Download HIV, Hepatitis and Other Blood-borne Pathogens

PowerPoint® to accompany
Medical Assisting
Chapter 21
Second Edition
Ramutkowski  Booth  Pugh  Thompson  Whicker
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
1
HIV, Hepatitis, and Other
Blood-borne Pathogens
Objectives:
21-1 Describe ways in which blood-borne pathogens
can be transmitted.
21-2 Explain why strict adherence to Universal
Precautions is essential in preventing the spread
of infection.
21-3 Describe the symptoms of hepatitis and
AIDS.
21-4 List and describe the blood tests used to
diagnose HIV infections.
2
HIV, Hepatitis, and Other
Blood-borne Pathogens
Objectives (cont.)
21-5 Identify chronic disorders often found in
patients who have AIDS.
21-6 Compare and contrast drugs used to treat
AIDS/HIV infection.
21-7 Describe the symptoms of infection by
other common blood-borne pathogens.
3
HIV, Hepatitis, and Other
Blood-borne Pathogens
Objectives (cont.)
21-8 Explain how to educate patients about
minimizing the risks of transmitting
blood-borne infections to others.
21-9 Describe special issues you may
encounter when dealing with patients who
have terminal illnesses.
4
Introduction

What you will learn:



HIV, hepatitis, and other blood-borne
infections
Expansion on OSHA blood-borne pathogen
standards and how to reduce your risk of
exposure to blood-borne pathogens.
Issues associated with terminal illnesses
such as AIDS
5
Transmission of Blood-borne
Pathogens


Blood-borne pathogens
are disease-causing
microorganisms carried
in the host’s blood.
Transmission from one
host to another through
contact with infected
blood, tissue, body
fluids, or mucous
membranes.
6
Transmission Agents






Blood
Blood products
Human tissue
Semen
Vaginal secretions
Saliva from dental
procedures.






Cerebrospinal fluid
Synovial fluid
Pleural fluid
Peritoneal fluid
Pericardial fluid
Amniotic fluid
The Centers for Disease Control and Preventions has
identified specific substances that can serve as
transmission agents for blood-borne diseases.
7
People at Increased Risk








People who come in contact with substances that
may harbor the pathogens.
Health-care professionals
Law enforcement officers
Mortuary or morgue attendants
Firefighters
Medical equipment service technicians
Barbers
Cosmetologists
8
Universal Precautions


The most effective
means of preventing the
spread of HIV, hepatitis
and other blood-borne
pathogens is avoid
contaminations.
Universal Precautions
is required by OSHA.
9
Disease Profiles


Keep up-to-date on developments to perform
your job effectively.
Knowledge needed:



Of symptoms that may indicate the patient has the
disease.
To provide education to patients to limit risks of
contracting disease.
To identify habits of your patients that increase
risk of spreading the disease.
10
Hepatitis
Viral infection of the liver that can
lead to cirrhosis and death
Hepatitis A – spread by fecal-oral
route
Hepatitis B – blood borne that
spreads with contact with
contaminated blood or body fluids
or sexual contact
11
Hepatitis (cont.)
Hepatitis C (non A, non B)- spread
through contact with contaminated
blood or body fluids and sexual
contact.
No cure
Many people are carriers
Causes immediate symptoms like
flu
Damages liver, causing liver failure
and death
12
Hepatitis cont.
 Hepatitis D (delta agent hepatitis) –
occurs when people are infected with
HBV.
 May make symptoms of hepatitis B but
more severe
 Associated with liver cancer
 Hepatitis E – caused by hepatitis E
virus (HEV)
 Transmitted by fecal – oral route
13
Risk Factors


Risk of contracting HIV from
a single needle stick is
approximately 0.5%
Risk for contracting Hepatitis
B from single needle stick is
6% to 33%.
The primary risk factor for HBV and HCV infection
is occupational exposure to the virus.
14
Infection Progression


Prodromal -general
malaise, maybe nausea
or vomiting, or no
symptoms
Icteric or jaundice –
yellowing of the skin,
eyes, mucous
membranes –


Appears 5-10 days after
initial infection
Convalescent – can last
2 to 3 weeks
15
Preventive Measures


Avoiding contact with contaminated
substances
A vaccine is available to prevent HBV
infections


Will not protect you from other strains of
hepatitis
Recommended for high risk medical
personnel, dialysis patients, homosexual
men, and IV drug users.
16
Apply Your Knowledge
A patient is diagnosed with Hepatitis E.
What caused it, and what was the most
likely route of transmission?
17
Apply Your Knowledge -Answer
A patient is diagnosed with Hepatitis E.
What caused it, and what was the most
likely route of transmission?
Hepatitis E is caused by hepatitis E virus
(HEV) and is transmitted by fecal – oral
route.
18
AIDS/HIV Infection



Virus that infects and destroys
components of the immune system.
HIV infection develops into AIDS.
Pathogen destroys helper T cells
(white blood cells component of
immune system).
19
Risk Factors for AIDS/HIV




People who have unprotected sexual
activity
IV drug users who share needles
Mother to fetus during pregnancy
Health care workers exposed to bloodborne pathogens because of a needle
stick (percutaneous exposure)
20
Progress of the Infection

Three main stages

Initial infection –can occur years after
exposure


Virus enters cell and makes copies-helper
T cells die.
Body immune system responds, cleaning
the blood supply of the virus, and the
virus enters an inactive phase.
21
Progress of the Infection
(cont.)
 Incubation period



Virus incorporates its genetic material
into the genetic material of the helper T
cells
Incubation period can be 8 to 15 years
Full blown AIDS


During the incubation period HIV
becomes active again and continues to
attack and kill helper T cells
200 or fewer helper T cells/mL blood
indicates full blown AIDS
22
Diagnosis of HIV/AIDS

Enzyme-linked immunosorbent assay
(ELISA)


Confirms presence of antibodies in
response to HIV
Western Blot Test or immunofluorescent
antibody (IFA)
23
Symptoms of HIV/AIDS







Systemic
Respiratory
Oral
Gastrointestinal
Peripheral nervous system
Skin- related
Kaposi’s sarcoma
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Preventive Measures

Prevention and sexual contract




Prevention and IV drug users


Use protection during sexual contract
Avoid multiple sexual partners
Avoid concurrent sexual transmitted infections
Avoid sharing or reusing needles
Prevention and medical procedures


Universal Precautions
Wash hands
25
AIDS Patients






No one is immune to AIDS
December 1966, 22.6 million men, women
and children were HIV infected worldwide.
In 2000 there were 200 million
Homosexual men
IV drug users
Women
26
Chronic Disorders of the AIDS
Patient





Impaired immune system
permits opportunistic
infections
Pneumocystis carinii
pneumonia
Kaposi’s Sarcoma
Non-Hodgkin’s lymphoma
Tuberculosis
Kaposi’s Sarcoma
27
Chronic Disorders of the
AIDS Patient (cont.)






Mycobacterium Avium Complex (MAC)
infections
Meningitis
Oral candidiasis
Vaginal candidiasis
Herpes Simplex
Herpes Zoster
28
Opportunistic
Infections of AIDS
1. Herpes simplex
2. Pneumocystis carinii
3. Kaposi’s sarcoma
4. Tuberculosis
5. Meningitis
6. Mycobacterium avium complex (MAC)
7. Non-Hodgkin’s lymphoma
8. Oral candidiasis
9. Herpes zoster
10.Tuberculosis
Identify where these opportunistic infections affect the body.
29
Opportunistic Infections of AIDS
(cont.)
1.
Herpes simplex – mouth, lips, genitalia
2.
Pneumocystis carinii – lungs
3.
Kaposi’s sarcoma – arms, legs, chest, neck, face, conjunctiva,
palate
4.
Tuberculosis – lungs
5.
Meningitis – brain
6.
Mycobacterium avium complex (MAC) – systemic
7.
Non-Hodgkin’s lymphoma – neck, armpits, groin
8.
Oral candidiasis – mouth, tongue, mucous membranes
9.
Herpes zoster – skin over ribs, neck, arms; nerves
10. Tuberculosis – lungs
30
Treating Opportunistic Infections


Drug side effects pose
major problems for the
AIDS patient.
Repeated episodes of
infection can leave
patient allergic to
treatment or intolerance
to medications.
31
Testing Regulations


CDC does not require
mandatory HIV testing
for health care workers.
Health care workers
chances of being infected
by a patient are greater
than a patient being
infected by a health care
worker.
32
Treatment for AIDS

Drugs



More than 20 drugs
available
See table 21-2 in text



Developed by Panel of
Clinical Practices for
Treatment of HIV
Infections

Must be made by
patient and physician
Delayed Treatment

Treatment Guidelines

Initialing Therapy
Postponement of drug
related adverse affects
Early Treatment


Suppresses viral
replication
Reduces risk of
transmitting to others
33
Other Blood-Borne Infections

Cytomegalovirus



Extremely common
infection
Pregnant women can
pass to newborns.
Erythema
Infectiosum



Parvovirus B19
Fifth disease
Human T-Cell
Lymphotropic Virus



HTLV-1
Appears in IV drug
users
Listeriosis


Caused by listeria
monocytogenes
Fever, shock, rash,
and aches
34
Other Blood-Borne Infections (cont.)

Malaria


Enters bloodstream
through mosquito’s
bite

Toxoplasmosis
Caused
by
toxoplasma gondii in
cat feces
Syphilis


Caused by treponema
pallidum
Three stages
35
Reporting Guidelines


Each state formulates
requirements for
reporting HIV
infections and AIDS
Verify the specific
guidelines in the state
you are employed.
36
Patient Education


Patient education is one
of the most effective
means of preventing
disease transmission.
You can assess the
patient’s understanding
of their risk for
infection and provide
information about
preventions and
treatments.
37
Patients with Special Concerns

Teenagers


Educate them about dangers
of HIV and AIDS
Patients about to be
discharged

Make sure that the patient
comes for follow-up, reports
any adverse reactions, and
knows signs and symptoms to
watch for.
38
Apply Your Knowledge
What guidance could you give a patient
with AIDS or Hepatitis that would
like more information about the
disease?
39
Apply Your Knowledge -Answer
What guidance could you give a patient
with AIDS or Hepatitis that would like
more information about the disease?
Suggest the patient contact government agencies
such as the CDC or the Consumer Information
Center by mail or by the Internet. In addition
local support groups and resource organizations
may be available in your area.
40
Summary
Medical Assistant
Use Universal Precautions, watch for signs of
infectious disease and education patient about risk
factors associated with blood-borne diseases.
You are to help prevent the spread of infectious
diseases.
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End of Chapter
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