Opportunistic Infections and AIDS-defining illnesses - CD4+ cell count, malignancy, treatment

Summary

This video discusses the progression of HIV infection, emphasizing its impact on CD4 T cell counts and the resulting non-AIDS and AIDS-defining conditions. It details how a decline in CD4 counts below specific thresholds leads to opportunistic infections and malignancies, including pneumocystis pneumonia and cerebral toxoplasmosis. The presentation also covers treatment options for these conditions and highlights the importance of prophylaxis in managing HIV-related health issues. By understanding these critical aspects, viewers gain insight into the complexities of HIV care and the significance of maintaining immune function.

Takeaways

• 😀 HIV infects and destroys CD4 T cells, leading to a decline in immune function over time.
• 😀 A CD4 count below 200 cells per microliter indicates the progression to AIDS.
• 😀 Non-AIDS defining conditions include oral candidiasis, shingles, and chronic diarrhea.
• 😀 Common AIDS defining conditions with CD4 counts below 200 include tuberculosis and Kaposi's sarcoma.
• 😀 Pneumocystis pneumonia is the most common cause of death in AIDS patients.
• 😀 Cerebral toxoplasmosis and cryptococcal infections are significant risks for patients with CD4 counts below 100.
• 😀 Opportunistic infections increase as CD4 counts decrease, with specific infections associated with defined thresholds.
• 😀 Mycobacterium avium complex and cytomegalovirus infections are critical concerns when CD4 counts drop below 50.
• 😀 Regular monitoring of CD4 counts is essential for managing HIV and preventing progression to AIDS.
• 😀 Early treatment and prophylaxis can help manage non-AIDS defining and AIDS defining conditions effectively.

Q & A

What is the relationship between HIV and CD4 T cells?

HIV infects and destroys CD4 T cells, leading to a decrease in their count over time. Without treatment, CD4 counts can drop below 200 cells per microliter, resulting in AIDS.

What defines AIDS in an individual with HIV?

AIDS is defined as the development of an AIDS-defining condition or a CD4 count less than 200 cells per microliter in someone with HIV.

What are some common non-AIDS defining conditions in HIV patients?

Common non-AIDS defining conditions include oral candidiasis, oral hairy leukoplakia, generalized lymphadenopathy, shingles, chronic diarrhea, and skin changes like molluscum contagiosum.

What is the most common AIDS-defining condition when CD4 counts are below 200?

Pneumocystis pneumonia is the most common cause of death in patients with AIDS and is characterized by gradual onset of low-grade fevers, non-productive cough, and dyspnea.

How is tuberculosis related to HIV and AIDS?

Mycobacterium tuberculosis is an AIDS-defining condition that can present with symptoms like cough, hemoptysis, fever, weight loss, or night sweats, especially when CD4 counts are low.

What treatment options are available for pneumocystis pneumonia?

Pneumocystis pneumonia is treated with trimethoprim and sulfamethoxazole.

What is progressive multifocal leukoencephalopathy (PML) and its cause?

PML is a demyelinating condition caused by reactivation of the JC virus, leading to neurological deficits and aggressive replication in the brain tissue.

What are some AIDS-defining conditions that occur with a CD4 count less than 100?

Conditions include cerebral toxoplasmosis, esophageal candidiasis, cryptococcal infections, cryptosporidiosis, and herpes simplex virus infections.

What distinguishes CNS lymphoma from cerebral toxoplasmosis in HIV patients?

CNS lymphoma typically presents with a single enhancing lesion on MRI, whereas cerebral toxoplasmosis presents with multiple enhancing lesions.

What treatments are used for cytomegalovirus (CMV) infections in HIV patients?

Treatment for CMV infections includes ganciclovir or valganciclovir, and it can cause various diseases such as CMV encephalitis, colitis, and retinitis.