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Hiv Aids Bloodborne Pathogens
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Hiv Aids Bloodborne Pathogens


Hiv Aids Bloodborne Pathogens

Hiv Aids Bloodborne Pathogens

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  • 1. HIV/AIDS and other Bloodborne Pathogens Orlando Tech Practical Nursing Program
  • 2. Course Objectives • What is HIV / AIDS? • How is it spread? • How can it be prevented? • What happens to people with AIDS? • Distinguish fact from fiction regarding HIV / AIDS
  • 3. Definition of HIV Human Immunodeficiency Virus HIV is the virus that causes AIDS
  • 4. Definition of AIDS Acquired Something a person gets from someone else Immune Your defense system for fighting off diseases Deficiency Below normal levels Syndrome Group of signs and symptoms that occur together
  • 5. When the HIV Virus Attacks It infects the helper T cells, first blocking their ability to recognize foreign substances, then changing the T cells into AIDS-virus factories Because the T cells no longer perform their infection fighting role, invading viruses can roam free. Meanwhile, the damaged T cells produce AIDS virus, which invades other T cells
  • 6. HIV Virus Structure
  • 7. HIV Attack on a T Cell
  • 8. For AIDS to be Transmitted • Virus must be present in an infected person • Infected body substance must enter the bloodstream of another person
  • 9. Body Substance Carriers • Blood • Semen • Vaginal Secretions • Breast Milk • Body substances that contain blood cells • Cerebrospinal fluid, synovial fluid, amniotic fluid
  • 10. Sexual Transmission • Semen, vaginal fluids, menstrual blood can carry the AIDS virus • These fluids can enter the bloodstream through microscopic tears or sores in the tissue of vagina, penis, anus or mouth
  • 11. Nonsexual Transmission • Sharing IV drug needles passes blood from one user to another • Infected mothers can infect unborn children or babies who are breastfed • Blood transfusions of infected blood
  • 12. Blood Transmission • An HIV-infected drop of human blood contains 1 to 100 live virus particles • Methods of blood transmission • Blood / blood product • Needle sharing • Occupational Exposure
  • 13. HIV is not transmitted through… Shaking hands Hugging Casual kiss Drinking fountain Food Door knobs Insects Hot tubs Pets Swimming pools Sneezing Dishes Coughing Toilet seat
  • 14. General Precautions • Don’t share razors, toothbrushes, dental floss, tattoo or ear piercing needles • Clean body fluid spills with a 1:10 bleach:H20 solution • Wear disposable gloves when cleaning blood spills • Dispose of waste materials in proper containers • Wash hands with soap and water
  • 15. Personal Prevention Autologous Transfusion The collection and storage of blood or blood components from a patient for subsequent transfusion to that same person is recommended prior to elective surgery
  • 16. Personal Prevention An infected person may show no outward sign of being infected… • Know your partner’s health status • Practice safer sex • Abstinence • Monogamy
  • 17. Occupational Exposure Transmission The risk of contracting HIV after one occupational exposure is about 0.3% Health care worker exposure can occur from: • Needlesticks • Blood splashes to the oral mucosa
  • 18. Universal Precautions • Approach every body fluid as if it was infected with HIV • Put a barrier between you and everyone’s body substances!
  • 19. Infection Control Practices • Wear PPE – Personal Protective Equipment masks, gloves, eyewear • Wash hands frequently for at least 15-30 sec. • Use puncture proof containers / Biohazard bags • Tie / close securely • Clean work areas with tuberculocidal solution or fresh 1:10 (bleach to water) solution
  • 20. HIV Testing Florida Statute 381.004 • Informed Consent • Anonymity • Results reported to DOH • Counseling • Confidentiality
  • 21. HIV Testing • HIV testing must be performed by a lab licensed by the Department of Health • All reactive tests must be retested using another confirmatory test such as a Western blot test. • Confirmation must be done before releasing results
  • 22. HIV Screening Testing • HIV ELISA, sometimes called an HIV enzyme immunoassay (EIA) is the first test to determine if an individual is positive for the HIV pathogen. • Detects either the presence of • antigen or antibody in your blood.
  • 23. HIV Western Blot Testing • Lupus, Lyme disease, and Syphilis may give a false positive ELISA screening. • More specific Western Blot is used to confirm if someone is truly HIV positive.
  • 24. Pathogenesis The Development of HIV into AIDS
  • 25. Pathogenesis Sero-conversion HIV positive  Symptomatic AIDS
  • 26. T Cells Lymphocyte subset responsible for cell-mediated immunity • Killer T cells  macrophages • Helper T cells “CD4”  activate and direct other immune cells and are the target of the HIV virus • Regulatory T cells  maintain immunity homeostasis
  • 27. Classification System of HIV Infection Clinical Categories A B C CD4+T-cell categories Asymptomatic, Symptomatic, AIDS-indicator acute HIV not A or C conditions 1. ≥ 500/µL A1 B1 C1 2. 200-499/µL A2 B2 C2 3. <200/µL A3 B3 C3 AIDS indicator -Tcell count
  • 28. Category A Conditions • Asymptomatic HIV infection • Persistent generalized lymphadenopathy • Primary acute HIV infection with accompanying illness
  • 29. Category B Conditions One of the following criteria must be met • The conditions are attributed to HIV infection or defective cell mediated immunity • The conditions have a clinical management that is complicated by HIV infection.
  • 30. Opportunistic Infections • An infection caused by an organism that does not usually trouble people with healthy immune systems. • Opportunistic infections (OIs) are primarily responsible for the morbidity and mortality associated with HIV disease
  • 31. Category B Conditions • Candidiasis • Cervical dysplasia • Cervical carcinoma in situ • Fever, diarrhea lasting longer than a month • Oral leukoplakia • Herpes zoster at least 2 distinct episodes • Idiopathic thrombocytopenic purpura • Pelvic Inflammatory Disease • Peripheral neuropathy
  • 32. Cervical Dysplasia
  • 33. Leokoplakia
  • 34. Herpes Zoster
  • 35. Category C Conditions • Candidiasis • Kaposi’s Sarcoma • Invasive cervical cancer • Tuberculosis • Cytomegalovirus • Pneumocystis carinii pneumonia • Herpes simplex • Salmonella septicemia • Histoplasmosis • Toxoplasmosis of brain • Lymphoma • Encephalopathy
  • 36. Oral Herpes Simplex
  • 37. Genital Herpes Simplex Vaginal Herpes Penile Herpes
  • 38. Kaposi’s Sarcoma
  • 39. Tuberculosis
  • 40. HIV Warning signs • Profound and unexplained fatigue • Chills or drenching night sweats • Weight loss 10% in less than 60 days • Lymphadenopathy • Dry cough • Blotches on or under skin, in mouth, nose, eyelids • Dementia, memory loss, tremors, depression
  • 41. AIDS Reported Cases New York California Florida Texas New Jersey Puerto Rico Illinois Georgia Pennsylvania Massachusetts
  • 42. Other Bloodborne Pathogens Hepatitis
  • 43. The Functions of the Liver • Detoxify everything you eat, breathe, and absorb through the skin • Convert nutrients in food into proteins, energy, hormones, clotting and immune factors • Store certain vitamins, minerals • Neutralize and destroy poisonous substances • Regulate fat stores • Remove bacteria from the blood stream
  • 44. Viral Hepatitis Acute Hepatitis • Infection following entrance of virus into the body • Symptoms may or may not be present • Disease develops in a 4 week period; then recovery • Rarely results in liver failure
  • 45. Viral Hepatitis Chronic Hepatitis • Acute hepatitis persisting > than 6 months • Only acute hepatitis B, C and D can become chronic • Results in a persistent liver injury • May lead to cirrhosis, and primary liver cancer
  • 46. Types of Hepatitis • Hepatitis A • Hepatitis D • Hepatitis B • Hepatitis E • Hepatitis C • Hepatitis G
  • 47. Transmission of Hepatitis • Enteral • Parenteral
  • 48. Enteral-Acquired Hepatitis Hepatitis A, Hepatitis E Transmission from stool-contaminated… • Water, ice cubes • Food shellfish, vegetables, fruits
  • 49. Hepatitis A • No chronic infection • Once you have had HAV you cannot get it again • 15% of infected people have prolonged or relapsing symptoms over a 6-9 month period • Epidemics both community-wide and nationwide • 1/3 Americans have evidence of past infection immunity
  • 50. Hepatitis A • Found in the feces of persons with hepatitis A • Spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A...oral-fecal route
  • 51. HAV Signs and Symptoms Adults are more symptomatic than children • Jaundice • Fatigue • Abdominal pain • Loss of appetite • Nausea • Diarrhea • Fever
  • 52. HAV Prevention and Treatment • Hepatitis A vaccine • Immune globulin given before and within 2 weeks after coming in contact with HAV • Always wash your hands with soap and water after using the bathroom, changing a diaper, and before preparing and eating food
  • 53. Parenteral-acquired Hepatitis Hepatitis B, C, D, G • Blood to blood Transfusion, tattoo, body piercing, needles, organ transplants, hemodialysis • Sexual intercourse • Mother to child • Household contact of infected persons
  • 54. Hepatitis B • Can exist on almost any surface outside the body for more than a month • Found in the blood, semen, and vaginal secretions of infected people • Low concentrations can be found in saliva • Blood concentration is 100 times greater than HIV • Can cause cirrhosis, liver failure, liver cancer
  • 55. HBV Statistics • HBV infects 1 out of every 20 people living in the US • ½ of HBV infected persons are symptomatic • Infected persons can spread with HBV, whether they have symptoms or not • 6% of infected adults will carry HBV in their bodies for years or for life and remain contagious
  • 56. HBV Signs and Symptoms • Extreme tiredness • Joint pain • Loss of appetite • Nausea, vomiting • Fever • Dark-colored urine • Ascites • Yellowish tinged skin and eyes
  • 57. HBV Transmission • Unprotected anal or vaginal sex • Needles used for drugs, body piercing, tattooing, • Contact with open sores • Sharing toothbrushes, razors, nail clippers, washcloths • Living with a person with ongoing HBV infection • Human bites
  • 58. Hepatitis C • Blood or body fluids from an infected person enters the body of a person who is not infected • IV drug users • Needlesticks or sharps exposures on the job • Infected mother to her baby during delivery
  • 59. HAC Statistics • 3.9 million people have been infected • 15-45% clear HCV naturally • 55-85 % retain the HCV virus and are infectious • 20 % of carriers develop cirrhosis and/or cancer • 3 % will die of complications related to Hepatitis C
  • 60. HAC Signs and Symptoms Most patients have no symptoms because the liver is a non-complaining organ Symptomatic patients may experience: • Fatigue • Jaundice • Nausea • Abdominal Pain • Diarrhea • Extreme Fatigue • Vomiting • Muscle and Joint Pain
  • 61. HAC Treatment • There is no vaccine for Hepatitis C • Drug treatment with interferon • Alcohol abstinence • Healthy low fat diet • Avoid NSAID medications • Avoid greater than 2 gm acetaminophen /day
  • 62. Healthcare Workers Risks Any healthcare worker that may come in contact with blood is at risk
  • 63. Healthcare Workers Risks • Contact with infected body fluids by not using PPE can lead to transmission through skin and mucous lesions • Needle stick injury or other sharps • Tying wires to close sternum may cause glove tearing and finger cuts
  • 64. Healthcare Workers Risks • HBV is transmitted more efficiently than HIV • HBV needlestick injury is 20 times more likely to transmit than a HIV needlestick injury • A single drop of contaminated blood has 100 million to 1 billion organisms
  • 65. Biohazard Labels and Signs •BIOHAZARD symbol must be clearly visible any where there is potentially infectious material •BIOHAZARD signs must be posted at the entrance of potentially hazardous work areas
  • 66. Laundry Practice • Laundry workers must wear PPE • Contaminated linens should be treated as if it were HBV/HIV infectious • Contaminated linen should be bagged on-site • Contaminated laundry should be transported in leak proof biohazard bags
  • 67. Hepatitis Prevention • Immunization for HBV • Avoid sharing personal items like needles, razors, scissors, toothbrush, pierced earrings that may be contaminated with blood • Cover open wounds • Disinfect / sterilize medical reusable devices • Use disposable needles, syringes, lancets
  • 68. Hepatitis Vaccination • Vaccine offers 85-95% prevention with inoculation series of 3 doses • There is no cure once infected • No cost to employees
  • 69. Personal Protective Equipment Employer Provided • Different sizes and readily accessible areas • Cleaning or disposal of PPE • Repair or replacement of PPE as needed Employee Guidelines • Replace surgical gloves when torn, soiled or punctured • Replace surgical gloves when integrity is compromised • Utility gloves may be cleaned and disinfected for re-use
  • 70. Recordkeeping • ID employees • HBV vaccination status • Examination, testing results and follow-up • Information regarding exposure follow-up • Training session dates • Program summary • Name & Qualification of Trainer • Name & job titles of attendees • Records must be available to employees and OSHA
  • 71. For More Information Centers for Disease Control National Library of Medicine The Hepatitis Foundation Occupational Safety & Health Administration