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HIV Pathology


Main Subtypes of HIV-1 ? * Group M, Subtype B (Americas/Europe)... * Seeing Group O now bc of immigrants
HIV-2 ? * Mainly in commercial sex-workers/Africas
HIV-1 tests ? * do not show HIV-2 or Group O from HIV-1... * need specific tests for these types
HIV-1 basics Hx ? * 50-90% with mild, self-limited, flu-like disease – nothing big... * Antibody test is always negative early on... * Tests to use are: p24 antigen positive and PCR tests positive
Early HIV ? * CD4 lowers and then rebounds, causing viremia to lower to get latent stage... * antigens are - bc virus is replicating in cells and HIV EIA is +.... * latency can last months to many years
CD4+ measurements do what ? * monitors HIV, not Dx it... * When CD4 lvls drop, latency is up and it becomes emergent again, and makes the person susceptible to opportunistic pathogens and secondary neoplasms
What Syncytia formation means ? * ppl that have this development have a lot worse prognosis
What is an HIV superinfection ? * someone with HIV becomes infected with a totally different subtype..... * Get recurrent HIV Sx.... * Restricted to window period of less than 3 years post infection
HIV and lab testing ? * CD4 count .... * HIV-1 DNA (sensitive in infants).... * HIV-1 RNA - best monitoring test, but $$$
HIV-1 Genotype and Phenotype ? * Genotype - looks at genetic makeup to see if superinfections or what mutations to see what meds to use.... * Phenotype - best to see drug/bug combos to use
Odd thing that seems to lower the mortality rate of HIV ? * HIv plus Hep-G infection
Pneumocystis jiroveci infection and stain needed to see it ? * Fungus that is airborne that causes pneumonia.... * See it on a GMS stain (silver stain)
Pneumocystis jiroveci what we see Cx and how to Dx ? * we see foamy exudates in the alveloi.... * A BAL is best for tissue Dx
Cytomegalovirus (CMV)what we see and what we see morphologically ? * it causes CMV retinitis, that causes blindness--- see it on a fundascopic exam.... * Morpho = see viral intranuclear & intracytoplasmic inclusions.... * it is a reactivation of the virus, not a reinfection
Mycobacterium avium Complex (MAC)morpho and Cx ? * use acid fast stains to see it, and it has a yellow color on gross exam..... * see no granulomas and is usually a Reinfection
Mycobacterium tuberculosis (MTB) ? * Reactivation of previous TB, no yellow color,and see small granulomas
Coccidioides immitis Infection where we see it and its morpho ? * found in Southwestern US & Mexico in dusty areas .... * morpho = thick walled spherules containing endospores
Cryptococcus neoformans causes what, how to test, and morpho ? * most common causes meningitis = headache/disorientation .... * test using a CSF lumbar puncture w/ India Ink Stain.... * morpho = mucoid exudate
Toxoplasma gondii Infection ? * causes headaches and see in ppl with Cats....
JC Polyoma Virus Infection ? * infection of oligodendrocytes --> CNS demyelination --> Progressive Multifocal Leukoencephalopathy (PML).... * Dymylination of the white matter
Herpesvirus Infection * see disseminated infections of blisters all over the body... * see Intranuclear inclusions w/ ground glass appearance
Candida Infections ? * budding white yeast with pseudohyphae in the GI/Resp Tract
Histoplasma capsulatum Infection ? * seen in bird roosting sites in the Mississippi, Ohio & St. Lawrence river valleys..... * yeasts inside macros and neutrophils.... * infect bone marrow
Gastrointestinal Protozoal Infections ? * diarrhea by Giardia and Cryptosporidia
Kaposi Sarcoma ? * See purple plaques on the body.... * seen in men with HIV.... * by HHV-8/KSHV.... * see in the heart and are a vascular tumor
Lymphoma ? * Primary CNS Lymphoma = HIV + EBV .... * Body cavity lymphomas = HIV + KSHV
Squamous cell carcinoma of uterine cervix and anus cancer ? * HPV positive and is reactivation of the infection
Created by: thamrick800