Question

A pregnant female of age 38 years, her weight is 80 Kg and her height is 160 cm, was admitted to hospital due to unknown reason high temperature 38 ºC, she had symptoms like night sweat, general weakness, weight loss of unknown reason, also non- itchy spots on her neck. The physician advised her to admit hospital for more investigations as she is pregnant in the 3^rd trimester, after blood test, WBC count was 3500 /mm³ and Hb was 9 g/dL, and she was told HIV-positive patient?

1-Would you recommend any other laboratory tests to prove she is HIV-positive patient? If yes, mention them with their normal values? (Please notice that your answer not to exceed 50 words, and list the reference you have used).

2-What are your dietary, exercise, and lifestyle recommendations for her as AIDS patient? (Please notice that your answer not to exceed 1 word page, single spaced, and list the reference you have used).

3-Do you advice her to take ART medication? If yes, Mention 2 medications used to treat AIDS? What are these medications originally used for ? What are the side effects of using these 2 medications you have mentioned, and what food- drug interaction may occur due to use these medications? (Please notice that your answer not to exceed 100 words for each question part, and list the reference you have used).

4-After delivering her baby as AIDS patient, do you advice her to breast-feed her baby? Explain?

Answer 1

1,

An HIV infection can be confirmed by western blot test or by ELISA test. Western blot is done if the ELISA test is positive.

During western bot test we are separating the blood proteins and separate specoific protein that indicate the HIV infection.

ELISA or enzyme-linked immunoassay is a commonly used laboratory test to detect antibodies. The normal or absence of HIV infection is detected when sample is titered using indirect immunofluorescence assays and any value less than or equal to 1:40 dilution (or < 1.0 IU) is negative.

2,

Diet of a HIV active patient should rich in protein and carbohydrate. Avoid excess sugar and fat. Add only low amount of fat and food should be rich in protein content. But include little good fat in every meals.

Lifestyle recommendations such as avoid sexual contact with partner because it lead to spread of infection to the partner. Use condom to avoid the spread. And the immune system functioning of the patient is altered. So need to avoid infecious condition. Because the patient get infections easily and it is difficult to treat the patient.

3,

Most of the antiretroviral drugs can be used in pregnancy to avoid the spread of the infection to baby and maintain the health of mother. so we can administer the ART drugs during pregnancy. Emtricitabine, lamivudine, zidovudin etc. are some examples of drug used to treat HIV infection.

Side effects such as allergic reactions, bleeding, diabetes, kidney, liver and pancrease damages are occur due to the use of ART drugs. During therapy need to take more amount of protein and fluids. And also monitor for any signs of bleeding or CNS depressions.

4

No breast feeding should be avoided. Because HIV virus can spread through body fluids such as breast milk. And also the HIV can spread from mother to baby. So as breast milk is an body fluid it contain and HIV and get infected to baby. So need to avoid breast feeding by an HIV infected mother and need to provide supplementary feeding to child.