCD4 +Tcell
s.
Mot
her
-to-
chil
dtransmissi
onofHIV-1ma yoccuri
nutero,a
t
theti
meofd eli
very
,ort h
roughbreas
t-f
eedi
ng,butmost
peri
natalinf
ect
ionsa r
et hou
ghttooc curaf
terexposur
e
duri
ngd el
iv
ery.
HI
Visnottra
nsmitt
edthroughcasual
contac
t
Ri
skfact
ors
Bl
oodandb l
oodproduct
sc a
ntransmitHIVtorec
ipi
ent
s.
However
,theri
skassoci
atedwithtransf
usi
onsh asbeenv
ir
tual
lyel
iminat
edasa
r
esul
tofv ol
unta
rys elf
-de
fer
ral,comp l
et
ion ofa deta
il
edh ealt
hh is
tor
y,
ex
tensi
vetesti
ng,heattreat
me ntofc l
ott
ingfact
orconcen
tra
tes,andmore
ef
fect
iv
ev i
rusi
nacti
vat
ionme t
hods
1
OMo
ARc
PSD|
682
831
9
MedSur
gExam 2PDF-Summar yBrunnerandSuddar
th'
s
Text
bookofMedi
cal
-Sur
gicalNursi
ng
Pr
imar
yConcept
sOfAdul
tNur
sing(
NovaSout
heast
ernUni
ver
sit
y)
,
, l
OMo
ARc
PSD
|68
283
19
Me
d-Su
rg.
Stu
dyGu
ideE
xam2
Ch
apt
er3
7-HI
V/AI
DS
KE
YTE RMS
EI
A( enzymei mmu noas say
):ab loodt estthatc and eterminethep re
senceof
ant
ibodiestoHIVi ntheb l
oodors al
iv
a;av a
riantofthistestiscall
ede n
zyme
l
inkedi mmu nosorbenta ssay(E LI
SA).Pos iti
ver esult
smu stb ev al
idat
ed,
usual
lywithWe st
e r
nb l
ottest.
HI
V-1:retr
ov i
rusis
olateda n
dr e
cog ni
zedast heetiol
ogica gentofHIVdiseas
e
HI
V-2:retr
ov i
rusi
de nt
if
iedin1986inp ati
entswi t
hAI DSinwe ster
nAf r
ic
a
opp
o r
tunist
icinfect
ion:il
lnes
sc ausedbyv ari
ousor gani
sms ,someofwh ich
usual
lydon otcaused i
seaseinp eopl
ewi t
hn orma li
mmu n esyst
ems
Kapos
i’
ss arcoma :
ma li
gnancythatinvol
vest heepithel
i
allayerofbloodand
l
ymp hat
icv ess
els
wast
ings y
n dro
me :i
n v
oluntar
ywe i
g htl
ossc onsis
tingofb othleanandfatbody
mass
Weste
rnb l
o tassay:abloodtestthatide
nti
fiesa n
tibodi
est oHIVa ndisusedto
conf
irmt heresul
tsofa nEIAorEL I
SAtest
Wh
atisHI Vinfect
iona ndAI DS
TheHI Va nt
ibodytest,ane nzymei mmu noassaybecame
avail
abl
ein1 984a l
lowi ngforearl
yd i
agnosisofthe
i
n f
ecti
onb ef
oreon se tofsympto ms.
Gay ,bisex
u al
,a n
dot h erme nwh oh av
es exwi thme n
r
e mainthep opul
ationmos taf
f ect
eda ndac c
ountfor
2%o fthepop u
lati
onb ut61%o fthenewi n
fecti
ons.
AIDS-rel
atedd eathsd ropp edby1 9 %g l
oball
yov erthe
peri
odfrom2 004to2 009alon
e ;and5 3%ofp r
egnant
wo menl i
vi
ngwi thHI Vh ada ccesst oantir
etr
ovi
ral
me di
cin
e stop reve ntt r
ansmissiono fHIVt ot h
e i
r
i
n f
ants
Howisi
ttran
s mit
ted
I
nfl
amma t
ionandbreaksi
ntheski
normucosar
esul
ti
nthe
i
ncr
easedp r
obabi
li
tyth
atanHIVexpos
urewi
l
lle
adto
i
nfe
cti
on .
(
HIV-
1)istran
smitt
edinbodyfl
ui
ds(b
lood,s
emi
nalf
lui
d,
, vagi
na l
secret
ions
,amn i
oti
cflui
d,an
db r
eastmil
k)t
hat
cont
a i
nfreevi
ri
onsa ndinf
ect
edCD4 +Tcell
s.
Mot
her
-to-
chil
dtransmissi
onofHIV-1ma yoccuri
nutero,a
t
theti
meofd eli
very
,ort h
roughbreas
t-f
eedi
ng,butmost
peri
natalinf
ect
ionsa r
et hou
ghttooc curaf
terexposur
e
duri
ngd el
iv
ery.
HI
Visnottra
nsmitt
edthroughcasual
contac
t
Ri
skfact
ors
Bl
oodandb l
oodproduct
sc a
ntransmitHIVtorec
ipi
ent
s.
However
,theri
skassoci
atedwithtransf
usi
onsh asbeenv
ir
tual
lyel
iminat
edasa
r
esul
tofv ol
unta
rys elf
-de
fer
ral,comp l
et
ion ofa deta
il
edh ealt
hh is
tor
y,
ex
tensi
vetesti
ng,heattreat
me ntofc l
ott
ingfact
orconcen
tra
tes,andmore
ef
fect
iv
ev i
rusi
nacti
vat
ionme t
hods
1
