Iv site infection symptoms: IV Line Infection – HSE.ie
IV Line Infection – HSE.ie
An intravenous (IV) line is a small plastic tube that goes into your vein. It is used to give you blood, fluid or medicine.
An IV line is also known as a cannula or drip. A needle is used to put the line through your skin into your vein.
How you get an IV line infection
An IV line creates a small hole in your skin. There is a risk that bacteria will travel along the tube and into your body.
IV lines are useful but can cause problems. They can become blocked, leak fluid into the skin and cause infection.
Preventing an IV line infection
It is OK to ask a doctor or nurse:
- if you really need an IV line. If you don’t have an IV line, you’re less at risk of getting an infection
- to clean their hands before they put in or touch your IV line
- to clean your skin before putting the IV line in
- if you still need an IV line in – the longer it’s in, the greater the risk of infection
It is OK to ask someone caring for you to clean their hands.
Symptoms of an IV line infection
Symptoms of IV line infection include:
- pain where your IV line is
- redness or swelling near the IV line
- crusting or scabbing appears on skin near your IV line
- oozing fluid, blood or pus from where the IV line goes through your skin
Talk to your doctor or nurse straight away if you notice any of these symptoms.
Septicaemia (bloodstream infection) is a serious infection. It happens when bacteria spread to your blood.
Septicaemia bloodstream infection can cause:
- a high temperature
- nausea (feeling sick)
Tell your doctor or nurse straight away if you notice any of the above.
Causes of an IV line infection
An IV line is more likely to cause an infection in people who are already very sick.
There are lots of people in hospital with infections or superbugs. It’s easy for these to spread in hospital.
Treatment of an IV line infection
Your doctor or nurse will talk to you about taking out the IV line and any treatment you might need. This may include antibiotics.
page last reviewed: 22/11/2019
next review due: 22/11/2022
What is Phlebitis: Symptoms, Causes and Treatment
Phlebitis (fle-BYE-tis) means inflammation of a vein. Thrombophlebitis is due to one or more blood clots in a vein that cause inflammation. Thrombophlebitis usually occurs in leg veins, but it may occur in an arm or other parts of the body. The thrombus in the vein causes pain and irritation and may block blood flow in the veins. Phlebitis can occur in both the surface (superficial) or deep veins.
- Superficial phlebitis affects veins on the skin surface. The condition is rarely serious and, with proper care, usually resolves rapidly. Sometimes people with superficial phlebitis also get deep vein thrombophlebitis, so a medical evaluation is necessary.
- Deep vein thrombophlebitis affects the larger blood vessels, usually deep in the legs. Large blood clots can form, which may break off and travel to the lungs. This is a serious condition called pulmonary embolism.
Superficial phlebitis can be a complication due to a medical or surgical procedure.
Injury to a vein increases the risk of forming a blood clot. Sometimes clots occur without an injury. Some risk factors for thrombophlebitis include the following:
- Prolonged inactivity – Staying in bed or sitting for many hours, as in a car or on an airplane, creating stagnant or slow flow of blood from the legs in a dependent position (This pooling of blood in the legs leads to thrombus formation.)
- Sedentary lifestyle – Not getting any exercise
- Smoking cigarettes
- Certain medical conditions, such as cancer or blood disorders, that increase the clotting potential of the blood
- Injury to your arms or legs
- Hormone replacement therapy or birth control pills
- Varicose veins
There is usually a slow onset of a tender red area along the superficial veins on the skin. A long, thin red area may be seen as the inflammation follows a superficial vein. This area may feel hard, warm, and tender. The skin around the vein may be itchy and swollen. The area may begin to throb or burn.
Symptoms may be worse when the leg is lowered, especially when first getting out of bed in the morning. A low-grade fever may occur. Sometimes phlebitis may occur where a peripheral intravenous line was started. The surrounding area may be sore and tender along the vein.
If an infection is present, symptoms may include redness, fever, pain, swelling, or breakdown of the skin.
Deep vein phlebitis
This can be similar in presentation to superficial phlebitis, but some people may have no symptoms.
One may have pain and swelling throughout the entire limb. For example, the lower leg may swell for no apparent reason. Some people also get fever from a superimposed bacterial infection and skin discoloration or ulcers if the condition becomes chronic and was inadequately treated earlier.
When to Seek Medical Care
Call your health care provider if you have signs and symptoms of swelling, pain, and inflamed superficial veins on the arms or legs. If you are not better in a week or two or if it gets any worse, get reevaluated to make sure you don’t have a more serious condition.
Deep vein thrombophlebitis requires immediate medical care. If you have any of these signs and symptoms, go to a hospital emergency department for evaluation:
- High fever with any symptoms in an arm or leg
- Lumps in a leg
- Severe pain and swelling in an arm or leg
- New, unexplained shortness of breath, which could be the first tip-off that a blood clot has already traveled to your lung; call 911if you are having trouble breathing.
Exams and Tests
Your health care provider will examine you and ask questions about your symptoms.
D-dimer is a blood test that measures a substance that is released as a blood clot dissolves. If this blood test is negative, and you have no risk factors, then it is unlikely that you have a blood clot.
Ultrasound can detect clots or blockage of blood flow, especially in larger, more proximal (upper leg) veins. A small hand-held instrument (probe) is pressed against your skin to help identify blood clots and where the obstruction is. This is a painless, noninvasive test.
Occasionally a venogram is needed to identify blood clots in the smaller, more distal veins. This is an invasive procedure that requires injecting X-ray dye or contrast material into a vein on the foot, then an X-ray is taken of the flow of the dye up the leg.
Phlebitis Treatment Self-Care at Home
An anti-inflammatory drug, such as aspirin or ibuprofen, can help lessen the pain and inflammation of superficial phlebitis. But check with your doctor first.
If you increase your walking, you increase blood flow. This helps prevent blood clots from developing.
Prescription leg compression stockings (knee or thigh high) improve your blood flow and may help to relieve your pain and swelling.
Avoid bed rest for prolonged periods. It can make your symptoms worse.
If you have deep vein thrombophlebitis, you may need to stay in the hospital for a few days for diagnosis and treatment to ensure that no complications occur.
If your evaluation shows superficial phlebitis and you are otherwise healthy, you can likely go home. You will need to use compression stockings and probably anti-inflammatory medications to control your symptoms. Additional management involves elevation of the arm/leg and application of warm compresses. Only a few cases require antibiotics.
If you have a history of deep vein thrombophlebitis, or if the phlebitis might possibly spread to the deep veins, you will need to take a blood thinner (anticoagulant). The duration of anticoagulant treatment is usually between 3-6 months or 3-12 months if this is the first time you’ve had DVT.
If you have signs of infection, you will need to take an antibiotic.
If the superficial phlebitis has progressed to involve the deep veins, then it is a serious condition that may even require hospital admission for treatment and further evaluation.
Next Steps Outlook
Phlebitis in the superficial veins is rarely serious and usually responds to pain control, elevation, and warm compresses for 1-2 weeks.
Media file 1: Superficial and deep vein systems in the leg.
Synonyms and Keywords
phlebitis, blood clot in the arm, blood clot in the leg, deep venous thrombophlebitis, thrombophlebitis, superficial vein thrombophlebitis, superficial phlebitis, thrombus, inflammation of a vein, deep vein thrombophlebitis
Superficial Vein Phlebitis: Treatment & Complications
Any vein can develop a blood clot. Blood clots in the deep veins are called deep vein thrombosis, or DVT. Blood clots in the superficial veins are called superficial vein thrombophlebitis…or SVT. Commonly, however, it is known simply superficial vein phlebitis.
We are often contacted from patients or their referring physicians for treatment for superficial vein phlebitis. These most commonly occur in varicose veins in the leg, but any superficial vein can develop a clot.
Clots in the superficial varicose veins of the legs can be a benign and self-limited problem. However, when the blood clot occurs in the larger superficial varicose veins, it can spread into the deep veins of the leg, referred to as a deep vein thrombosis (DVT) and potentially break off and move through the heart to the lungs, called a pulmonary embolism…or PE. Therefore superficial vein phlebitis is considered a serious medical condition.
Generally the treatment of superficial vein phlebitis is to prevent spread to the deeper veins. Sometimes this requires a blood thinner. Patients should be seen by a qualified healthcare provider who can help determine the extent of the clot (usually with Ultrasound), then develop a short and long term treatment plan.
Findings on Physical Exam
Clots in the superficial veins most frequently occur in the legs in association with varicose veins. When a blood clot occurs in the arm, it is general associated with an IV placement.
Phlebitis refers to acute inflammation of the vein, and thrombo- refers to a clot in the vein. Clot itself is highly inflammatory.
When a person has superficial vein phlebitis, they will often have pain, tenderness, redness and what feels like a cord under the skin. This can be quite painful. This can look like an infection, although most are not infected with bacteria. It can also look like a deep vein thrombosis.
Ninety percent of cases of phlebitis occur in people with pre-existing varicose veins. When varicose veins are not present, and the patient has not had a recent IV, then medical causes can be considered as well.
Clinical Course and Complications of Superficial Vein Phlebitis
Most clinical presentations are uncomplicated with typical findings of tenderness, firm skin, pain, and redness along the varicose vein. The degree of inflammation varies depending on the length of the vein affected. There is often a cord like feeling under the skin that feels like a small rope, with redness over this cord. Low-grade fever may be present in uncomplicated superficial thrombophlebitis, but high fever should increase suspicion for infection in the superficial thrombophlebitis.
Complications of superficial vein phlebitis can also occur. The biggest concern in the short term is spread from the superficial veins to the deep veins. Long term, the phlebitis can re-occur. Rarely, infection can arise in the clotted veins, which is associated with high fever, and redness that extends well past the affected vein. In these patients, IV antibiotics are required, and possibly removal of the infected vein.
The diagnosis of phlebitis and thrombosis of the lower extremity superficial veins is usually clinically apparent based upon the patient’s complaints and physical examination as described above, especially in patients with known risk factors.
The need for duplex ultrasound or further evaluation with laboratory or other studies depends upon the clinical scenario. Most feel that duplex examination is essential for patients with suspected superficial vein thrombosis due to the high rate of concurrent deep vein thrombosis (DVT), as well as to accurately make the diagnosis and define the location of the clot so the patient can be reevaluated if the symptoms worsen.
Treatment of Phlebitis
Treatment differs depending upon whether the thrombosis affects larger superficial varicose veins, as well as the greater, or small saphenous veins, and how close the clot is to the junctions with the deeper veins. This can be determined by ultrasound. Also if the condition seems to be worsening, that can mandate a different treatment approach.
For uncomplicated disease, treatment is primarily aimed at alleviating symptoms and preventing spread of clot into the deep venous system. This is done with compression hose, exercise, leg elevation and non steroidal anti-inflammatory medications.
Usually a close follow up is planned, and follow up ultrasound is performed until it is clear the condition has resolved. In some cases, anticoagulant medication is used stop the clotting process in an effort to prevent spread of the clot to the deeper veins. This can include drugs like Xarelto and Eliquis, or shots like Low Molecular Heparin (Lovenox or Arixtra).
You and your care provider can discuss if anticoagulant medications are indicated, and if so, for how long. Long term if the condition was triggered by large varicose veins, then you might consider discussing if your varicose veins should be treated with procedures like Closurefast, Venaseal, Varithena, or some form of sclerotherapy to help reduce the risk of recurrence in the future.
Generally, if you think you might have superficial vein phlebitis you should seek medical input, especially if the veins are red, hot, tender and hard and if the condition seems to be worsening.
Oregon’s Leading Vein Care Specialists
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What You Need to Know
This material must not be used for commercial purposes, or in any hospital or medical facility. Failure to comply may result in legal action.
WHAT YOU NEED TO KNOW:
What is phlebitis?
Phlebitis is inflammation of the wall of your vein. Inflammation may be caused by damage to or infection of your vein. Phlebitis may occur in a vein in your arm or leg. Symptoms include pain, redness, and swelling near the vein. Symptoms may appear when you are receiving an IV medication, or 48 to 96 hours after you receive the medicine.
What increases my risk for phlebitis?
- An IV catheter placed in a vein in your arm or leg
- IV injections of amiodarone, vancomycin, ciprofloxacin, or chemotherapy medicines
- A condition that affects your blood vessels, such as varicose veins or venous insufficiency
- IV drug abuse
How is phlebitis treated?
Medicines may be given to decrease pain and swelling. Your IV catheter will be removed. Do the following to manage your symptoms:
- Apply a warm compress to your vein. This will help decrease swelling and pain. Wet a washcloth in warm water. Do not use hot water. Apply the warm compress for 10 minutes. Repeat this 4 times each day.
- Elevate your leg or arm above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your leg or arm on pillows or blankets to keep it elevated comfortably.
- Wear pressure stockings if directed. Pressure stockings improve blood flow and help decrease pain and swelling. Pressure stockings can also help decrease your risk for blood clots in your legs. Wear the stockings during the day. Do not wear them overnight when you sleep.
- Do not inject illegal drugs. Talk to your healthcare provider if you use IV drugs and need help to quit.
When should I seek immediate care?
- Your leg or arm turns pale or blue.
- Your leg or arm feels hot or cold.
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
When should I contact my healthcare provider?
- You have a fever.
- You have more pain, swelling, or warmth near your vein.
- Your symptoms do not improve within 72 hours.
- You have questions or concerns about your condition or care.
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
© Copyright IBM Corporation 2021 Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Infiltration and extravasation care
What is a peripheral IV device?
A peripheral IV is a catheter (a very thin, flexible tube) that is inserted into a small vein in the scalp, hand, arm, leg or foot. This is done to give fluids or medicines directly into the bloodstream. The IV is secured with tape or a type of dressing.
What is an infiltration or extravasation?
Sometimes, the fluid or medicine leaks into the tissue around the vein. The difference between an infiltration and extravasation is the type of medicine or fluid that is leaked.
- Infiltration – if the fluid is a non-vesicant (does not irritate tissue), it is called an infiltration.
- Extravasation – if the fluid is a vesicant (a fluid that irritates tissue), it is called an extravasation. Tissue damage from these fluids may or may not be seen at the time the leak occurs, and may take weeks or months to develop.
How does this happen?
- Catheters can become clogged over time
- Catheters can come out unexpectedly
- IV fluids can leak out of the vein or artery because of irritation
What are signs of an infiltration/extravasation?
- Redness around the site
- Swelling, puffy or hard skin around the site
- Blanching (lighter skin around the IV site)
- Pain or tenderness around the site
- IV not working
- Cool skin temperature around the IV site or of the scalp, hand, arm, leg or foot near the site
What happens after an infiltration/extravasation?
- The site will be assessed and evaluated
- Depending on severity, additional health team members (such as a pharmacist or advanced practice nurse specializing in skin care) may be consulted to discuss treatment options
- The IV will be removed
- The site will be checked hourly until it returns to baseline
How is it treated?
Some possible treatments are:
- Elevate the site as much as possible to help reduce swelling.
- Apply a warm or cold compress (depending on the fluid) for 30 minutes every 2-3 hours to help reduce swelling and discomfort.
- Medication-If recommended, medicine for extravasations is given within 24 hours for best effect.
The most common medicine is hyaluronidase (Wydase®) and it is given in small amounts just under the skin.
What can I do to help prevent an infiltration/extravasation?
- Let your child’s health care team know if your child has had multiple attempts to place an IV in the past.
- If the IV dressing becomes loose, let the nurse know so it can be changed or appropriately reinforced.
- Be careful when moving your child to prevent the IV from being bumped, tugged, or dislodged.
- Do not allow your child to pull on the IV. Use distraction to take your child’s mind off of it. Ask Child Life for activities your child can do.
- If an immobilizer or soft tie is needed to help protect the IV site, leave it on.
- Keep bedding off of the IV site.
- If you are concerned that the IV might not be working or looks different, let the nurse know.
What else do I need to know?
Depending on the severity of the infiltration/extravasation, you may be instructed to monitor the affected area after discharge.
Call your clinic if the affected area is getting worse, such as:
- Increased swelling
- Skin opening up
Go to the Emergency Room right away if your child has any of the following:
- Temperature higher than 101.5° F
- Hand, arm, leg, or foot near the removed IV site changes color (blue-purple).
- Hand, arm, leg, or foot near the removed IV site changes temperature (becomes cold).
- Hand, arm, leg, or foot near the removed IV site becomes swollen and firm and cannot move fingers or toes.
Children’s Wound Ostomy Care Practitioners Team is a group of advanced practice nurses that can help with infiltrations and extravasations. They are available during business hours for follow-up outpatient visits. Appointments can be scheduled by calling 651-220-6530.
This information is not specific to your child, but provides general information. If you have questions, please call your provider or clinic.
Last reviewed 7/2019
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Superficial thrombophlebitis | DermNet NZ
Author: Vanessa Ngan, Staff Writer, 2013. Minor revision, 22 February 2014.
What is superficial thrombophlebitis?
Superficial thrombophlebitis is an inflammation of a superficial vein due to a blood clot and is found just under the skin. It most commonly affects the veins in the leg but can occur in other veins around the body, for example, on the arms, penis and breasts.
What causes superficial thrombophlebitis?
The cause of superficial thrombophlebitis is not completely clear but it is believed to be associated with a change in the dynamic balance of haemostasis. In 1846, the German pathologist Virchow showed that damage to a blood vessel wall, abnormal blood flow, or a change in blood constituents causing abnormal blood clotting, could lead to inflammation or formation of blood clots in the veins.
Who gets superficial thrombophlebitis?
Superficial thrombophlebitis can occur spontaneously and without apparent reason.
Risk factors for superficial thrombophlebitis
- History of superficial phlebitis, deep vein thrombosis, and pulmonary embolism
- Varicose veins — people with varicose veins are prone to minor injuries of the blood vessels, which can lead to inflammation.
- Intravenous injection or infusion sites — superficial thrombophlebitis in the arm or neck region may occur at infusion sites or sites of trauma.
- Blood clotting abnormalities — there are various conditions or drugs that can make blood clot more easily and cause superficial thrombophlebitis:
- Pregnancy — through most of the pregnancy and for about 6 weeks after delivery. Thrombophlebitis is especially of concern in pregnant women who carry prothrombin 20210 gene mutation, as they have a predisposition to clotting.
- Oral contraceptive pill and hormone replacement therapy — high dose oestrogen treatments may increase the risk of thrombosis by 3–12 times.
- Diseases associated with vasculitis, such as Buerger disease and polyarteritis nodosa
- Underlying cancer
- Reduced blood flow (stasis) — this may occur in veins in people during long air flights, those that are immobile, or had recent major surgery.
What are the signs and symptoms of superficial thrombophlebitis?
Characteristic signs and symptoms of superficial thrombophlebitis include:
- Slight swelling, redness and tenderness along a part of the affected vein
- Veins on the foot, ankle and area just behind the knee are swollen and pop-out
- Other veins in the affected area may appear blue colour
- If a blood clot develops the vein may feel hard or knobbly
- If the condition has been present for a while and the swelling has resolved, the skin may appear stained or darkened.
How is superficial thrombophlebitis diagnosed?
The visual characteristics of superficial thrombophlebitis are not enough to confirm the diagnosis as several other conditions have similar symptoms. A thorough history and complete physical examination are essential.
If the condition is often recurring or there is the possibility of complications, your doctor may perform other tests, such as blood tests, ultrasound scan and radiographic imaging.
What is the treatment for superficial thrombophlebitis?
Mild cases of superficial thrombophlebitis may not need any treatment. Usually, symptoms will resolve within 3–4 weeks. You should try to keep up with normal routines and remain active.
In more severe cases the following treatments may be used.
- Raise the leg and apply warm compresses. This can be done with a hot flannel placed over the vein or using a blanket and hot water bottles. Take care not to burn.
- Elastic supports or compression stockings can help to reduce swelling whilst the inflammation settles.
- Painkilling medication — paracetamol, aspirin or non-steroidal anti-inflammatories such as ibuprofen. Always check with your doctor or pharmacist before taking any medication.
- Anti-inflammatory gels or creams such as ibuprofen gel may be useful in mild cases.
- Low molecular weight heparin (LMWH) medications, for example, enoxaparin, may help to reduce swelling and pain and also decrease the chances of blood clots moving further up the vein and causing a DVT.
- Antibiotics should be taken if an infection is present.
- Puncture and evacuation — this procedure gives rapid relief and resolution of a palpable clot that causes extreme pain. It involves puncture incision with a needle and evacuation of the clot after local anaesthesia.
- Surgical excision and ligation — patients with septic thrombophlebitis require urgent venous excision to stop the spread of bacterial infection. This is done with a direct cut over the vein and removal of the infected segment and any surrounding infected or necrotic tissue. This procedure may also benefit patients with recurrent superficial thrombophlebitis that do not respond to any other treatments.
What is the outcome after superficial thrombophlebitis?
Superficial thrombophlebitis is not usually a serious condition and often settles down and goes away on its own within 2–6 weeks. However, it can be recurrent and persistent and cause significant pain and immobility. In addition, complications may occur if the affected veins become infected or the blood clot moves further up the vein to where the superficial and deep veins join; leading to a more serious condition called deep vein thrombosis (DVT).
Phlebitis Grading Scale – Pedagogy
Phlebitis should be documented using a uniform standard scale for measuring grade and severity. Any incidence of phlebitis greater than grade 2 should be reported to the physician and other appropriate healthcare personnel. Ongoing observation of sites should continue for 48 post removal to detect post-infusion phlebitis. All patients with an intravenous access device should have the IV site checked every shift for signs of infusion phlebitis. The subsequent score and action(s) taken (if any) must be documented.
Download a printable copy of the
Phlebitis Grading Scale Poster
This reference correlates to the online continuing education course Basics of Peripheral IV Therapy.
No signs of phlebitis
One of the following signs is evident:
Possibly first signs of phlebitis
TWO of the following are evident:
Early stage of phlebitis
ALL of the following are evident:
Medium stage of phlebitis
ALL of the following signs are evident and extensive:
Advanced stage of phlebitis
Or the start of thrombophlebitis
ALL of the following signs are evident and extensive:
Advanced stage thrombophlebitis
With permission from Andrew Jackson – Consultant Nurse,
Intravenous Therapy & Care, The Rotherham NHS Foundation Trust
90,000 All about HIV / AIDS
About HIV / AIDS. Etiology of HIV infection. Introduction.
HIV infection is a disease caused by the human immunodeficiency virus, persisting for a long time in lymphocytes, macrophages, cells of the nervous tissue, as a result of which slowly progressive damage to the immune and nervous system develops, manifested by secondary infections, tumors, subacute encephalitis and other pathological changes, leading to the death of the patient.
HIV infection is a change of stages, the last of which is designated by the term AIDS – acquired immunodeficiency syndrome, which is the final, terminal stage of the process.
Causative agent and epidemiology of HIV infection
The causative agent of HIV infection is the human immunodeficiency virus, belongs to the subfamily of lentiviruses, the family of retroviruses. There are two types of virus – HIV-1 and HIV-2. The viral particle has a shape close to spherical, with an average diameter of 100-120 nm, consisting of a nucleus surrounded by an envelope.The nucleus contains RNA and enzymes – reverse transcriptase (revertase), integrase, protease. The presence of reverse transcriptase provides a reverse direction of the flow of genetic information: not from DNA to RNA, but on the contrary, from RNA to DNA.
The virion contains a shell and a nucleoid. The outer membrane is permeated with viral proteins: transmembrane and outer glycoproteins. Proteins perform the function of determinants and are involved in attachment to the membrane of the host cell. On the inner side of the membrane there is a scaffold formed by the p 17 protein, which surrounds the internal structure of the virion – the nucleoid (core).The core membrane itself is formed by the p 24 protein. Inside the nucleoid is the virus genome, consisting of 2 RNA chains surrounded by the p 7 and p 9 proteins.
The life cycle of HIV includes the processes of specific sorption of the virus on CD 4 (+) – lymphocytes due to membrane diffusion processes, the synthesis of a DNA copy of the genome and its further integration into the chromosome of the host cell.
When HIV enters a cell under the action of the reverse transcriptase enzyme, HIV DNA is formed, which is incorporated into the host cell’s DNA, which further produces viral particles.
HIV is not resistant in the environment. It is completely inactivated by heating at a temperature of 56 ° C for 30 minutes, quickly dies when boiling (1-3 minutes), as well as under the influence of disinfectants at concentrations usually used in practice. HIV is at the same time resistant to ultraviolet rays and ionizing radiation.
The source of infection is a person infected with HIV both in the asymptomatic stage of the carrier and in the advanced clinical manifestations of the disease.The virus is found in blood, semen, cerebrospinal fluid, breast milk, menstrual blood, vaginal secretions, which are factors in the transmission of HIV infection. In saliva, lacrimal fluid, urine, HIV is in a small amount, insufficient for infection.
Ways of HIV transmission – sexual (heterosexual and homosexual), parenteral and vertical.
Parenteral transmission occurs mainly among intravenous drug users.In this case, HIV transmission factors can be both shared syringes and needles, and the drug itself, to which blood is added for the purpose of “cleaning”. Infection is possible when using HIV-contaminated medical equipment that has not undergone appropriate processing.
The vertical route of transmission can be from an infected mother to a child during pregnancy and childbirth, as well as during breastfeeding, it is also possible for a mother to become infected from an HIV-infected child while feeding him.
Pathogenesis of HIV infection.
When HIV enters a cell, RNA under the influence of revertase turns into DNA, which is incorporated into the DNA of the host cell, producing new viral particles – copies of the RNA of the virus, remaining in the cell for life. The nucleus is surrounded by a shell, which contains the g p 120 protein, which determines the attachment of the virus to the cells of the human body that have a receptor – protein CD 4.
HIV is adsorbed on cells, the membrane of which includes the CD 4 protein.These are T-lymphocytes with the CD 4 (+) phenotype, macrophages, B-lymphocytes, neuroglia cells (as a result, the central nervous system is damaged), intestinal mucosa cells, dendritic cells. First of all, C D 4 (+) – lymphocytes, which are the central figure of the immune response, are affected. The reason for the decrease in T-helper cells is not only the direct cytopathic effect of the virus, but also the fusion of uninfected cells with infected ones and the formation of synthesia.
At the same time, there is a violation of the function of B-lymphocytes.the number of immunoglobulins, circulating immune complexes increases, which leads to a greater decrease in C D 4 (+) – lymphocytes. All of these mechanisms form various clinical manifestations of the disease. As a result of damage to the central links of the immune system, a person infected with HIV becomes defenseless against pathogens of various infections, primarily opportunistic microorganisms, which do not pose a threat to a practically healthy person.
In connection with the progression of the secondary immunodeficiency state, tumor and autoimmune processes are formed, the central nervous system is always involved in the pathological process, where the virus penetrates together with infected monocytes. Damage to neuroglial cells leads to 90,022 trophic damage to neurons, brain tissue, impaired brain activity, and ultimately the development of AIDS dementia (dementia).
Russian classification of HIV infection, 2006 (V.V. Pokrovsky)
Stage 1 – “incubation stage” – the period from the moment of infection until the appearance of the body’s reaction in the form of clinical manifestations of “acute infection” and / or the production of antibodies. Its duration usually ranges from 3 weeks to 3 months, but in isolated cases it can take up to a year
Stage 2 – “the stage of primary manifestations” – is associated with the manifestation of the body’s primary response to the introduction and replication of HIV in the form of clinical manifestations and / or the production of antibodies.The stage of the primary manifestations of HIV infection can have several variants of the course.
2A “Asymptomatic”, characterized by the absence of any clinical manifestations of HIV infection. The body’s response to the introduction of HIV is manifested only by the production of antibodies.
2B “Acute infection without secondary diseases” manifests itself in a variety of clinical symptoms. The most frequently recorded fever, rashes on the skin and mucous membranes (urticarial, papular, petechial), swollen lymph nodes, pharyngitis.There may be an increase in the liver, spleen, diarrhea. Sometimes this variant of the course is called “mononucleosis-like” or “rubella-like” syndrome
2B “Acute infection with secondary diseases” is characterized by a significant decrease in the level of CO2-lymphocytes. As a result, against the background of immunodeficiency, secondary diseases of various etiologies appear (candidiasis, herpes infection, etc.). Their manifestations, as a rule, are mild, short-term, respond well to therapy, but can be severe (candidal esophagitis, pneumocystis pneumonia), in rare cases, even death is possible.
The duration of clinical manifestations in the second stage can vary from several days to several months, but they are usually recorded within two to three weeks.
In general, the duration of the stage of primary manifestations of HIV infection is one year from the onset of symptoms of acute infection or seroconversion.
Stage 3 – “subclinical stage” – is characterized by a slow increase in immunodeficiency, which is associated with the compensation of the immune response due to the modification and excessive reproduction of C04 cells.The rate of reproduction of HIV during this period slows down in comparison with the stage of primary manifestations.
The main clinical manifestation of the subclinical stage is “persistent generalized lymphadenopathy” (PGL). It is characterized by an increase in at least two lymph nodes, in at least two unrelated groups (not counting the inguinal), in adults up to a size of more than 1 cm in diameter, in children – more than 0.5 cm, which lasts for at least three months. On examination, the lymph nodes are usually elastic, painless, not adhered to the surrounding tissue, the skin above them is not changed.
The duration of the subclinical stage is from two to three to 20 years or more, but on average it lasts 6-7 years. The rate of decrease in the level of CO2-lymphocytes during this period averages 50-70×106 / l per year.
Stage 4 – “the stage of secondary diseases” – is associated with the depletion of the population of C04 cells due to the ongoing replication of HIV. As a result, against the background of significant immunodeficiency, infectious and / or oncological secondary diseases develop.Their presence determines the clinical picture of the stage of secondary diseases.
Depending on the severity of secondary diseases, stages 4A, 4B, 4B are distinguished.
4A usually develops 6-10 years after infection. It is characterized by bacterial, fungal and viral lesions of the mucous membranes and skin, inflammatory diseases of the upper respiratory tract. Usually stage 4A develops in patients with a level of C04 lymphocytes of 500-350×106 / L (in healthy individuals, the number of C04 lymphocytes ranges from 600-1900×106 / L).
4B occurs more often 7-10 years after infection. Skin lesions during this period are of a deeper nature and are prone to a protracted course. Internal organ lesions begin to develop. Weight loss, fever, localized Kaposi’s sarcoma, and peripheral nervous system involvement may occur. Usually stage 4B develops in patients with a C04 lymphocyte level of 350-200×106 / L.
4B is mainly detected after 10-12 years from the moment of infection.It is characterized by the development of severe, life-threatening secondary diseases, their generalized nature, and damage to the central nervous system. Usually stage 4B occurs when the level of C04 lymphocytes is less than 200×106 / L.
Despite the fact that the transition of HIV infection to the stage of secondary diseases is a manifestation of the depletion of the protective reserves of the infected person’s body, this process is reversible (at least for a while). Clinical manifestations of secondary diseases may disappear spontaneously or as a result of ongoing therapy.Therefore, in the stage of secondary diseases, the phases of progression (in the absence of antiretroviral therapy or against the background of antiretroviral therapy) and remission (spontaneous, after previously conducted antiretroviral therapy or against the background of antiretroviral therapy) are distinguished.
Stage 5 – “terminal stage” – is manifested by the irreversible course of secondary diseases. Even adequately conducted antiretroviral therapy and treatment of secondary diseases are not effective.As a result, the patient dies within a few months. At this stage, the number of C04 cells, as a rule, is below 50×106 / l.
About COVID-19 coronavirus infection | Official site of Novosibirsk
Coronavirus infection (COVID-19)
Symptoms of the disease are similar to those of regular (seasonal) flu:
• high body temperature
• labored breathing
• muscle pain
Prevention of coronavirus infection
one. Refrain from visiting public places : shopping centers, sports and entertainment events, transport during rush hour;
2. Use a disposable medical mask (respirator) in public places, changing it every 2-3 hours ( more about using masks ).
3. Avoid close contacts and stay in the same room with people who have visible signs of SARS (coughing, sneezing, nasal discharge).
4. Wash p uki with soap and water thoroughly after returning from the street, contact with strangers.
5. Disinfect gadgets, office equipment and touching surfaces.
6. Limit if possible with close hugs and handshakes when greeting.
7. Use only personal hygiene items (towel, toothbrush).
For suspected coronavirus infection:
1. Stay at home. If you feel worse, call a doctor, inform him about your places of stay in the last 2 weeks, possible contacts. Strictly follow your doctor’s recommendations.
2 Minimize contact with healthy people, especially the elderly and those with chronic diseases. It is better to take care of the sick one person.
3. Use when coughing or sneezing with a disposable tissue or handkerchief, covering your mouth. If they are absent, sneeze in the elbow.
4. Use personal hygiene items and disposable dishes.
5. Provide with damp cleaning with disinfectants and frequent ventilation.
Notes on symptoms, prevention of coronavirus infection (pdf)
Last modified 16.06.2020 13:24
Inflammation of the gums: causes, symptoms, treatment
Inflammation in the gums is an unpleasant phenomenon that causes discomfort to both the patient and others – bad breath accompanies almost any inflammation of the gums. The presence of such a disease is a threat to dental health and not only. Infected saliva passing from the mouth to the stomach can cause more serious consequences at the systemic level. The use of remedies for inflammation of the gums and regular check-ups with the dentist are the main preventive measures aimed at protecting human health.
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Why gums become inflamed
Microbes . The main reason why inflammation develops in the gums is the presence of pathogenic bacteria, which are a natural part of the microflora of the oral cavity. With proper and regular care of your teeth and gums, they are not a threat. And in cases where oral hygiene leaves much to be desired, food fragments remaining in the interdental spaces become a favorable environment for the uncontrolled reproduction of microbes.In the course of their vital activity, they form a plaque, which mineralizes and hardens over time. This is how tartar appears. It leads to the drooping of the gums, impaired blood circulation in them and a decrease in local immunity.
Smoking . Substances contained in tobacco smoke disrupt the acid-base balance of the oral cavity and the balance of microflora, contribute to a deterioration in blood circulation in the gums, which, in turn, leads to a deficiency of nutrients in the oral cavity.
Other reasons .The use of certain medications and an inherited predisposition to gum disease can also contribute to the development of inflammation.
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What hurts the gums
Gingivitis and periodontitis are diseases that can begin to develop asymptomatically and seem harmless, even if a person feels the first signs of trouble. In fact, they not only cause discomfort and pain, but can also lead to a high probability of tooth loss if left untreated.
Gingivitis . It develops in the gum tissue and can be the initial stage of a more serious lesion. Plaque and calculus cause inflammation, which can lead to drooping gums and bleeding.
Periodontitis . This disease often develops as a “logical continuation” of gingivitis, which was left without treatment, or when its treatment was incorrect or incomplete. The defeat of the gum tissue during periodontitis is more severe: the gums gradually loosen and descend, exposing the neck of the tooth.Without proper therapy, this disease can lead to the destruction of not only soft tissues, but also the ligamentous apparatus of the tooth and bone tissues. In this case, the most important task is to select a means to strengthen the gums and stop the inflammatory process in them.
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Signs of gum disease
Swelling . This is the first symptom that is noticeable to the patient himself and gives some discomfort. The gums acquire a pronounced red color and feel soft when touched.
Bleeding. It may not appear immediately – when eating, the patient feels only a specific metallic taste in the mouth, and only as the disease progresses, traces of blood are found on the toothbrush.
Bad breath . It manifests itself almost simultaneously with bleeding. After brushing your teeth, the unpleasant odor diminishes only slightly.
Increased sensitivity of teeth . Descent of the gums leads to exposure of the tooth neck, which is more sensitive than the crown.Eating cold, hot, sweet, sour foods and drinks causes discomfort or even pain.
Loose teeth . It develops gradually and speaks of damage to the ligamentous apparatus of the tooth – the structures that hold it in the jaw bones.
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How to treat gum disease
Antibiotics. It is logical to assume that the bacterial inflammatory process should be treated with antibacterial drugs. But things are not as simple as they seem.Inflammation is directly related to imbalance in the microflora in the oral cavity. Antibiotics only exacerbate the situation, making it almost catastrophic. They do not distinguish between beneficial and harmful bacteria, disrupting the vital activity of both. For this reason, antibiotic therapy is a useful remedy for gum disease only when a specific causative agent of the disease has been identified and treatment is carried out with an antibiotic to which it is sensitive.
Folk remedies .Gargling solutions containing herbal teas or extracts, brushing your teeth with table salt or baking soda, and many other treatments can appear to be effective remedies for gum disease. But it should be borne in mind that without identifying the cause of the disease and eliminating it, such therapy will be useless at best. The use of folk remedies makes sense only as an auxiliary, but not the main method of treatment.
Back to Contents
How to Prevent Gum Disease
Prevention aimed at strengthening the gums is a comprehensive measure that should include:
- Compliance with oral care rules .There are two things you can do to reduce your risk of plaque and inflammation. Firstly, regular brushing of teeth with a brush of suitable hardness and using a therapeutic and prophylactic paste. Secondly, the obligatory cleaning of the interdental spaces with dental floss;
- diet correction . A good remedy for gum disease can be the presence in the diet of solid vegetables and fruits, foods rich in vitamins and minerals;
- gum massage .Regular massage with a special brush or the back surface of a regular brush, on which there is a rubber relief, can also be used as a means to strengthen the gums. This procedure stimulates blood circulation and the flow of nutrients and oxygen;
- Using mouthwash . A properly selected tooth and gum rinse not only helps to eliminate inflammation, but is also an important measure for the prevention and strengthening of local immunity. LISTERINE® Fresh Mint Rinse removes food fragments from the mouth after brushing, reduces bacteria and generally reduces the formation of plaque – the main cause of inflammation in the oral cavity.
The information in this article is for guidance only and does not replace professional advice from a dentist. Consult a qualified professional for diagnosis and treatment.
90,000 HIV is not a death sentence yet!
With a diagnosis of HIV infection in the 21st century, one can not only live a long and fulfilling life, but also give birth to a healthy child. Naturally, such a scenario is possible subject to regular visits to the doctor and the fulfillment of his appointments.The main thing you need to know about HIV today is that infection is not a sentence, but slightly different living conditions. Medicine does not stand still, every year more and more new antiretroviral drugs appear, the systematic intake of which can slow down the development of the disease, prolong life for many years.
So, what is HIV, AIDS and how to protect yourself and your loved ones?
HIV (Human Immunodeficiency Virus) is a virus that deprives the human body of protection by destroying the immune system.A person can live with HIV infection for a long time, the course of the disease depends on many factors: lifestyle, initial state of health of a person at the time of infection, alcohol and drug use, timely treatment started.
AIDS (acquired immunodeficiency syndrome) – the final stage of HIV infection. If untreated, half of HIV-infected people develop AIDS within 10 years after infection, but this period is different for all people.And many of those who were diagnosed with HIV twenty years ago are still alive thanks to timely treatment and care for their own health.
The virus can enter the human body in several ways :
1) during unprotected sexual intercourse;
2) through blood among drug users who use shared syringes, needles, containers, filters to inject drugs;
3) when applying tattoos, piercing with non-sterile instruments, using shared razors;
4) in medicine: transfusion of blood and blood products, transplantation of organs and tissues;
5) from an infected mother to a child during pregnancy, childbirth or breastfeeding.According to statistics, if all the rules for taking antiretroviral drugs are observed, a healthy child is born to an HIV-infected mother in 99% of cases.
The clinical picture of the disease HIV infection at the initial stages is very scarce. From the moment of infection until the first symptoms of infection appear, a long latent (incubation) period passes – from 1 month. up to 4-6 years old. The only way to determine if a person is infected or not is to have a blood test for HIV.After the incubation period, in 50-70% of cases, there is a period of primary clinical manifestations lasting from several days to 2 months in the form of an increase in body temperature (above 38 * C) with profuse sweating, symptoms of general intoxication (lethargy, depression, decreased performance). General symptoms appear – fever, pharyngitis, muscle and joint pain, drowsiness and malaise, anorexia and weight loss.
Measures to prevent HIV infection and AIDS:
1) Avoid promiscuous sex;
2) Always use a condom during sexual intercourse;
3) Do not use shared needles, ink tanks for tattooing, use only disposable needles and syringes;
4) If infected blood comes into contact with injured areas of mucous membranes or skin, immediately wash it with running water and soap, treat the wound and consult a doctor;
5) Lead a healthy lifestyle.Do not use alcohol and drugs! They reduce critical judgment, which can lead to risky behavior.
The first step towards HIV / AIDS prevention remains steadfastly testing for the virus. Regardless of what the result will be – negative or positive – the person will definitely receive support and advice, learn about what to do next. If necessary, specialists will select an individual treatment. HIV testing can be done at the YNAO “NTsGB”, by contacting the HIV consultative diagnostics room at st.Geologorazvedchikov, 7, therapeutic building, office No. 9.
90,000 News –
Government of Russia
The Russian Federation in the context of the global pandemic of the new coronavirus makes
everything you need to prevent the spread of infection, protect your health
citizens and assistance to the sick.
Is a challenge to the whole society. It requires the most coordinated action,
recognition of responsibility not only for your health, but also for your health
belongs to the family of viruses that are widespread in animals and humans.
Only a few of them are dangerous. In the case of the new coronavirus
infection, the disease in the overwhelming majority of cases occurs in the lung
form. Mortality is significantly lower than that caused by other coronaviruses
SARS / SARS (9.6%) and Middle East Respiratory Syndrome
(36%). The incubation period lasts up to 14 days. The sick person can transmit
infection before symptoms appear.The elderly are at risk – they have
the disease can proceed with severe complications.
Today the situation
characterized as a global pandemic. This is one of the worst global crises in
the healthcare sector over the past 50 years.
Thanks to the created
service for ensuring sanitary and epidemiological well-being, financial
support of scientific research and development in this area, Russia has
a significant resource for responding to such threats.
Of the Government of the Russian Federation in the previous two and a half months
allowed to keep the situation under control and gave valuable time for
development of additional measures to combat the spread of the new coronavirus
the task is to slow down the spread of infection, to prevent a sharp increase in the number of cases
by limiting the transmission of coronavirus within the country, as well as to protect
risk groups, primarily the older generation. Government of the Russian
The Federation will continue to take all necessary measures for this.
Priorities – early
identification and prevention of transmission of the disease within the country, timely and
high-quality medical care for the sick. All measures taken
For their development and
implementation and monitoring of key indicators
sanitary and epidemiological welfare and health care is responsible
operational headquarters under the leadership of Tatiana Alekseevna Golikova.
1. Prevention of the importation of a new coronavirus infection on
the territory of the Russian Federation.
efforts taken by the Government of the Russian Federation ensured the prevention of
importation and spread of infection from the very beginning, when in our country
there was information about the outbreak of coronavirus in China.So, was strengthened
sanitary and quarantine control at the state border using thermal imaging equipment,
limited air and rail links with China, and then with others
countries where the situation is unfavorable, a medical
monitoring those who returned from abroad and those who had contact with them.
A decision was made on
suspension of entry for citizens of all foreign countries (with the exception of
certain categories of persons).
if necessary, restrictive measures will be adjusted taking into account the analysis
epidemic situation in foreign countries.All solutions are directed
exclusively to protect the health of the population of Russia.
2. Timely detection of cases of infection in the territory
Russian Federation and prevention of the spread of the disease within the country.
2.1. Revealing and
to identify patients, diagnostic test systems have been developed. Organized by
testing of all citizens arriving in the country from the states where it is installed
the spread of a new coronavirus infection, and people who came into contact with the newcomers, and
also patients with pneumonia.
all necessary studies are provided with test systems. Stock created in
700 thousand test systems, which will be replenished. Daily power
production – up to 100 thousand. There is no deficit in diagnostics.
A decision was made on
delivery of test systems to all regions of Russia for organizing and conducting
research on the basis of laboratories entitled to work with groups III-IV
pathogenicity in the manner prescribed by the constituent entities of the Russian Federation.
Data on all
laboratory tests for coronavirus will be centralized.IN
if the pathogen is identified, the laboratory will confirm
to combat the spread of coronavirus infection recommends to citizens
apply for testing for a new coronavirus infection only in cases where
when you really need it.
distribution within the Russian Federation.
restrictive measures will continue to be adopted and, if necessary, will be strengthened.Among them, the reduction
and cancellation of mass sports, cultural events, holding
anti-epidemic measures by enterprises and organizations, including disinfection
premises and ensuring the appropriate working regime for employees.
existing requirements for isolation and strict medical supervision in
in relation to persons who have arrived from other countries, and citizens in contact with them.
The Government of the Russian Federation revised the procedure for registration, issuance and
payment of sick leave to citizens in quarantine.Medical
organizations will receive the right to issue certificates of incapacity for work remotely without
full-time examination of a patient who has indications for quarantine.
sick leave payments in these cases: payment will be made directly
to a citizen in advance until the closure of the work ability sheet.
decisions of the Chief Sanitary Doctor were given instructions to the subjects of the Russian
Federation to work with legal entities and individual
entrepreneurs on the organization of the working regime of workers, including
mandatory disinfection of contact surfaces in all rooms for
Subjects of the Russian
The Federation is instructed to ensure compliance with the anti-epidemic regime in
educational organizations, including, if necessary, the transition to
distance learning and work. Ministry of Education of the Russian
Federation created a working group that will develop a unified procedure
organization and support of education in a distance form.
To reduce risks
diseases The government recommends all citizens to limit contacts, in
if symptoms of the disease appear – an acute respiratory viral infection
(ARVI) do not leave the house and call a doctor immediately.For employers
consider the possibility of transferring employees to work in remote access.
counteracting the spread of infection depends on the efforts of each of us.
3. Timely and high-quality medical care
data indicate that in most cases (80%) the disease occurs in
easy form. However, in 15-20% of cases, especially in older people with
concomitant diseases, the course of the disease is complicated by pneumonia, and in a number
cases require intensive care.
medical organizations to provide assistance to the sick is one of the main conditions
Ministry of Health of Russia
the readiness of the medical network was assessed. The preparation of medical
organizations to different scenarios of the development of the situation. More than 55 thousand deployed
infectious beds, of which more than 12 thousand – intensive care and 396 –
observators. 7.5 thousand Meltzer boxes were prepared.
organizations have more than 40 thousand artificial lung ventilation devices, 124
extracorporeal membrane oxygenation (ECMO) apparatus.The government
The Russian Federation has allocated resources for additional purchases of over 500
devices, including 17 ECMO devices.
organizations have created a stock of medicines, an irreducible stock of funds
personal protection. 6 thousand are ready to provide medical assistance today
infectious disease doctors and almost 2 thousand pulmonologists, more than 18 thousand nurses.
Of the Russian Federation for material incentives for medical workers
a decision was made to allocate funds from the reserve fund.The funds will
aimed at paying cash incentives to employees of institutions
health care and science of Rospotrebnadzor, district doctors – therapists,
general practitioners, pulmonologists, infectious disease specialists,
anesthesiologists-resuscitators, nurses, paramedics and obstetricians
FAPs, ambulance medical personnel, nursing staff,
who are involved in the implementation of measures to combat the new coronavirus infection.
Work in progress
on methodological support of prevention and treatment based on the latest
available scientific evidence.Recommendations were brought to medical organizations,
algorithms for the diagnosis and treatment of a new coronavirus infection.
Russia has a successful
experience in combating epidemics in the country and the world. More than a century of history and
the internationally recognized potential of Russian scientific institutions in
the field of epidemiology and virology help to develop effective measures to
contain the epidemic, create opportunities to help all
needy and saving lives. Our efforts are focused on developing a vaccine and
development of effective treatment regimens.
Decisions made and
recommendations, primarily in terms of prohibitions and restrictions, can be
seem excessive. However, it is they who, according to scientists, are
effective in countering the epidemic.
Responsibility and unity,
taking care of your health and those of others, mutual support and trust will allow
our country to cope with the current situation.
90,000 HIV infection – Articles for the population – Hislavichi district hospital
Today, there is perhaps no person in the world who would not know what HIV is.
HIV, or Human Immunodeficiency Virus, is the causative agent of HIV infection and AIDS, acquired immunodeficiency syndrome. HIV infection is an infectious disease that arises from HIV and ends in AIDS. AIDS, or acquired immunodeficiency syndrome, is the final stage of HIV infection, in which the immune system of a person is damaged to such a level that it is unable to resist any type of infection. Any, even the smallest infection, can cause serious illness and even death.
Human Immunodeficiency Virus
Human Immunodeficiency Virus (HIV) is a group of retroviruses called lentiviruses (they are also called “slow” viruses). This name is explained by their peculiarity – from the moment of infection to the time of the first symptoms of the disease and especially to the development of AIDS, it takes a long time, in some cases the process is delayed for years. In 50% of HIV carriers, the duration of the asymptomatic period is ten years.
When HIV infection enters the bloodstream, it attaches to the blood cells responsible for immunity.This is due to the fact that on the surface of such cells there are CD 4 molecules that are recognized by HIV. Inside these cells, HIV actively multiplies and, before an immune response occurs, the infection is distributed throughout the body. The first to be hit are the lymph nodes, which contain many immune cells.
Throughout the entire period of illness, there is no effective response to the presence of HIV. This can be mainly explained by the fact that immune cells are damaged and cannot function fully.In addition, HIV is highly variable. The result of this is that the immune cells simply do not identify the virus.
As HIV progresses, it infects an increasing number of CD 4 lymphocytes (immune cells), over time their number decreases until they become critically small, which will be considered the beginning of AIDS.
How can you get infected with HIV
1. Through sexual contact. In the vast majority of cases, HIV infection is sexually transmitted.There is a lot of HIV in semen, while the virus tends to accumulate in semen, especially during inflammatory diseases – epididymitis, urethritis, when semen contains many inflammatory cells that contain HIV. For this reason, the risk of HIV transmission increases with concomitant infections that are transmitted through sexual contact. In addition, concomitant genital infections are often associated with the development of all kinds of formations that violate the integrity of the genital mucosa – cracks, ulcers, vesicles, etc.HIV can also be found in vaginal secretions and cervical secretions.
During anal sex there is a significant increase in the risk that HIV from semen will enter the body through the rectal mucosa. Moreover, with anal intercourse, the risk of injury to the rectum, that is, direct contact with blood, increases.
2. In injection drug users – while sharing syringes and needles.
3. During a blood or blood component transfusion procedure.
In preparations of donated blood, platelet mass, fresh frozen plasma, preparations of coagulation factors, HIV may be present.
If infected blood has been transfused into a healthy person, infection occurs in 90-100% of cases.
It is impossible to get infected with the introduction of normal immunoglobulin and special immunoglobulins, since these drugs are processed for complete inactivation of the virus.
Since the mandatory procedure for HIV testing of blood donors was introduced, the risk of getting an infection in this way has been significantly reduced.However, if the donor is in the “blind period”, that is, when infection has already occurred, but antibodies have not formed, the recipient cannot be protected from infection.
4. From mother to child. HIV has the ability to cross the placenta, so infection of the fetus can occur during pregnancy or during childbirth. In Europe, the risk of HIV transmission from an infected mother to her child is about 13%, while in Africa it is 45-48%. The magnitude of the risk depends on the level of organization of medical supervision and treatment of a woman at the stage of pregnancy, the medical indications of the mother and the stage of HIV.
Among other things, there is a real risk of transmission during breastfeeding. The presence of the virus in breast milk and colostrum of a sick woman has been proven. If the mother is HIV-positive, breastfeeding is contraindicated.
5. From the sick to the medical staff and vice versa. Risk levels of infection:
• 0.3% – if injured by sharp objects, on which the blood of HIV-infected people remains,
• less than 0.3% – if it comes into contact with damaged skin and mucous membranes of infected blood.
In theory, it is difficult to imagine HIV transmission from healthcare provider to patient.But in the 90s of the last century in the United States, a message was spread about the infection of five patients from a dentist who had HIV infection, while the method of transmission of the infection has not been clarified. Further observing the patients of HIV-infected doctors (gynecologists, surgeons, dentists, obstetricians), the researchers did not reveal the facts of infection transmission.
How it is impossible to get infected with HIV
If there is a person who is infected with HIV among people you know, you need to know that HIV cannot be infected:
• while sneezing and coughing
• through a handshake
• through a kiss or hug
• sharing food with the sick person or drinking
• in baths, swimming pools, saunas
• by “injections” in the subway.Information about the probable acquisition of infection through needles placed on seats by people infected with HIV, or through an injection of an infected needle in a crowd, is nothing more than fiction. The virus lives in the environment for a very short time, moreover, the concentration of the virus at the tip of the needle is too low for infection.
Saliva and other body fluids contain very little virus, which is not enough to infect. There is a risk of infection if there is blood in body fluids (sweat, saliva, feces, urine, tears).
Acute febrile phase
Acute febrile phase occurs approximately 3-6 weeks after infection. It manifests itself not in all HIV-infected people, only in 50-70%. In the rest of the patients, the incubation period is replaced by an asymptomatic phase.
The acute febrile phase has nonspecific manifestations, such as:
• Fever: an increase in temperature, in most cases not exceeding 37.5 degrees (the so-called subfebrile condition).
• Sore throat.
• Lymph nodes in the armpits, groin and groin enlarge, forming painful swelling.
• Pain in the head and eyes.
• Soreness in joints and muscles.
• Malaise, drowsiness, weight loss, loss of appetite.
• Vomiting, nausea, diarrhea.
• Changes in the skin: skin rashes, ulcers on the skin and mucous membranes.
• It is also possible to develop serous meningitis, when the membranes of the brain are affected (this condition is accompanied by pain in the head, photophobia).
The duration of the acute phase is up to several weeks. After this period, most HIV-infected people enter the asymptomatic phase.At the same time, in about 10% of patients, HIV is characterized by a fulminant course, when the condition deteriorates sharply.
Asymptomatic phase of HIV infection
Asymptomatic phase has a long course. In about 50% of HIV-infected people, the asymptomatic phase can last up to 10 years. The rate at which this phase proceeds depends on the rate at which the virus multiplies. In the asymptomatic phase, there is a decrease in the number of CD 4 lymphocytes. When their level drops to below 200 µl, we can talk about the presence of AIDS.
In the asymptomatic phase, clinical manifestations of the disease may be absent.
A number of infected patients suffer from lymphadenopathy – an enlargement of all groups of lymph nodes.
AIDS – advanced stage of HIV
This stage is characterized by the activation of the so-called opportunistic infections, that is, infections that are caused by opportunistic microorganisms, which, in turn, belong to the normal inhabitants of the human body and normally cannot give rise to the disease.
Body weight is reduced by 10% in relation to the original.
The skin and mucous membranes are affected by viruses, fungi, bacteria:
• Candidal stomatitis: a white cheesy plaque forms on the oral mucosa (thrush).
• Hairy leukoplakia of the mouth – white plaques, covered with grooves, grow on the lateral parts of the tongue.
• The presence of the varicella zoster virus (the causative agent of chickenpox) causes shingles. On large areas of skin, usually on the trunk, extremely painful rashes are formed, which are blisters.
• Frequent recurrent attacks of herpes infection.
• Sinusitis (frontal sinusitis, sinusitis), sore throat (pharyngitis), otitis media (otitis media) are common. The patient has a decrease in the number of platelets, blood cells involved in the clotting process (thrombocytopenia). This causes the appearance of hemorrhages (hemorrhagic rash) on the skin of the legs and hands, as well as bleeding of the gums.
Body weight is reduced by more than 10%.
The following are added to the infections already mentioned:
• Diarrhea for no apparent reason and / or fever lasting more than 1 month
• Tuberculosis of various organs
• Pneumocystis pneumonia
• Kaposi’s sarcoma
Helminthiasis • Intestines Lymphomas 90 130 • Severe neurological disorders develop.
When should HIV infection be suspected?
• Fever of unknown cause lasting more than 7 days.
• For some unknown reason (in the absence of inflammatory diseases), there is an increase in all kinds of groups of lymph nodes: axillary, cervical, inguinal, especially if the symptoms do not disappear for several weeks.
• Persistent diarrhea for several weeks.
• Signs of thrush (candidiasis) appear in the mouth of an adult.
• Herpetic eruptions of extensive or atypical localization.
• Regardless of any reason, body weight is dramatically reduced.
Who is at increased risk of getting HIV infection
• Men of non-traditional sexual orientation.
• Injection drug addicts.
• Persons who have anal sex.
• Women of easy virtue.
• People who already have sexually transmitted diseases.
• People who have more than one sexual partner, especially if they do not use condoms.
• Patients who need hemodialysis (“artificial kidney”).
• Those who require a blood or blood component transfusion.
• Health workers, mostly those who are in contact with patients infected with HIV.
• Children whose mothers are infected.
Alas, today there is no effective vaccine against HIV, despite the fact that scientists in many countries are conducting research in this direction, with which they pin great hopes. At the same time, HIV prevention is currently based on general prevention measures: 90 130 1.Safe sex. Protection with a condom during sexual intercourse helps to avoid infection. But the use of this method of protection cannot give a 100% guarantee, even if used correctly.
To ensure that there is no risk of infection, both sexual partners must undergo a special examination.
2. Avoid drug use. If it is not possible to get rid of the addiction, you need to use only disposable games, do not use syringes or needles that have already been used by someone.
3. If the mother is HIV-positive, breastfeeding should be avoided.
Prevention of opportunistic infections
Infections caused by opportunistic microorganisms are called opportunistic. Conditionally pathogenic microorganisms constantly reside in the human body and, under normal conditions, cannot lead to the development of diseases.
To improve the quality of life and increase its duration, prevention of opportunistic infections is carried out for AIDS patients:
• Prevention of tuberculosis: in order to timely identify a patient who is infected with microbacteria of tuberculosis, all patients with HIV are given a Mantoux test every year.If there is no immune response to tuberculin (i.e., the reaction is negative), it is advised to drink anti-tuberculosis drugs for 12 months.
• Pneumocystis pneumonia prophylaxis: if an HIV-infected patient has a CD4 lymphocyte count of less than 200 / μl and an unreasonably high temperature (from 37.8 degrees) for two weeks, prophylaxis with biseptol is performed.
• AIDS-dementia syndrome. A gradual decline in intelligence, characterized by problems with attention and concentration, difficulty solving problems and reading, and decreased memory, is called dementia.
In addition, AIDS dementia syndrome can manifest itself as a disturbance in movement and behavior: it is difficult for a person to maintain a certain posture, he has difficulty walking, becomes lethargic, and various parts of his body begin to twitch (so-called tremors).
The later stages of this syndrome are also characterized by fecal and urinary incontinence, in some cases by the manifestation of a vegetative state.
AIDS dementia syndrome occurs in a quarter of all HIV-infected people. The etymology of this syndrome has not been fully established.There is a version that its appearance is associated with the direct effect of the virus on the spinal cord and brain.
• Epileptic seizures. They can be caused by the following factors: 90 130 a) neoplasms 90 130 b) opportunistic infections that affect the brain 90 130 c) AIDS dementia syndrome 90 130 The most common causes: cerebral lymphoma, toxoplasmic encephalitis, AIDS dementia syndrome and cryptococcal meningitis.
• Neuropathy. A common complication of HIV infection.It can manifest itself at any stage of the disease. Diverse in clinical manifestations. The early stages may be accompanied by symptoms such as progressive muscle weakness, mild sensory disturbances. Over time, the symptoms may worsen, complicated by leg pain.
For HIV treatment to be successful and to increase the life expectancy of HIV patients, early diagnosis is essential.
When is it necessary to be tested for HIV?
• if there was unprotected vaginal, oral or anal intercourse (without a condom or if it broke in the process) with a new partner.
• if you have been sexually assaulted.
• if your sexual partner has had sex with another person.
• if your past or present sex partner is infected with HIV.
• if used needles have been used to create tattoos and piercings, inject drugs or other substances.
• if there was contact with the blood of a person infected with HIV.
• if your sex partner has used used needles or has any other risk of transmission.
• if another sexually transmitted infection has been detected.
In most cases, for the diagnosis of HIV infection, methods are used, the essence of which is to determine the content of antibodies to HIV in the blood, that is, specific proteins formed in the body of an infected person as a reaction to the penetrated virus. Such antibodies are formed 3-24 weeks after infection. For this reason, an HIV test can only be carried out after this period of time. The final analysis is best done after 6 months from the time of the alleged infection.
A commonly used method for diagnosing HIV is the enzyme-linked immunosorbent assay (ELISA), also known as ELISA. This method shows a sensitivity to antibodies above 99.5%, therefore it seems to be the most reliable. Test results can be negative, positive, or questionable.
Treatment of HIV and AIDS
Therapy for patients diagnosed with AIDS involves the use of antiviral drugs that suppress the multiplication of the virus.
After the diagnosis is confirmed, the course of treatment of patients is determined.Treatment should be individualized and take into account the level of risk. The decision to start antiretroviral treatment is made depending on the severity of the risk of progression of HIV infection and the severity of the risk of severity of immunodeficiency. If antiretroviral treatment is started before virologic and immunologic signs of disease progression appear, the benefits may be less pronounced and lasting.
Viral therapy is prescribed for patients with acute infection.The main principle of the treatment of AIDS, as well as in other viral diseases, is the timely treatment of the main disease and complications caused by it, primarily Kaloshi’s sarcoma, pneumocystis pneumonia, lymphoma of the DNS.
There is evidence that therapy in AIDS patients for opportunistic infections, Kaposi’s sarcoma, is based on high doses of antibiotics and chemotherapy. It is best to combine them. When choosing a drug, in addition to sensitivity data, it is important to consider how the patient tolerates it, as well as the functional state of his kidneys (this is important to prevent drug accumulation in the body).The result of the treatment depends, in addition, on how carefully the chosen course is adhered to, as well as on the duration of therapy.
Despite the fact that the number of drugs and types of treatment for patients with AIDS is quite large, the final results of treatment at the moment are very modest and do not lead to complete cure of the disease, since clinical remissions are associated only with a slowdown in the multiplication of the virus and, in some cases, with a visible a decrease in the morphological signs of the disease, but not with their complete disappearance.For this reason, only by preventing the progression of the virus can most likely give the body immunity to opportunistic infections and the formation of malignant tumors by restoring the immune system or replacing destroyed immune cells.
According to the WHO, HIV infection is a deadly infectious disease that has claimed more than 25 million lives over the past 30 years. In 2010, there were about 34 million HIV-positive people in the world.
What is HIV / AIDS?
Human Immunodeficiency Virus (HIV) is a retrovirus that infects cells of the immune system and makes them unable or incapable of performing their functions. Immunodeficiency resulting from HIV infection makes the body more vulnerable to a wide range of infections and diseases, which, as a rule, people with healthy immune systems can resist.
AIDS (Acquired Immunodeficiency Syndrome) is the terminal stage of HIV infection, which can occur after 10-15 years of infection.This stage is characterized by the development of certain types of cancer, infectious diseases, or other clinical conditions.
What is the difference between HIV and AIDS?
HIV is a virus that can lead to diseases such as AIDS. HIV belongs to a subset of retroviruses, or slow viruses. Although HIV is the cause of AIDS, a patient can live with HIV for many years before the disease develops into AIDS.
HIV is not transmitted by air and is not spread through casual contact, kissing or hugging.The virus can enter the body through unprotected intercourse, as well as through activities that pose an increased risk of infection – through contact with blood, semen, breast milk and other body fluids of HIV-infected people.
This is a progressive disease. When HIV enters the body, it attacks specific cells in the immune system. These cells are called CD4 or T helper cells. They are an important part of the immune system that helps the body fight off infections and diseases.If the CD4 cells are not working properly, the body is more susceptible to various diseases.
AIDS is the terminal stage of HIV infection. A patient is considered to have AIDS if the CD4 cell count falls below 200 and the patient suffers from 1 or more opportunistic infections (OIs). Opportunistic infections are infections that, as a rule, the body of a healthy person can successfully fight.
There are several stages of HIV infection before AIDS is diagnosed:
- 1.Incubation period. The earliest stage, immediately after infection occurs. HIV can infect cells and begin replicating before the immune system responds. Symptoms may be similar to those of the flu.
2. Stage of the immune response. The next stage is characterized by the body’s response to the presence of the virus. Even if the patient does not feel any changes, his body tries to fight the virus by producing antibodies to it. This stage, when the patient stops being HIV negative and becomes HIV positive, is called “seroconversion”.
3. Asymptomatic stage. The disease can enter a stage called the “asymptomatic phase”. The patient is infected with the human immunodeficiency virus, and it causes harm to the body that the patient does not feel
4. Symptomatic stage. At this stage, the patient begins to experience symptoms of the disease, such as certain infections, including Pneumocystis pneumonia.
AIDS is diagnosed when a patient has various symptoms and infections and certain test results.
How is HIV transmitted?
Infection with HIV can occur through unprotected direct contact with an infected person’s body fluids, such as blood, breast milk, semen and vaginal secretions. This infection is not spread through everyday household contact such as kissing, hugging and shaking hands, or eating and drinking together.
As for the vertical transmission of the virus from mother to child, if a pregnant woman undergoes complex antiretroviral therapy in a timely manner and a number of preventive measures are taken, the probability of infecting a child can be reduced to 1-2%.
The main method for laboratory diagnosis of HIV infection is the enzyme-linked immunosorbent assay of antibodies to the virus. This is a safe and harmless blood test that detects the presence of antibodies in the blood, which indicates the presence of HIV.