Assignment task: A case of HIV infection
Tomos is a 28-year-old man who has presented himself for HIV testing at a sexual health clinic. He has been feeling increasingly unwell and is worried about being exposed to HIV infection a couple of months ago. During the consultation, Tomos reveals that he has been working as a volunteer, teaching English in Cape Town, South Africa. He was there for the past year and has just returned back home to the UK. While in Cape Town, Tomos celebrated his 28th birthday with his friends and they all got quite drunk and he can't remember everything clearly. On the spur of the moment, they all decided to get tattoos at a local studio.
Back in the UK, at the sexual health clinic, the HIV test is performed and Tomos is found to be HIV positive. He is then referred on to a specialist HIV clinic where his positive test is confirmed. His CD4 cell count is found to be 140 cells/microlitre and his viral load is 168,324 copies/mL. Tomos has previously been fit and well and does not take any regular medications. The doctor at the specialist clinic commenced ART with Truvada and Tivicay tablets.
1. How might Tomos have contracted HIV infection? Consider possible risk factors as well how the virus is transmitted.
2. Which cells are targeted by HIV and what happens when these cells are exposed to the virus (i.e. how does HIV enter the cells, replicate, and then go on to infect other cells)?
3. What signs and symptoms might Tomos be experiencing? What further symptoms would be expected if Tomos did not get treatment?
4. What precautions could Tomos have taken to prevent contacting HIV infection?
5. What tests and markers are used to diagnose HIV infection?
6. What are the aims of antiretroviral therapy?
7. What are the different types of antiretroviral drugs, what do they target and how do they work?
8. What baseline tests/checks should be carried out before commencing treatment? (PP)