CASE STUDY 5 6

CaseStudy 5

Q1

Thefactors that increase the risk of mother-to-child transmission areassociated with the child, disease itself, and mother. The motherlyfactors are the characteristic of the virus, low CD4+ T cell count inthe blood, and level of the viral load. The chances of HIVtransmission through breastfeeding are usually higher when a motherwho was infected postnatally has a higher viral load. Also, there isa high correlation between mothers with suppressed immunity and thenumber of HIV -1 DNA in the breast milk. This increases the chancesof HIV transmission through breastfeeding (Green, 2012). Besides,vitamin A deficiency increases the likelihood of HIV transmissionfrom the mother-to-child. Insufficient vitamin A in mothers with HIVinfections reduces T and B cell’s role which raises virus load inmothers as well as lowering the number of antibodies. Moreover,insufficient vitamin A can advance HIV disease which in turn willincrease the risk of HIV transmission from the mother-to-child.Furthermore, vitamin A deficiency in women with CD4+Tcell count falls below 400 cells /µl enhances the number of HIV-1DNA in the breast-milk cells thus, the risk of HIV transmission fromthe mother-to-child. Another risk of HIV transmission frommother-to-child is poor breastfeeding technique which leads tofissured nipples (Green, 2012). Delivery factors such as impairedreliability of epithelial surfaces due to insufficient vitamin A alsoincrease the probability of HIV transmission. Factors that caninterfere with the reliability of infants’ oral thrush furtherincrease the risks of HIV transmission through breastfeeding. HIVtransmission mostly occurs through breastfeeding. Milk from themothers has antibodies which contain all forms of immunoglobulin.Lack of specific HIV immunoglobulin such as IgM in the breast milkraises the chances of HIV transmission through breastfeeding.

Q2

Highlyactive antiretroviral therapy (HAART) is a management system forhelping persons living with HIV infections. This therapy uses acombination of several drugs which can suppress HIV replication toreduce the number of deaths that results from HIV infections. Also,highly active antiretroviral therapy helps patients by minimizingvirus resistance.

TheAntiretroviral Medications during Pregnancy

MostARV drugs are linked with some degree of toxicity unless they areused as a strong combination treatment for mothers with HIVinfections or single, dual, or triple treatment to prevent HIVinfections among the infants (Porth, 2011). However, the risk oftoxicity depends on several factors such as the time of exposure andthe number of drugs combination. When short-course antiretroviralregimens are administered for a short period during pregnancy, theyare safer than when used for a long duration (Porth, 2011). The mainconcern why certain antiretroviral drugs should not be administeredduring early pregnancy is because pregnancy changes the way the bodyreacts to medicines. Therefore, some drugs might have adversereactions in the body. The antiretroviral drugs are useful to apregnant woman who has never used them before, and may includenucleoside reverse transcriptase inhibitors (NRTIs), integrase strandtransfer inhibitor (INSTI), a protease inhibitor (PI) which isaccompanied by ritonavir.

Q3

OpportunisticInfections That Affect Individuals with HIV infections.

Epsteinbarr virus (EBV)

EBVis one of the first opportunistic infection that indicatesimmunodeficiency in persons living with HIV. This virus causes whitepatches in the mouth, especially on the cheeks and sometimes on thesides of the tongue usually referred to as oral hairy leukoplakia(OHL). The risk factor of contracting EBV is when the CD4+Tcell count falls below 500 cells/µl (Schaefer et al., 2015).

Humanherpes virus 8 (HHV -8)

HHV- 8 is a double-stranded DNA. The virus is associated with Kaposisarcoma, which is usually transmitted through infected blood as wellas saliva that is greasy. People with CD4+Tcell count below 200 cells /µl have a high risk of contracting thevirus. Also, homosexual stands a higher probability of getting theHHV-8 virus.

Cytomegalovirus(CMV)

Cytomegalovirusbelongs to the herpes virus family, and it is a double-strandedvirus. It can be acquired when a person is in direct link withinfected vaginal secretions, blood, semen, and saliva. People withHIV who stand a higher risk of contracting this virus are those withcompromised immunity which has caused localized end-organ disease.Moreover, those with HIV -1RNA in higher loads and their CD4+Tcell count is less than 50 cells /µl, have a higher likelihood ofsuffering from CMV (Schaefer et al., 2015).

Varicellazoster virus (VZV)

Varicellazoster is in the herpesviridae family, and it is a double-strandedDNA virus. VZV causes chickenpox or skin rash with blisters. Thosepeople with compromised immunity and aged persons have higher risksof contracting VZV.

Mycobacteriumtuberculosis (TB)

Mycobacteriumtuberculosis is a bacterium that causes the highest number of deathsamong persons with HIV. This infection mostly occurs during the latestages of HIV. TB can affect a person who has any CD4+T cell count,but those people with greater risks are those whose CD4+Tcell count falls below 200 cells /µl (Schaefer et al., 2015).

References

Green,C. J. (2012). Maternalnewborn nursing care plans.Sudbury, MA: Jones &amp Bartlett Learning.

Porth,C. (2011). Essentialsof pathophysiology: Concepts of altered health states.Philadelphia: Wolters Kluwer/Lippincott Williams &amp Wilkins.

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Schaefer,C., Peters, P. W. J., &amp Miller, R. K. (2015). Drugsduring pregnancy and lactation: Treatment options and riskassessment.London, UK: Elsevier/Academic Press.

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