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the effects of the genetic mutation which alters the expression of the CCR5 cell receptor and its clinical significanceoCCR5- chemokine receptor (react better with macrophage tropic)- usually cause the primary HIV infection, do not cause syncytium formation (infected cells that fuse and form multinucleate)Protein found on the surface of WBCsUse CCR5 as a mode of entry and infect host cellsCertain individuals carry a mutation of gene, protecting themagainst these strains of HIVGP120 (protein unit found on envelope glycoprotein structure) is encoded for HIV-1 gene- spike ike struct locatedon surface of virus, is a chemokine mimic and binds to CCR5Binding to CD4 alone can cause GP120 shedding, must bind to co-receptor CCR5 in order for fusion to proceedCCR5-using viruses are the predominant species isolated during the early stages of viral infection, suggesting that these viruses may have a selective advantage during transmission/acute phase of diseaseCCR5 receptor antagonists have been designed to interfere with associated binding between GP120 envelope and CCR5Differentiate between the difference in the diagnoses of HIV Infection and AIDS and describe the clinical implications. oHIV diagnosis: Test for antibodies against HIV proteins (particularly p24- comesdirectly from the HIV virus), if individual is seropositive, diagnosis of AIDS is made in association with various clinical symptoms oAIDS diagnosis: By decrease CD4+ cell numbers at or below 200 cells/uLEvaluate the clinical manifestations which indicate a compromised immune system ina person with HIV infection and develop a plan to decrease the risk for opportunistic infections. oClinical manifestations: Depletion of CD4+ cells causes profound effect on the immune system, may be asymptomatic in early stagesoARTEvaluate the diagnostic tests used to screen for HIV infection and describe the clinical implications of each test. May use any of 3 body fluids to detect antibodies
(blood, oral fluids- not saliva, urine) Positive blood tests will need western blot confirmation, or HIV viral load testHIV EIA (3rdgeneration immunoassay): Enzyme linked immunosorbent assay, screens for antibodies, IgM & IgG, only (as opposed to virus itself), called an indirect test4thGeneration immunoassay: Detects both HIV antibody and p24 antigen, testing for early infections during window period, good for early detecting before antibody development as well as antibodies that are present when chronic infection has been establishedType of InfectionEtiologyClinical ManifestationsPathophysiology pneumocystis jiroveci pneumonia (PCP)-Serious infection that causes inflammation and fluid buildup in your lungs-Spread through the airMild symptoms- fever (low grade for HIV), dry cough/wheezing, SOB when active, fatigue, chest pain with inhalation, *most common opportunistic infection-ART & preventive drugs have decreased infected-Test to diagnose: look at fluid/tissue from lungs from oral sample bronchoscope, biopsy