Hepatitis and HIV control and

prevention
 Presented BY:

ASMA ALSHEHRI SHAHAD Almoqhrabi

Scenario:
Patient admitted to ICU have respiratory infection caused by pneumocystis pneumonia
(PCP) , hepato-splenomegaly and pharyngitis.
 
Chest radiograph was normal.
On going IV medication trimethoprim , sulfamethoxazole and corticosteroids. 

The findings after Nursing assessment are 

Fever 38.1
Rash 
Diarrhea 
Headache 
Nausea and vomiting

What’s your expectation? 

What’s your precaution ? 

 
During the shit

the nurse inserted the cannula she had stick needle

injury. 

She ignore what happened and continue her

management because the blood culture result showed
no growth for micro organisms. 

After the end of the shift she endorses her patient

then she go to her home after a challenging day. 
In the 2nd day :

She cover the same patient after assessment .

The watcher tells her that her husband
diagnosed with AIDS.
HIV
?
What is the different between AIDS and HIV?
Definition:
Impaired cellular immunity is the
underling pathophysiology
consequence of AIDS is caused by
the viral agent HIV.
 Transmission:
HIV is transmitted from person to person by blood and bodily fluids

The HIV does not transmit easily. Why? Certain )small tear(
1- HIV is cannot survive long outside the body.
amount of portal of
Survival time depends on the size of the droplet. virus entry
As the droplet dries, HIV dies.
)viral load(
2-Not all body fluids have been implicated in the transmission of HIV.
only (blood, semen, vaginal fluid, and breast milk.)

The risk of HIV transmission to HCW is low if SP are followed.

Viral replication:
Viral replication:

The new virions expelled from the Approximately 30% of the viral burden is regenerated
daily in the bloodstream.
.host cell by budding

The weakens of the cell wall to

CD4+ T cells, leading to cellular
instability. destruction of the bone
marrow and lymphoid tissues

. immunosuppression
 Immune
Defects
 
Patients with HIV infection
exhibit impaired activation of both
 ".cellular and humoral immunity

increasing susceptibility to
opportunistic infections and
.neoplasms
Signs and Symptoms
 Fever (96%)
 Adenopathy (74%)
 Pharyngitis (70%)
 Rash (70%)
 Myalgias (54%)
 Less Frequently, Diarrhea (32%)
 Headache (32%)
 Nausea/Vomiting (27%)
 Hepato- Splenomegaly (14%)
 Weight Loss (13%)
 Thrush (12%)
 Neurologic Symptoms (12%)

No organ system escapes involvement in HIV infection.

 
Laboratory and diagnostic

Used To detect :  To evaluate progression:

o ELISA : if positive need 2nd to confirm; o Nucleic acid test ( viral load test )
o If negative need 2nd in 6 month.  o HIV RNA PCR 
o Branched-chain DNA 
o CBC 
o Rapid plasma reagin 
o Chest radiograph 
o Western blot :Highly sensitive and specific. o Serum chemistries 
o Papanicolaous test to cervical cancer 
o PCR. For genetic material o Anal carcinoma 
o Ppd test
o Hepatitis serology 
o Toxoplasmosis serology 
o Cytomegalovirus CMV antibody serology 

Normal CD4 + T cell count is around 1000 cells/mm

Management 
 Involves a complex and multi-system assessment

1-control opportunistic infection 

• Maintain of safe IC measures. 

• use prophylaxis 
• Vaccination guidelines should implemented 

2- Use Antiretroviral therapy (ART) to reduced viral load

goal :CD4+ above 200 cells/mm3 then we can stop prophylaxis. 

The classes include:

1- the nucleoside/nucleotide reverse transcrip- tasę inhibitors (NRTIS),
2- nonnucleoside reverse transcriptase inhibitors (NNRTIS),
3- protease inhibitors (Pls),
4- fusion in- hibitors (Fls),
5- integrase strand transfer inhibitors (INSTIS),
6- CCR5 antagonists (CCR5S). 
Prophylactic
Possible after exposure to HIV,
preferably within 1 to 72 hours. After 72
 .hours, not recommended

The CDC recommends that use of

ART provided protection against the
.HIV infection
people who are HIV negative and (
.risk of exposure to HIV infected
Summary
Apply the SP will reduce HIV transmission

HIV is transmitted by blood and bodily fluids

HIV lead to immunosuppression .

HIV infection effect to multi-systems.

ART provided protection against the HIV infection.

?
The nurse is assisting in planning care for a client with
A diagnosis of immunodeficiency and should incorporate which action
As priority in the plan?

1- identifying factors that decreased the immune function.

2- providing emotional support to decrease fear.
3- start ART
4-protecting the clint from infection.
Hepatitis
 Out Line

01 02 03
Defination Types Transmition

04 05
Prevent Reference
 Introduction
Viral hepatitis is a global public health problem affecting
millions of people every year, causing disability and death.
 Defination
Hepatitis is an inflammation of the liver, most
commonly caused by a viral infection
‫؟‬
 Types
HBV HCV HDV

infections occur
exclusively in persons
infected with HBV.
Transmission
 Main transmission modes hepatitis B and C virus

Hepatitis C virus (HCV) Hepatitis B virus (HBV)

Blood-to-blood contact by unsafe * blood-to-blood contact by unsafe *

injecting practices blood transfusion, injecting practices, blood transfusion,
.unsterile medical equipment .unsterile medical equipment

Sexual contact (less common) * . Mother-to-child transmission *

Sexual contact *
•
•
Physical Examination
Prevention
Main prevention measures hepatitis B and C:

• Promote vaccination against hepatitis B

• Avoid sharing injecting equipment

• Promote safe sex

• Ensure adequately sterilized medical equipment

• Promote hepatitis B and C testing and counselling services

raising awareness of all types of viral hepatitis infections help reduce
transmission in the community.

•Implementation of blood safety strategies.

effective public education on blood donation and donor selection

quality-assured screening of all donated blood and blood

components used for transfusion can prevent transmission of HBV
and HCV.
Co-infection of HCV :
HIV is common, especially among people
who inject drugs
 References

● WHO/Europe | Hepatitis

● https://apps.who.int/iris/bitstream/handle/10665/130012/WHO_HSE

● Critical care Nursing Aholistic APProach.pdf

Thanks