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R. Reti, D. Findlay (eds.)Oral Board Review for Oral and Maxillofacial Surgeryhttps://doi.org/10.1007/978-3-030-48880-2_23
23. Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome
Human immunodeficiency virus (HIV)SeroconversionHighly active antiretroviral therapy (HAART)Acquired immunodeficiency syndrome (AIDS)Pneumocystis jirovecii pneumoniaKaposi’s sarcomaProgressive multifocal leukoencephalopathy
Definition/Pathophysiology
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HIV is an RNA retrovirus that infects CD4 cells that causes varying levels of immunosuppression with the possible progression to AIDS.
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AIDS – the result of progressive HIV infection in which a person has a weakened immune system and meets specific diagnostic criteria (see below).
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HIV is an infectious disease transmissible by sexual contact, exposure to infected blood/organ donations, perinatally, or via IV drug abuse.
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For several years, HIV-infected patients can remain clinically asymptomatic; however, during this phase the CD4 count gradually decreases complicated with development of opportunistic infections, autoimmune conditions, and neoplasms.
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HIV infection can manifest itself along a continuum as it may progress from initial infection to latency to progression to AIDS.
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According to the Centers for Disease Control (CDC), a patient has AIDS in the presence of HIV in combination with:
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1.
A CD4+ T-cell count of 200 cells/μL or less.
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2.
A CD4+ T-cell percentage of total lymphocytes of 15% or less.
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3.
One or more of AIDS-defining illnesses (Table 23.1).
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AIDS defining illnesses
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Burkitt’s lymphoma |
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Candidiasis of bronchi, esophagus, trachea, or lungs |
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Coccidioidomycosis |
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Cryptococcosis, extrapulmonary |
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Cryptosporidiosis, chronic intestinal for longer than 1 month |
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Cytomegalovirus (CMV) |
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Encephalopathy (HIV-related) |
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Herpes simplex |
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Histoplasmosis |
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Invasive cervical cancer |
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Kaposi’s sarcoma (KS) |
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Lymphoma |
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Mycobacterium avium complex (MAC) |
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Mycobacterium tuberculosis |
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Pneumocystis jirovecii pneumonia |
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Progressive multifocal leukoencephalopathy |
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Salmonella septicemia |
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Toxoplasmosis of the brain |
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Wasting syndrome |
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