Watson J, Kietrys DM, Galantino ML. HIV Fact Sheet for Clinicians (2014)
FACT SHEET FOR CLINICIANS
HIV DISEASE
HIV SCREENING AND TESTING:
DEFINITION: Human immunodeficiency virus (HIV) is a retrovirus that infects and destroys helper T cells (CD4 cells) of the immune system. If untreated, the HIV disease will progress to an advanced stage (acquired immunodeficiency syndrome or “AIDS”)1
HIV EPIDEMIC IN THE UNITED STATES:
1981: First recognized cases of HIV 2 Currently approximately 1.1 million people living with HIV 2 1 out of 5 do not know they are infected because they have not been tested 2 Approximately 50,000 new infections every year2 Increased prevalence rate of new infections in African Americans, with African American females representing the greatest number of new cases 2‐4 Populations at risk also include: IV drug users; men who have sex with men (MSM)2,4
TRACKING OF DISEASE PROGRESSION:
TRANSMISSION AND PREVENTION: 5
Infection transmitted through bodily fluids: semen, vaginal fluid, blood, blood derived fluid, breast milk Routes: o Sex o IV drug use o Intrauterine or during birthing process o Blood to blood contact NOT transmitted through saliva, sweat, or tears HIV does not survive long outside of the body and cannot reproduce once outside of the host 2,5 Standard Precautions should be taken with patients with HIV disease (as with all patients)
Rapid HIV Antibody Testing o Typically involves oral swab or small volume blood sample6 o Results in approximately 20 minutes 6 o If positive, needs to be confirmed with Western Blot or Enzyme Immunoassay Test (EIA) 6‐9, 11 Ora‐Quick ® 6,10 o First FDA approved at home test for HIV o Utilizes oral swab testing o Can be purchased over the counter The potential of screening negative for HIV is possible up to 6 months post exposure. It is recommended that testing be completed every 3‐6 weeks for 6 months post exposure.
CD4 Count: 12 CD4 count marks the degree of immunocompromise. It measures the number of CD4 cells per µL of blood. In a healthy individual the CD4 count should be between 500‐ 1500cells/µL. A person living with HIV is diagnosed with AIDS if their CD4 count falls below 200cells/µL. C4:C8 Ratio: 12 This test looks at the CD4/CD8 lymphocyte ratio and is a reflection of immune system health. A normal ratio is between 1 and 4. Less than 1 is indicative of a decline in CD4 cells. Viral Load (VL):12‐ 14 Viral load indicates the number of copies of HIV RNA/µL of plasma. This measurement is an indicator of the magnitude of viral replication. VL in a HIV+ individual who is successfully treated with anti‐ retroviral drugs should be “undetectable” (