HIV & STI notes

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Yr 4: HIV & STI notes

Highly Active Antiretroviral Therapy - HAART:

Highly Active Antiretroviral Therapy - HAART Nucleoside Reverse Transcriptase Inhibitors (NRTIs eg Zidovudine) +/- Nucleotide Reverse Transcriptase Inhibitor (eg Tenofovir) Protease Inhibitors ( PIs eg Kaletra) Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs eg Efavirenz) + or

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0 5 10 15 20 25 30 35 40 Year Unintentional injury Cancer Heart disease Suicide HIV infection Homicide Liver disease Stroke Diabetes *Preliminary data Trends in Rates of Death from Leading Causes of Death Among Persons 25-44 Years Old, USA, 1982-1997 From national vital statistics, Centers for Disease Control & Prevention Deaths per 100,000 Population 82 84 86 88 90 92 94 96 83 85 87 89 91 93 95 97 *

HIV and AIDS diagnoses and deaths, UK:

HIV and AIDS diagnoses and deaths, UK Numbers will rise, for recent years, as further reports are received. Clinician reports of new HIV/AIDS diagnosis

HIV diagnoses by exposure category, UK:

HIV diagnoses by exposure category, UK Numbers will rise, for recent years, as further reports are received. Clinician reports of new HIV/AIDS diagnosis

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Primary HIV Infection

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Seborrhoeic dermatitis Eosinophilic folliculitis

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Facial and perianal HPV

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Facial Molluscum contagiosum

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Oral and nasal Herpes Simplex

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Severe psoriasis

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Severe Herpes simplex

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Herpes zoster

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Oral Candida

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Kaposis sarcoma

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KS

Bronchoscopic views - KS:

Bronchoscopic views - KS

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TB

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PCP

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Cerebral toxoplasmosis

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Primary CNS lymphoma

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HIV related cerebral atrophy

Genital HPV Infection:

Genital HPV Infection Genital warts Subclinical infection detected by colposcope Subclinical infection detected by DNA or RNA probes Prior infection - evidenced by antibodies No prior or current infection Adapted from Koutsky L. Am J Med 1997; 102(5A): 3-8 25% 60% 10% 4% 1%

How STIs disseminate:

Ro = B x c x D Basic Reproductive rate Transmission efficiency Rate of sex partner change Duration of infectiousness How STIs disseminate

Malignant HPV-Associated Disease:

Malignant HPV-Associated Disease Invasive cervical cancer vulvar/anal/vaginal cancer Photographs courtesy of Professor Gerd Gross and Dr Renzo Barrasso

Oral signs:

Oral signs

Skin signs:

Skin signs

Case 1:

Case 1 Vulva was normal Cervix looked like this Chlamydia positive

Case 2:

Case 2 What in the examination might distinguish between them? Vulvitis:

Case 2 Appearance of discharge:

Case 2 Appearance of discharge

Case 3 appearance of cervix:

Case 3 appearance of cervix

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