Acquired Immunodeficiency Syndrome




Risk





  • USA incidence of HIV: 50,000 per year



  • USA prevalence of HIV: 1.2 million




    • Sub-Saharan Africa prevalence: 25.8 million in 2014




  • USA prevalence of AIDS (HIV stages 3 and 4): 26,688




    • All but 8 were age 13 or older






Perioperative Risk





  • Susceptibility to infection



  • Drug interactions



  • Occupational exposure/viral transmission





Perioperative Risk





  • Susceptibility to infection



  • Drug interactions



  • Occupational exposure/viral transmission





Overview





  • AIDS is the clinical syndrome representing the late and more severe stages of infection with HIV.



  • Once inside the host, HIV attaches and is internalized to CD4+ T4 helper lymphocytes. Viral RNA is transcribed into the cell’s DNA allowing formation of viral progeny within the host. Host’s CD4+ T4 helper lymphocytes become defective and unable to help fight opportunistic infections and neoplasms causing progressive immunocompromisation.



  • In 2007 WHO published a clinical classification system for HIV/AIDS; stages 1 to 4 are based on clinical symptoms and presence of associated illnesses, and AIDS is defined by the presents of features of stages 3 and 4.





Etiology





  • Transmission can occur when there is contact between HIV-infected blood or contaminated body fluids and open wounds, broken skin, or mucus membranes.



  • During sexual encounters, delivery of a fetus, breastfeeding, inoculation by contaminated needles, and occupational exposure.





Usual Treatment





  • Regimen of HAART.




    • Target different stages in HIV replication cycle.




  • Pts may be taking additional drugs, both for treatment and for prophylaxis targeting associated illnesses, such as other antivirals, antifungals, antibiotics, and/or chemotherapy drugs.


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Sep 1, 2018 | Posted by in ANESTHESIA | Comments Off on Acquired Immunodeficiency Syndrome

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