Question

For the past several weeks, Mr. A has been feeling run down, and he has noticed a weight loss of 10 pounds over the past month. He reports night sweats and a nagging cough that just would not go away. His TB skin test was positive, and the diagnosis was confirmed with a blood test and sputum culture. Mr. A had been healthy up until about 9 months ago when he started noticing that he stayed sick all the time. He said, “It just seems like my immune system is gone.”

1. Why has the health care provider ordered an HIV test?
2. What additional manifestations would possibly indicate HIV?
3. Mr. A is devastated that anyone would even think he had HIV because he has never “been with another man.” Upon what information will the nurse base the response?
4. Mr. A’s HIV ELISA test was positive. What is the next step in diagnosis?

Mr. A is shocked at the news that he has HIV since he has never been stuck with a contaminated needle, has never had sex with a man, and has been in a monogamous heterosexual relationship for the past 6 months and she does not have HIV.

5. What could be the source of his infection?
6. What is the significance of the window period?
7. Several months later, Mr. A’s CD4⁺ T-cell count is 250 cells/µL and he has several painful lymph nodes. What are the three stages of HIV infection, and what is Mr. A’s current status?
8. Mr. A was started on a combination of medications and he wants to know why he has to take so many and if he will be cured. How will the nurse respond?
9. What is wasting syndrome?

Answer 1

AIDS is caused by the HIV virus. When it enters into the body it results in profound immunosuppression and opportunistic infections, malignancies, wasting, and CNS degeneration. The HIV attack CD4+ T lymphocytes (helper T cells)- enabling normally harmless organisms to cause deadly infections.

While HIV is a virus that may cause an infection, AIDS (which is short for acquired immunodeficiency syndrome) is a condition.

*In the present scenario, Mr A has been feeling run down, and he has noticed a weight loss of 10 pounds over the past month. He reports night sweats and a nagging cough that just would not go away. His TB skin test was positive, and the diagnosis was confirmed with a blood test and sputum culture. Mr A had been healthy up until about 9 months ago when he started noticing that he stayed sick all the time. He said, “It just seems like my immune system is gone.”

1. Why has the health care provider ordered an HIV test?

The patient who has got the HIV infections are profound immunosuppression prone to get the opportunistic infection and one of the common is T.B infections and are the common cause of death in HIV patients.

2. What additional manifestations would possibly indicate HIV?

The symptoms of HIV infection are acute, mono-like syndrome with fever, fatigue, myalgias, sore through, night sweats, GI problems, weight loss, nagging cough, lymphadenopathy, maculopapular rash and headaches. Here for Mr A is showing the symptoms of HIV such as fatigue, night sweats, weight loss, nagging cough as well his test for T.B was positive.

3.Mr. A is devastated that anyone would even think he had HIV because he has never “been with another man.” Upon what information will the nurse base the response?

Mr.A, he has never been stuck with a contaminated needle, has never had sex with a man, has been in a monogamous heterosexual relationship for the past 6 months and she does not have HIV, maybe she is in the window period of HIV.

4.Mr. A’s HIV ELISA test was positive. What is the next step in diagnosis?

Here Mr.A having the HIV ELISA test was positive, a follow-up test will be conducted. If the follow-up test is also positive, it means he is HIV-positive.or we can say that a positive ELISA test is usually confirmed by means of another subsequent ELISA test.

or an HIV western blot assay, nowadays it is not practising.

5. What could be the source of his infection?

Maybe his partner could be the source of infection if Mr, A never had a contaminated needle prick or never had sex with a man.

6. What is the significance of the window period?

Window period means it is the time between infection and when HIV can be detected on a test. During the window period, a person can be infected with HIV and be very infectious but still test HIV negative. The length of the window period varies depending on the test used. During the window period, a person can have a negative result on an HIV test despite having HIV.

7. Several months later, Mr A’s CD4⁺ T-cell count is 250 cells/µL and he has several painful lymph nodes. What are the three stages of HIV infection, and what is Mr A’s current status?

*Stage 1 (HIV Infection):

CD4+ cell count of at least 500
- Flu-like illness; occurs one to six weeks after infection
- Mild symptoms
- The infected person can infect other people

*Stage 2 (HIV Infection):

CD4+ cell count of 350-499
- Free from symptoms
- Maybe swollen glands
- HIV antibodies are detectable in blood

*Stage 3((Advanced HIV Disease/AHD):

-CD4+ cell count 200-349
- Immune system deteriorates and symptoms start
- Opportunistic infections and cancers start to appear

Here Mr A.is the Stage 3 of HIV

8.Mr. A was started on a combination of medications and he wants to know why he has to take so many and if he will be cured. How will the nurse respond?

- The immune system weakens too much as CD4 cells decrease
- AIDS is confirmed in the patient with HIV whose CD4+ T-Cell count is less than 200; cannot revert back from HIV if the count goes up.

If you are showing the compliance with the treatment the condition will be improved and not goes to the stage of AIDS.

9. ?What is wasting syndrome?

The condition may occur in people with advanced HIV disease and consists of unwanted weight loss of 10% or more of a person's body weight. The treatment for this consists of having a diet high in calories and protein to prevent muscle loss.