< PreviousHIV Symptoms & Diagnosis What are the symptoms of HIV/AIDS? _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ How is AIDS diagnosed? _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Who should get tested for HIV? _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Source: National Institutes of Health; U.S. Department of Health and Human Services. www.newpathlearning.com © Copyright NewPath Learning. All Rights Reserved. 94-6892Getting Tested Types of HIV tests There are three types of tests used to diagnose HIV infection: • Antibody tests check for HIV antibodies in blood or oral fluid. HIV antibodies are disease-fighting proteins that the body produces in response to HIV infection. Most rapid tests and home-use tests are antibody tests. • Antigen/antibody tests can detect both HIV antibodies and antigens (a part of the virus) in blood. • Nucleic Acid Tests (NATs) look for HIV in the blood. NATs are very expensive and not routinely used for HIV screening unless the person had a high-risk exposure or shows early symptoms of HIV infection. What do test results mean? HIV Negative: Patients should continue taking steps to avoid getting HIV. Those at high risk of becoming infected may take medicines to prevent HIV (called pre-exposure prophylaxis or PrEP). HIV Positive: Most patients will start antiretroviral therapy ( ART ) a combination of HIV medicines taken every day to treat HIV infection. ART helps people with HIV live longer, healthier lives and reduces the risk of transmission of HIV to others. Why Get Tested? The only way to know for sure whether you have HIV is to get tested. Knowing your HIV status gives you powerful information to help take steps to stay healthy. Is HIV testing confidential? HIV testing can be confidential or anonymous. Confidential testing means that HIV test results will include your name and other identifying information, and the results will be included in your medical record. HIV-positive test results (without any personal information) will be reported to local or state health departments to be counted in statistical reports. Anonymous testing means you don’t have to give your name when you take an HIV test. When you take the test, you receive a number. To get your HIV test results, you give the number instead of your name. Where can I get tested for HIV? • Your healthcare provider • Hospitals, medical clinics and community health centers • Use the CDC testing locator (gettested.cdc.gov) • Home testing kits from a pharmacy or online Each HIV test has a different window period. The window period is the time between when a person gets HIV and when a test can accurately detect HIV infection. Source: National Institutes of Health; U.S. Department of Health and Human Services. www.newpathlearning.com © Copyright NewPath Learning. All Rights Reserved. 94-6893Getting Tested Types of HIV tests There are three types of tests used to diagnose HIV infection: • _______________________________________________________ _______________________________________________________ • _______________________________________________________ _______________________________________________________ • _______________________________________________________ _______________________________________________________ What do test results mean? HIV Negative: __________________________________________________________________ _____________________________________________________________________________ HIV Positive: ___________________________________________________________________ _____________________________________________________________________________ Is HIV testing confidential? _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Where can I get tested for HIV? • _______________________________________________________ • _______________________________________________________ • _______________________________________________________ • _______________________________________________________ Why Get Tested? _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Source: National Institutes of Health; U.S. Department of Health and Human Services. www.newpathlearning.com © Copyright NewPath Learning. All Rights Reserved. 94-6893HIV Progression How is HIV monitored? Stages of HIV Infection Without treatment, HIV infection advances in stages, getting worse over time. HIV gradually destroys the immune system and eventually causes Acquired Immunodeficiency Syndrome ( AIDS ). CD4 cells HIV You want your CD4 count to be HIGH CD4 Cell Count You want your viral load to be LOW HIV Load Test Also called an HIV RNA test, tracks how many HIV particles are in a sample of blood. CD4 cells are specialized cells that destroy HIV. The higher the CD4 count, the healthier your immune system. There are three stages of HIV infection: Acute HIV Infection This is the earliest stage and it generally develops within 2 to 4 weeks after HIV infection occurs. During this time, some people have flu-like symptoms. HIV multiplies and spreads throughout the body, destroying CD4 cells. The level of HIV in the blood is very high, which greatly increases the risk of transmission. Chronic HIV Infection The second stage is chronic HIV infection . The virus continues to multiply in the body but at very low levels . People with chronic HIV infection may not have any HIV-related symptoms, but they can still spread HIV to others. Without treatment, chronic HIV infection usually advances to AIDS in about 10 years. AIDS This is the final, most severe stage of HIV infection. People with HIV are diagnosed with AIDS if they have a CD4 count of less than 200 cells/mm 3 or if they have certain opportunistic infections, such as pneumonia, toxoplasmosis, and tuberculosis (TB). Without treatment, people with AIDS typically survive about 3 years. In addition to other general health tests, blood tests will be used to monitor a patient with HIV infection. These test results will help the health care provider decide whether they should make changes to a patient’s treatment. Source: National Institutes of Health; U.S. Department of Health and Human Services. www.newpathlearning.com © Copyright NewPath Learning. All Rights Reserved. 94-6894HIV Progression How is HIV monitored? _____________________________________________________________________________ CD4 Count ______________________________________ ________________________________________________ Viral Load Test ___________________________________ ________________________________________________ Stages of HIV Infection _____________________________________________________________________________ _____________________________________________________________________________ There are three stages of HIV infection: Acute HIV Infection: __________________________________________________________ ___________________________________________________________________________ Chronic HIV Infection: ________________________________________________________ ___________________________________________________________________________ AIDS: _____________________________________________________________________ ___________________________________________________________________________ CD4 cells HIV Source: National Institutes of Health; U.S. Department of Health and Human Services. www.newpathlearning.com © Copyright NewPath Learning. All Rights Reserved. 94-6894B cell antibodies dendritic cell neutrophil virus Killer T-cell injects toxins to destroy infected cell macrophage chemical signals viral proteins CD4 Helper T-cell memory Helper T-cell Killer T-cell attacks virus directly APC Dendritic cell engulfs virus – presents viral proteins on cell surface Releases chemicals to initiate adaptive immune response Innate Defense – Barriers to infection (skin, mucus, cilia, etc.) Phagocytosis by neutrophils, macrophages and dendritic cells may lead to initiation of an Immune Response initiates immune response infected body cell engulfed by macrophage Adaptive Immune Response 1. APC (Antigen Presenting Cell) activates CD4 Helper T-cells 2. CD4 cells stimulate B-cells to make antibodies 3. Antibodies coat viruses so they can’t infect other cells, or mark them for destruction by phagocytes (like neutrophils) 4. Helper T-cells activate Killer T-cells to destroy pathogens & infected cells 2 3 4 1 The Immune System CDC scanning electron micrograph of HIV budding (green) from surface of T-cell (blue). Note the macrophage (pink). An infectious disease is a disease that can be spread from one organism to another. Many infectious diseases, such as HIV, are caused by organisms that are too small to see without a microscope. Organisms that are the cause of diseases are called pathogens. Body Defenses against Pathogens There are two main parts to the immune system – the innate and adaptive systems. These two immune systems complement each other in reactions to a pathogen or harmful substance, and are closely connected to each other. • Innate Immune System The innate immune system provides a general defense against pathogens, so it is also called the nonspecific immune system. It works mostly at the level of immune cells like scavenger cells or killer cells. These cells mostly fight bacterial infections. • Adaptive Immune System In the adaptive immune system, particular agents like antibodies target very specific pathogens that the body has already been exposed to. That is why it is called a learned defense or a specific immune respone. By constantly adapting and learning, the body can also fight against bacteria or viruses that change over time. How does HIV affect the immune system? Source: National Institutes of Health; U.S. Department of Health and Human Services. HIV specifically attacks Helper T cells ( CD4 ) and uses them to make copies of new viruses. Many T-cells are destroyed in the process. If the body cannot replace T-cells fast enough, the immune system becomes weakened and can no longer launch a specific immune response. The body becomes susceptible to many opportunistic infections. This immunodeficiency is described in the name acquired immunodeficiency syndrome, or AIDS. www.newpathlearning.com © Copyright NewPath Learning. All Rights Reserved. 94-6895The Immune System Pathogens & Disease _____________________________________________________________________________ _____________________________________________________________________________ Body Defenses against Pathogens Innate Immune System ___________________________________________________________ _____________________________________________________________________________ Adaptive Immune System _________________________________________________________ _____________________________________________________________________________ How does HIV affect the immune system? _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Draw an example of Innate Defense Draw an example of Adaptive Immune Response www.newpathlearning.com © Copyright NewPath Learning. All Rights Reserved. 94-6895 Source: National Institutes of Health; U.S. Department of Health and Human Services.HIV uses host cells (including CD4 cells) to replicate. HIV medicines can inhibit or stop the HIV life cycle at different stages of development. • Binding: CCRS Antagonist, Post-attachment Inhibitors • Fusion: Fusion Inhibitors • Reserve Transcriptions: NNRTIs, NRTIs • Integration: Integrase Inhibitors • Budding: Protease Inhibitors CD4 cell HIV new HIV Binding 1 Fusion 2 Reverse Transciption 3 Integration 4 Replication 5 Assembly 6 Budding 7 HIV DNA HIV structures HIV RNA CD4 DNA HIV Medications There are more than 30 HIV medicines approved by the U.S. Food and Drug Administration (FDA) to treat HIV infection. They are grouped into 7 drug classes according to how they fight HIV: • Non-nucleoside reverse transcriptase inhibitors (NNRTIs) • Nucleoside reverse transcriptase inhibitors (NRTIs) • Protease inhibitors (PIs) • Fusion inhibitors • CCR5 antagonists • Integrase strand transfer inhibitors (INSTIs) • Post-attachment inhibitors HIV Treatments HIV Care & Treatment There is no cure for HIV infection, but medicines (called antiretrovirals) can slow or prevent HIV from advancing from one stage to the next. These medicines also reduce the risk of HIV transmission to others. People on antiretroviral therapy (ART) take a combination of HIV medicines (called an HIV treatment regimen) every day. Treatment is most successful when a patient actively takes part. Overall, the benefits of HIV medicines far outweigh the risk of side effects. In addition, newer HIV regimens cause fewer side effects than regimens used in the past. ART can’t cure HIV, but HIV medicines can help people with HIV live longer, healthier lives. How do HIV medicines work? HIV medicines prevent HIV from making copies of itself, which reduces the amount of HIV in the body (also called the viral load ). Having less HIV in the body gives the immune system a chance to recover. Even though there is still some HIV in the body, the immune system is strong enough to fight off opportunistic infections and certain HIV- related cancers. A main goal of ART is to reduce a person’s viral load to an undetectable level. This means that the level of HIV in the blood is too low to be detected. People with HIV who maintain an undetectable viral load have effectively no risk of transmitting HIV to others. www.newpathlearning.com © Copyright NewPath Learning. All Rights Reserved. 94-6896 Source: National Institutes of Health; U.S. Department of Health and Human Services.CD4 cell 1 2 3 4 5 6 7 HIV DNA HIV structures HIV RNA CD4 DNA HIV Treatments How do HIV medicines work? _____________________________________________________________________________ _____________________________________________________________________________ List HIV Medications _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Describe HIV Care & Treatment _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ________________________ ________________________ ________________________ ________________________ ________________________ ________________________ ________________________ ________________________ ________________________ ________________________ ________________________ ________________________ www.newpathlearning.com © Copyright NewPath Learning. All Rights Reserved. 94-6896 Source: National Institutes of Health; U.S. Department of Health and Human Services.Living with HIV Dealing with HIV Stigma HIV-related stigma refers to negative beliefs, feelings and attitudes towards people living with HIV, their families, HIV health care providers, and members of groups that have been heavily impacted by HIV, such as gay and bisexual men, homeless people, street youth, and mentally ill people. HIV discrimination refers to the unfair and unjust treatment of someone based on their HIV status. HIV discrimination is often fueled by false information about HIV and AIDS, and pre-existing biases against certain groups or sexual behaviors. People with HIV are entitled to the same rights as any other patient in the medical system. These rights include safety, competent medical care, and confidentiality. The Americans with Disabilities Act (ADA) protects people who are discriminated against because they have HIV or have a relationship with someone with HIV. Eat Healthy Following a healthy diet provides the body with energy & nutrients to fight HIV and other infections; helps maintain a healthy weight; improves absorption of medicines; helps manage potential side effects. Stay Active Exercise can help maintain good physical and mental health. It can increase strength, endurance, fitness, and help the immune system work better to fight infections. Don’t Smoke People that live with HIV who smoke may have a poorer response to antiretroviral therapy (ART). They also have a shorter lifespan than people with HIV who do not smoke. Take Medications Effective treatment depends on taking HIV medicines every day and exactly as prescribed. Keep all appointments with health care providers. Take HIV medications every day Get recommended vaccines Use condoms during sex Limit alcohol Don’t smoke or use drugs Eat healthy food Be active every day Keep all medical appointments Staying Healthy with HIV www.newpathlearning.com © Copyright NewPath Learning. All Rights Reserved. 94-6897 Source: National Institutes of Health; U.S. Department of Health and Human Services.Next >