Abstract

HIV (Human Immunodeficiency Virus) is a virus, which attacks the immune system of the body. It is the virus, which is responsible for causing AIDs (Acquired Immunodeficiency Syndrome), which is a condition of lack of body immunity. This paper discusses what HIV is, signs and symptoms, causes, HIV pathophysiology, nursing assessment and implications, medication, risk factors, and nursing considerations.

HIV

HIV (Human Immunodeficiency Virus) is a virus: lentivirus, which attacks the immune system of the body. HIV belongs to the virus family known as retrovirus (WHO, 1998). It is the virus, which is responsible for causing AIDs (Acquired Immunodeficiency Syndrome), which is a condition of lack of body immunity. HIV damages a specific type of white blood cells known as CD4+/T4 cells (CDC, 2006). CD4+/T4 cells are the cells that help the body to fight infections, which causes various types of diseases. HIV destroys these cells, causing their number to reduce in the body. With a low number of CD4+ cells, the body is unable to guard itself against infections; including opportunistic infections (CDC, 2006).

When HIV stays in the body for a long time without treatment or rather control, it results into AIDs. This implies that infection with HIV does not mean that somebody has acquired AIDs. Early diagnosis of HIV helps in its treatment and/or control, in order to prevent it from progressing to its last stage, which is AIDs. Therefore, with early intervention, HIV can be treated in order to slow it down, or even stop it from damaging the white blood cells (CDC, 2006).

HIV is spread from one person to another in a number of ways. They are transfer of blood, vaginal fluids, breast milk, semen, and pre-ejaculate from the body of an infected person to another. This means that, having unprotected sexual intercourse with a person infected with HIV can result into acquisition of HIV. However, research studies indicate that individuals who have unprotected anal sex have a high risk of acquiring HIV than those who have unprotected vaginal sex. According to study conducted by CDC (2006), “among men who have sex with other men, unprotected receptive anal sex is riskier than unprotected insertive anal sex.” In addition, having sexual intercourse with more than one partner increases the risk of acquiring HIV, especially in the presence of sexual transmitted diseases. Additionally, oral sex can also lead to infection with HIV especially when it is unprotected.

An infected mother can pass HIV to a child either before birth, during birth, or when breastfeeding. A lot of care is observed when an infected mother is expecting a child, and even after birth of the child to avoid the risk of spreading the virus from the mother to the child. Sharing of needles or other sharp objects also increases the risk of acquiring HIV. High prevalence rate of HIV is usually present among the drug abusers because in many cases, they share needles and syringes when injecting the drugs into their bodies. Blood transfusion from an infected person to uninfected person automatically results to spread of HIV.

During the early stages of infection with HIV, the symptoms are usually not very clear. At first, probably within the first three or four months of infection, an individual may experience headaches, muscle and joint aches, fever, skin rashes, sore throat, and swollen glands. In many cases, these signs and symptoms are confused to be sign and symptoms of flu or common colds (Cichocki, 2009). These symptoms usually disappear within two or three weeks. An individual can then stay for quite a number of years without experiencing any of the signs and symptoms of HIV. If such a person does not seek treatment, then the HIV continues to destroy the CD4+ cells, thus weakening the body’s immune system. At a certain point, when the CD4+ cells count is very low: very weak body immune system, the aforementioned signs and symptoms reappear, and this time, they do not disappear at all. Others symptoms such as weight loss, feelings of extreme tiredness, excess sweats especially during the night, high fever, and swollen lymph nodes accompany the aforementioned symptoms (Cichocki, 2009).

The pathophysiology of HIV is as follows. When the body is infected with HIV, the body experiences the ‘window effect’ (CDC, 2006). Window effect entails production of anti-HIV antibodies by the body. These antibodies stay in the body for quite some time before they disappear. Usually, detection of anti-HIV antibodies is possible within four to six months after infection (CDC, 2006). Once HIV is in the body, it attacks cells such as macrophages, lymphocytes, neuron cells, and the langerhans (CDC, 2006). Once inside these cells, they are able to attach themselves on the surface of T4 cells, which is made of protein molecules known as CD4. Since the surface of T4 cells is made of protein molecules: CD4, the HIV penetrates inside CD4 until it enters inside T4 cells (CDC, 2006).

Once inside T4 cells, HIV inserts its genetic materials into the nucleus of the T4 cells. The HIV genetic materials take over T4 cells and HIV starts to duplicate itself (CDC, 2006). HIV does this to as many T4 cells as possible. Invasion and replication of HIV inside T4 cells causes T4 cells to die. The body is then left with HIV genetic materials. HIV is able to mature and reproduce very rapidly. Therefore, with time, HIV dominates the body immune such that the body is unable to distinguish the ‘invaders’ (CDC, 2006). The more the HIV genetic materials stay in the body for a long time without treatment, the more the body’s immune system become weak and eventually, results into AIDs.

Nursing assessment of an individual infected or suspected to be infected with HIV entails testing for presence of HIV antibodies in urine or mouth fluids. If HIV antibodies are found in urine or mouth fluid, a blood test is taken for confirmation purposes. Once a nurse confirms presence of HIV antibodies in a patient, baseline assessment entails assessing the patient’s medical and social history (Simmons, 2002). This includes asking the patient when he/she became HIV+, if the patient has other diseases such as TB, whether the patient has ever hand complications related to HIV or had a surgery, or even admitted to hospital for HIV. Others include determining presence of STDs, if any other member of the family has HIV, and the social and economic status of the patient’s family. The next assessment entails physical examination where a nurse checks the patient’s weight, general appearance, and status of lymph nodes, abdomen, lungs, chest, and skin (Simmons, 2002). A nurse can then undertake laboratory tests to check the CD4 count and other tests such as CBC if needed. Once HIV antibodies are found to be presence in the blood, a nurse develops an intervention plan. This includes putting a patient under antiretroviral therapy in order to boost the patient’s immune system, as well as treatment of all opportunistic infections found in the patient. It also entails symptoms management and nutrition management, among others (Simmons, 2002).

Nursing implications to HIV patients include providing support to HIV patients’ caregivers through educating them on things such as nutrition management, physical care, symptoms management, and universal precautions (Vitiello & Winters, 2004). However, the main nursing implication in HIV is pain control and ensuring maintenance of patient’s dignity (Vitiello & Winters, 2004). Currently, the only available treatment for HIV is antiretroviral therapy (ART). ART entails taking various combinations of medicines, which help to boost the body immunity but do not cure HIV. The main risk factor of HIV, if it stays in the body for a long period without treatment is death. Other risk factors include acquisition of opportunistic infections, TB, and different types of cancer, which are usually rare. Nursing considerations when handling HIV patients include assessing the HIV stage in order to develop an appropriate intervention plan, and the patient’s and patient’s family attitudes towards the infection.

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