HIV/AIDS
and other Bloodborne Pathogens




                                              Orlando Tech
                   ...
Course Objectives


•   What is HIV / AIDS?
•   How is it spread?
•   How can it be prevented?
•   What happens to people ...
Definition of HIV


  Human
  Immunodeficiency
  Virus
  HIV is the virus that causes AIDS
Definition of AIDS

Acquired
  Something a person gets from someone else
Immune
  Your defense system for fighting off dis...
When the HIV Virus Attacks

It infects the helper T cells, first blocking their ability to
  recognize foreign substances,...
HIV Virus Structure
HIV Attack on a T Cell
For AIDS to be Transmitted


 • Virus must be present in an infected person

 • Infected body substance must enter the

  ...
Body Substance Carriers


•   Blood
•   Semen
•   Vaginal Secretions
•   Breast Milk
•   Body substances that contain bloo...
Sexual Transmission


• Semen, vaginal fluids, menstrual blood can

 carry the AIDS virus
• These fluids can enter the blo...
Nonsexual Transmission


• Sharing IV drug needles passes blood from

 one user to another
• Infected mothers can infect u...
Blood Transmission


• An HIV-infected drop of human blood contains

  1 to 100 live virus particles
• Methods of blood tr...
HIV is not transmitted through…


    Shaking hands   Hugging
    Casual kiss     Drinking fountain
    Food            Do...
General Precautions


•   Don’t share razors, toothbrushes, dental floss,
    tattoo or ear piercing needles
•   Clean bod...
Personal Prevention



Autologous Transfusion
The collection and storage of blood or blood
components from a patient for s...
Personal Prevention


 An infected person may show no outward
 sign of being infected…
 •   Know your partner’s health sta...
Occupational Exposure Transmission


 The risk of contracting HIV after one occupational exposure
 is about 0.3%
 Health c...
Universal Precautions


 • Approach every body fluid as if

   it was infected with HIV
 • Put a barrier between you and

...
Infection Control Practices

 • Wear PPE – Personal Protective Equipment

          masks, gloves, eyewear
 • Wash hands f...
HIV Testing


 Florida Statute 381.004
 •   Informed Consent
 •   Anonymity
 •   Results reported to DOH
 •   Counseling
 ...
HIV Testing


• HIV testing must be performed by a lab

  licensed by the Department of Health
• All reactive tests must b...
HIV Screening Testing


 • HIV ELISA, sometimes called an HIV enzyme

  immunoassay (EIA) is the first test to determine
 ...
HIV Western Blot Testing


• Lupus, Lyme disease, and Syphilis may give a

 false positive ELISA screening.
• More specifi...
Pathogenesis



      The Development of
         HIV into AIDS
Pathogenesis


           Sero-conversion
               HIV positive

                   
          Symptomatic AIDS
T Cells

Lymphocyte subset responsible for
cell-mediated immunity
• Killer T cells  macrophages
• Helper T cells “CD4”  ...
Classification System of HIV Infection


                           Clinical Categories
                                  ...
Category A Conditions


•   Asymptomatic HIV infection
•   Persistent generalized lymphadenopathy
•   Primary acute HIV in...
Category B Conditions


One of the following criteria must be met
• The conditions are attributed to HIV infection

  or d...
Opportunistic Infections

• An infection caused by an organism that does

  not usually trouble people with healthy immune...
Category B Conditions

 • Candidiasis
 • Cervical dysplasia
 • Cervical carcinoma in situ
 • Fever, diarrhea lasting longe...
Cervical Dysplasia
Leokoplakia
Herpes Zoster
Category C Conditions

• Candidiasis                • Kaposi’s Sarcoma

• Invasive cervical cancer   • Tuberculosis

• Cyt...
Oral Herpes Simplex
Genital Herpes Simplex

Vaginal Herpes
                         Penile Herpes
Kaposi’s Sarcoma
Tuberculosis
HIV Warning signs


•   Profound and unexplained fatigue
•   Chills or drenching night sweats
•   Weight loss 10% in less...
AIDS Reported Cases

            New York
            California
             Florida
             Texas
           New Je...
Other Bloodborne Pathogens




                 Hepatitis
The Functions of the Liver

•   Detoxify everything you eat, breathe, and absorb
    through the skin
•   Convert nutrient...
Viral Hepatitis


Acute Hepatitis
• Infection following entrance of virus into the body

• Symptoms may or may not be pres...
Viral Hepatitis


Chronic Hepatitis
•   Acute hepatitis persisting > than 6 months
•   Only acute hepatitis B, C and D can...
Types of Hepatitis



     • Hepatitis A   •   Hepatitis D
     • Hepatitis B   •   Hepatitis E
     • Hepatitis C   •   H...
Transmission of Hepatitis



             • Enteral
             • Parenteral
Enteral-Acquired Hepatitis


Hepatitis A, Hepatitis E
Transmission from stool-contaminated…
  • Water, ice cubes

  • Food...
Hepatitis A

•   No chronic infection
•   Once you have had HAV you cannot get it again
•   15% of infected people have pr...
Hepatitis A


• Found in the feces of persons with hepatitis A

• Spread from person to person by putting

  something in ...
HAV Signs and Symptoms

 Adults are more symptomatic than children
 •   Jaundice
 •   Fatigue
 •   Abdominal pain
 •   Los...
HAV Prevention and Treatment


• Hepatitis A vaccine

• Immune globulin given before and within 2 weeks after

 coming in ...
Parenteral-acquired Hepatitis


 Hepatitis B, C, D, G
 • Blood to blood

   Transfusion, tattoo, body piercing, needles,
 ...
Hepatitis B

• Can exist on almost any surface outside the body for

  more than a month
• Found in the blood, semen, and ...
HBV Statistics


• HBV infects 1 out of every 20 people living in the US

• ½ of HBV infected persons are symptomatic

• I...
HBV Signs and Symptoms

•   Extreme tiredness
•   Joint pain
•   Loss of appetite
•   Nausea, vomiting
•   Fever
•   Dark-...
HBV Transmission


• Unprotected anal or vaginal sex
• Needles used for drugs, body piercing, tattooing,
• Contact with op...
Hepatitis C


 • Blood or body fluids from an infected person

  enters the body of a person who is not infected
 • IV dru...
HAC Statistics


• 3.9 million people have been infected

• 15-45% clear HCV naturally

• 55-85 % retain the HCV virus and...
HAC Signs and Symptoms

Most patients have no symptoms because
the liver is a non-complaining organ
Symptomatic patients m...
HAC Treatment


• There is no vaccine for Hepatitis C

• Drug treatment with interferon

• Alcohol abstinence

• Healthy l...
Healthcare Workers Risks



          Any healthcare worker
         that may come in contact
            with blood is at...
Healthcare Workers Risks


•   Contact with infected body fluids by not using
    PPE can lead to transmission through ski...
Healthcare Workers Risks


•   HBV is transmitted more efficiently than HIV
•   HBV needlestick injury is 20 times more li...
Biohazard Labels and Signs



  •BIOHAZARD symbol must be clearly visible any

  where there is potentially infectious mat...
Laundry Practice


• Laundry workers must wear PPE

• Contaminated linens should be treated as if it were

  HBV/HIV infec...
Hepatitis Prevention

•   Immunization for HBV
•   Avoid sharing personal items like needles,
    razors, scissors, toothb...
Hepatitis Vaccination


•   Vaccine offers 85-95% prevention
    with inoculation series of 3 doses
•   There is no cure o...
Personal Protective Equipment

Employer Provided
• Different sizes and readily accessible areas

• Cleaning or disposal of...
Recordkeeping

•   ID employees
•   HBV vaccination status
•   Examination, testing results and follow-up
•   Information ...
For More Information

Centers for Disease Control
www.cdc.gov
National Library of Medicine
www.nlm.nih.gov
The Hepatitis F...
Upcoming SlideShare
Loading in …5
×

Hiv Aids Bloodborne Pathogens

7,200 views

Published on

Hiv Aids Bloodborne Pathogens

Published in: Health & Medicine
1 Comment
16 Likes
Statistics
Notes
No Downloads
Views
Total views
7,200
On SlideShare
0
From Embeds
0
Number of Embeds
1,157
Actions
Shares
0
Downloads
0
Comments
1
Likes
16
Embeds 0
No embeds

No notes for slide

Hiv Aids Bloodborne Pathogens

  1. 1. HIV/AIDS and other Bloodborne Pathogens Orlando Tech Practical Nursing Program
  2. 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. 3. Definition of HIV Human Immunodeficiency Virus HIV is the virus that causes AIDS
  4. 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. 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. 6. HIV Virus Structure
  7. 7. HIV Attack on a T Cell
  8. 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. 9. Body Substance Carriers • Blood • Semen • Vaginal Secretions • Breast Milk • Body substances that contain blood cells • Cerebrospinal fluid, synovial fluid, amniotic fluid
  10. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 20. HIV Testing Florida Statute 381.004 • Informed Consent • Anonymity • Results reported to DOH • Counseling • Confidentiality
  21. 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. 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. 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. 24. Pathogenesis The Development of HIV into AIDS
  25. 25. Pathogenesis Sero-conversion HIV positive  Symptomatic AIDS
  26. 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. 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. 28. Category A Conditions • Asymptomatic HIV infection • Persistent generalized lymphadenopathy • Primary acute HIV infection with accompanying illness
  29. 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. 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. 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. 32. Cervical Dysplasia
  33. 33. Leokoplakia
  34. 34. Herpes Zoster
  35. 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. 36. Oral Herpes Simplex
  37. 37. Genital Herpes Simplex Vaginal Herpes Penile Herpes
  38. 38. Kaposi’s Sarcoma
  39. 39. Tuberculosis
  40. 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. 41. AIDS Reported Cases New York California Florida Texas New Jersey Puerto Rico Illinois Georgia Pennsylvania Massachusetts
  42. 42. Other Bloodborne Pathogens Hepatitis
  43. 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. 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. 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. 46. Types of Hepatitis • Hepatitis A • Hepatitis D • Hepatitis B • Hepatitis E • Hepatitis C • Hepatitis G
  47. 47. Transmission of Hepatitis • Enteral • Parenteral
  48. 48. Enteral-Acquired Hepatitis Hepatitis A, Hepatitis E Transmission from stool-contaminated… • Water, ice cubes • Food shellfish, vegetables, fruits
  49. 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. 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. 51. HAV Signs and Symptoms Adults are more symptomatic than children • Jaundice • Fatigue • Abdominal pain • Loss of appetite • Nausea • Diarrhea • Fever
  52. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 62. Healthcare Workers Risks Any healthcare worker that may come in contact with blood is at risk
  63. 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. 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. 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. 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. 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. 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. 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. 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. 71. For More Information Centers for Disease Control www.cdc.gov National Library of Medicine www.nlm.nih.gov The Hepatitis Foundation www.hepfi.org Occupational Safety & Health Administration www.osha.gov

×