HIV/AIDS

Difference between HIV and AIDS

Etiology

  • RNA retrovirus – Human Immunodeficiency Virus

Pathology

  • HIV – specific affinity for – CD4+ T helper cells – Therefore damage cell mediated immune system
  • Enters host – replicates using host DNA – stay latent – cell fusion/cell death
  • Notes under Virology

Modes of spread

  • Vertical transmission and breast feeding
  • Sexual contact
  • Parental exposure:
    • Organ transplant
    • Blood transfusion
    • Contaminated needles
    • Artificial insemination

Clinical

1. Systemic signs and symptoms

  • Chronic fever
  • Weight loss
  • Diarrhea
  • TB
  • Persistent generalized lymphadenopathy
  • Encephalopathy (AIDs dementia)
  • Other STIs

2. Oral infections

  • Fungal:
    • Candidiasis
    • Histoplasmosis
    • Cryptococcus neoformans
    • Penicilliosis
  • Protozoa: Leishmania

3. Oral neoplasms

4. Other manifestations

Lesions commonly and least commonly

Diagnosis

  • ELISA
  • PCR
  • CD4 counts
  • CD4 : CD8
  • Indirect immunofluorescence – HIV specific IgM

Management

  • ARVs eg. Zidovudine, Ritonavir

Clinical features of pediatric AIDs

Age of onset: Neonate to late infancy

Infections:

  • Fungi – C. albicans
  • Mycobacteria – M. TB, M. bovis, atypical
  • Bacteria – S. pneumonia, S. aureus, Gram -ve’s
  • Virus – HSV, EBV, VZV, CMV, adenovirus
  • Protozoa – P. carinii (Update: Now considered a fungus by the name Pneumocystis jirovecii)

Malignancy:

Nutrition:

  • Diarrhea
  • Failure to thrive

Systemic:

  • Fever
  • Lymphadenopathy
  • Hepatosplenomegaly

Parotid: Diffuse, non suppurative enlargement

CNS: Developmental delays

AIDS dysmorphic syndrome: Variable teratogenicity