Nursing AIDS


The Disease, The Stats, The Battle for Nursing Care
By: Debra Duttchen & Susan Gerritsen



Pathophysiology

Human immunodeficiency virus (HIV), the virus the causes acquired immune deficiency syndrome (AIDS), was first diagnosed in North America in 1983. HIV disease is characterized �by the gradual deterioration of immune function� (NIAID, 2001). �Immune cells called (Cluster Designation) CD4+ T cells are disabled and killed during the typical course of infection� (NIAID, 2001). CD4+ T cells are sometimes referred to as �helper T cells. A healthy, uninfected individual has a CD4+T cell count of approximately 800 to 1200mm3. As the HIV disease progresses, infected individuals CD4+T cell count gradually falls. Once the CD4+T cell count falls below 200mm3, the individual becomes �vulnerable to opportunistic infections and cancers that typify AIDS� (NIAID, 2001).

Transmission

There are three major routes of HIV transmission. The most common is sexual intercourse with an infected partner. The second route of transmission involves contact with infected blood; this includes transfusion of blood or blood parts, or sharing of contaminated needles or syringes. The third major route of infection is pre or perinatal. �Almost all HIV-infected children acquire the virus from their mothers before or during birth� (NIAID, 2001).

Glossary
apoptosis:
cellular suicide, also known as programmed cell death. HIV may induce apoptosis in both infected and uninfected immune system cells.
B cells:
white blood cells of the immune system that produce infection-fighting proteins called antibodies.
CD4+ T cells:
white blood cells that orchestrate the immune response, signalling other cells in the immune system to perform their special functions. Also known as T helper cells, these cells are killed or disabled during HIV infection.
CD8+ T cells:
white blood cells that kill cells infected with HIV or other viruses, or transformed by cancer. These cells also secrete soluble molecules that may suppress HIV without killing infected cells directly.
cytokines:
proteins used for communication by cells of the immune system. Central to the normal regulation of the immune response.
cytoplasm:
the living matter within a cell.
B cells:
white blood cells of the immune system that produce infection-fighting proteins called antibodies.
cytokines:
proteins used for communication by cells of the immune system. Central to the normal regulation of the immune response.
follicular dendritic cells (FDCs):
cells found in the germinal centers (B cell areas) of lymphoid organs. FDCs have thread-like tentacles that form a web-like network to trap invaders and present them to B cells, which then make antibodies to attack the invaders.
Kaposi's sarcoma:
a type of cancer characterized by abnormal growths of blood vessels that develop into purplish or brown lesions. killer T cells: see CD8+ T cells.
lentivirus:
"slow" virus characterized by a long interval between infection and the onset of symptoms. HIV is a lentivirus as is the simian immunodeficiency virus (SIV), which infects nonhuman primates.
lymphoid organs:
include tonsils, adenoids, lymph nodes, spleen and other tissues. Act as the body's filtering system, trapping invaders and presenting them to squadrons of immune cells that congregate there.
opportunistic infection:
an illness caused by an organism that usually does not cause disease in a person with a normal immune system. People with advanced HIV infection suffer opportunistic infections of the lungs, brain, eyes and other organs.
pathogenesis:
the production or development of a disease. May be influenced by many factors, including the infecting microbe and the host's immune response.
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