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Myco-Viro > (1) HIV > Flashcards

(1) HIV Flashcards

1
Q

most common medical condition associated with HIV patients

A

Pneumonia

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2
Q

continuous uprise of the
chest when breathing

A

Retractions

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3
Q

the px presenta a Respiratory Rate of 25, what category does this fall?

A

tachypnea

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4
Q

characterized by having blue finger tips; lack of oxygen

A

Cyanotic

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5
Q

caused by the Human Immunodeficiency Virus (HIV) attacking the CD4+ T lymphocytes

A

ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)

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6
Q

AIDS individuals have lowered count of this cell

A

CD4+ levels (T helper)

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7
Q

what CD4+ level presents with px with AIDS

A

y CD4+ levels of less than or
equal to 0.1

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8
Q

what is teh LAST STAGE of HIV infection

A

AIDS (<200 CD4+)

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9
Q

what family HIV belongs to, also give the family’s characteristic

A

**Retroviridae
**
- 2 Copies of ssRNA
- Genome packed with several enzymes

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10
Q

Give the characteristic of RETROVIRIDAE

A
  • ssRNA
  • Postive sense
  • Enveloped
  • Icosahedral
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11
Q

where does HIV virus binds to?

A

CD4+ cells

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12
Q

what happens to HIV virus after binding to CD4+ cells

A

D4+ cells and becomes internalized which will then decrease to an undetectable level

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13
Q

why when a px with HIV have lower body immune defense to other pathogens?

A

the immune system is focused on the HIV so it left the other pathogen unnoticed making the px immunocompromised and nagkakasakit

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14
Q

what is the replication princple for HIV virus

A

Reverse transctription

RNA –> DNA

uses reverse transcriptase

Viral DNA becomes incorporated into the host DNA, enabling further replication and multiplication

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15
Q

HIV virus are member of?

A

Retroviruses and Lentivirus

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16
Q

can HIV virus multiply on its own? Yes or mo

A

nawp, in need of host DNA then reverse transcription

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17
Q

TOF

HIV virus can destroy so many of these cells that the body can’t fight
infections or opportunistic diseases

A

EURT

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18
Q

TOF

HIB infection is a lifetime disease

A

F (HIV) gurl if nag t ka whats HIB then????

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19
Q

how many HIV Genome

A

9 genes

3 categories:
- Structural proteins
- Regulatory proteins
- Accessory/Auxiliary proteins

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20
Q

HIV Structure

genomic region encoding capsid proteins which mainly functions as part of the viral structure

A

Group-specific Antigen
(gag)

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21
Q

Enumerate the Group-specific Antigen
(gag)

A
  • p55
  • p17
  • p24
  • p7
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22
Q

HIV structure

genomic region encoding the viral enzymes

A

Polymerase
(pol)

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23
Q

Enumerate the Polymerase
(pol)

A
  • Reverse Transcriptase (p66/p51)
  • Protease (p10)
  • Integrase (p31)
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24
Q

HIV structure

genomic region encoding for glycoproteins

A

Envelope
(env)

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25
Q

Enumeare the ENV proteins

A
  • gp160
  • gp120
  • gp41
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26
Q

HIV structure

  • Precursor, therefore, cannot be seen within the viral structure.
  • Myristolated protein
A

p55

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27
Q

HIV structure

Matrix; helps hold the envelope proteins to the virus.

A

p17

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28
Q

HIV structure

Capsid and Nucleocapsid

A

p24 (capsid)
p7 (nucleocapsid)

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29
Q

HIV structure

Copies the virus’s RNA genome into DNA

A

Reverse
Transcriptase
(p66/p51)

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30
Q

HIV structure

  • Processes proteins made from HIV’s genome so that they can become part of new fullyfunctioning HIV particles
  • Important for the viral replication.
A

Protease
(p10)

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31
Q

HIV structure

  • Integrates the DNA copy of HIV’s genome into the host DNA.
  • without this, means no replication.
A

Integrase
(p31)

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32
Q

9 HIV GENOME

positive regulator of transcription; accelerates the production of more HIV

A

Transactivator
(tat)

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33
Q

9 HIV GENOME

stimulates the production of
HIV proteins, but suppresses the expression of HIV’s regulatory genes

A

Regulator of Viral Expression (rev)

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34
Q

9 HIV GENOME

retards HIV replication (cellular proteins)

A

Negative Replication Factor (nef)

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35
Q

9 HIV GENOME

increases the infectivity of the HIV (APOBEC3G), causing longer infections

A

Virion Infectivity Factor
(vif)

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36
Q

9 HIV GENOME

Transport of DNA to nucleus; accelerates the production of HIV proteins; arrests cell cycle

A

Viral Protein R
(vpr)

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37
Q

9 HIV GENOME

promotes intracellular degradation of CD4 and enhances release of virus
from cell membrane

A

Viral Protein U
(vpu)

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38
Q

9 HIV GENOME

act aspromoters/enhancers of infection; “sticky ends”, which the integrase protein uses to insert the HIV genome into host DNA

A

Long Terminal Repeat
(LTR)

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39
Q

Structural Proteins

A

gag, pol, env

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40
Q

Regulatory Proteins

A

tat, rev

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41
Q

Accessory Proteins

A

nef, vif, vpr, vpu, LTR

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42
Q

Types of HIV

3 distinct virus groups (env
gene based): M, N, O

A

HIV-1

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43
Q

Types of HIV

5 subtypes identified: A, B,
C, D, E

A

HIV-2

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44
Q

Types of HIV

Contains genes that encodes the structural proteins of the virus: gag,
pol, env

A

HIV-1

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45
Q

Types of HIV

MAJOR difference with HIV– 1 is that it lacks the vpu gene and has a vpx
gene not contained in HIV-1

A

HIV-2

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46
Q

Types of HIV

Also contains 6 other genes
(tat, rev, nef, vif, vpr, and
vpu)

A

HIV-1

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47
Q

origin of HIV virus came from cross-species infection by what virus from
monkeys in rural Africa

A

simian viruses from
monkeys

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48
Q

Origin of AIDS/HIV

In 1930 the Simian Immunodeficiency Virus (SIV) was introduced to humans that gave rise to ?

A

HIV–1 group M

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49
Q

TOF

Current evidence: primate counterparts of HIV-1 & HIV – 2
transmitted to humans on multiple (at least 7) different
occasions

A

True

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50
Q

enumerate the transmission of HIV virus

A
  • Sexual Contact
  • Needle Sharing
  • Mother-to-child transmission (vertical transmission)
  • Contaminated blood transfusions and organ transplan
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51
Q

HIV cannot be transmitted through??

A

 Kissing
 Hugging and other forms of touching
 Sharing food and cutlery
 Insect bites
 Toilet seats
 Bathing
 Sneezes and coughs
 Sweat

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52
Q

High titers of HIV are found in?

A

Blood and Semen

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53
Q

Life Cycle of HIV

after the VIRUS enter through transmission, what will happen next

A

it will go to the macrophages and
the dendritic cells, affecting the lymphatic system, and then to the blood.

bold = APCs (recall hema)

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54
Q

Life cycle of HIV

TOF

When the transmission is through needle sharing, the pathogenesis is faster as the infection goes straight to the blood

A

True

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55
Q

Enumerate the life cycle of HIV

A
  1. Binding
  2. Fusion
  3. Reverse transcription
  4. Integration
  5. Replication
  6. Assembly
  7. Budding (ikaw)
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56
Q

life cycle of HIV

The HIV virus would attach itself to the receptors of the surface of a CD4 cell

A

BINDING

57
Q

Life cycle of HIV

what receptors are in the surafe of a CD4 cell for budding

A

CD4 receptor along with
the CCR5 and CXCR4 coreceptors.

58
Q

Life cycle of HIV

The HIV envelope and the CD4 cell membrane fuse together which allows entry of HIV enzymes and cells to the CD4 cells

A

FUSION

59
Q

Life cycle of HIV

HIV reverse transcriptase convert its genetic material RNA to DNA.

A

REVERSE TRANSCRIPTION

60
Q

Life cycle of HIV

Inside the CD4 cell nucleus, HIV releases integrase (an HIV enzyme) then integrates to insert its viral DNA into the DNA of the CD4 cells.

A

INTEGRASE

61
Q

Life cycle of HIV

  • Then HIV virus begins to use the machinery of the CD4 cell to make long chains of HIV proteins.
  • The protein chains are building blocks for more HIV
A

REPLICATION

62
Q

Life cycle of HIV

The new HIV proteins and HIV RNA move to the surface of the cell and assemble into immature noninfectious HIV

A

ASSEMBLY

63
Q

Life cycle of HIV

Newly formed immature HIV pushes itself away from the host CD4 cell then releases protease which acts to break up the long protein chains that form the immature virus

A

BUDDING

64
Q

Life cycle of HIV

The smaller HIV proteins combine to form mature
infectious HIV.

A

BUDDING

65
Q

proteins involved in binding

A

gp160

120 + 41

66
Q

proteins involved in Fusion

A

gp41

67
Q

proteins involved in Reverse transcription

A

p66/51

68
Q

proteins involved in integration

A

p31

69
Q

proteins involved in budding

A

p10

70
Q

pathogenesis of HIV virus

A

Preferentially infects and kills helper (CD4+) T
lymphocytes

71
Q

what happens when HIV infects and kills cd4?

A

o Loss of cell-mediated immunity
o High probability of opportunistic infections

72
Q

Pathogenesis

TOF
Main immune response consists of cytotoxic (CD8+)
lymphocytes

A

eurt

73
Q

Primary HIV to Chronic Infection

what is the first thing should take place for HIV virus?

A

Primary infection

74
Q

Primary HIV to Chronic Infection

early signs/manifestration of HIV

A

infection in lymphoid tissue-lymphadenopathy

75
Q

Primary HIV to Chronic Infection

leading to a wide dissemination to
lymphoid organs. During this, there is a partial immunologic control of virus replication

A

Massive viremia

76
Q

Primary HIV to Chronic Infection

Trapping of virus and establishment of?

A

chronic, persistent
infection

77
Q

Primary HIV to Chronic Infection

immune activation is mediated by?

A

cytokines and HIV
envelope-mediated aberrant cell signaling

78
Q

Primary HIV to Chronic Infection

Accelerated virus replication occurs wherein there is a rapid?

A

rapid CD4+ T cell turnover

79
Q

Primary HIV to Chronic Infection

final part (diko gets hehi)

A

Destruction of the Immune system

80
Q

STAGES OF INFECTION

HIV Virus: peaked (all time high)
CD4: still high but decreasing (di biumababa ng 500
Anti-HIV antibody: gradual increase

2-4 weeks

A

Primary Infection

81
Q

STAGES OF INFECTION

HIV virus: decrease (near the 0 value, has fluctuation)
CD4: gradual decrease (<500)
anti-HIV antibody: all time high

6-10 years

A

Latency

82
Q

STAGES OF INFECTION

HIV virus: increasing from a dormant value
cd4: decreasing
Anti-HIV antibody: decrease

2-3 years (after 6-10 years)

A

AIDS

83
Q

STAGES OF INFECTION

skin and mucous membrane immune defects

systematic immune deficiency

A

AIDS

84
Q

etting tested immediately for HIV will not work. Therefore, it is recommended to be tested within

A

3rd or 6th month of infection

85
Q

CLINICAL SYNDROMES

  • M. tuberculosis (disseminated tuberculosis)
  • HSV (HSV esophagitis)
  • C. albicans (esophageal candidiasis)
  • HHV-8 (Kaposi’s sarcoma)
A

CD4: <500

86
Q

CLINICAL SYNDROMES

  • P. jiroveci (PCP pneumonia)
  • T. gondii (cerebral toxoplasmosis)
  • C. neoformans (Meningoencephalitis)
  • C. immitis (Coccidioidomycosis)
  • C. parvum (chronic diarrhea)
A

CD4: <200

87
Q

CLINICAL SYNDROMES

  • M. avium (invasive pulmonary disease)
  • H. capsulatum (Histoplasmosis)
  • CMV (CMV retinitis)
A

CD4: <50

88
Q

STAGES OF THE VIRUS

  • Primary infection
  • Short, lasts for 2-4 weeks
  • Accompanied by flu-like illness; might also include fevers, chills, night sweats, and rashes
A

Stage 1

89
Q

STAGES OF THE VIRUS

  • The CD4+ cell count is at least 500 cells per microliter.
  • Diagnostic tests are not applicable
A

Stage 1

90
Q

STAGES OF THE VIRUS

  • Clinically asymptomatic/ WINDOW PERIOD
  • Lasts for an average of 5-10 years
  • This stage is free from symptoms.
A

Stage 2

91
Q

STAGES OF THE VIRUS

  • The CD4+ cell count is 350 to 499 cells per cubic meter
  • HIV antibodies are detectable in the blood
A

Stage 2

92
Q

STAGES OF THE VIRUS

  • Symptomatic HIV infection
  • The symptoms are mild such as skin rashes, fatigue, night sweats, slight weight loss, mouth ulcers, and fungal skin (candida albicans) and nail infections.
  • The CD4+ cell count is 200 to 349 cells per cubic meter.
  • Clinical diagnosis and blood test may be used.
A

Stage 3

93
Q

STAGES OF THE VIRUS

  • HIV to AIDS
  • Most common opportunistic infections manifest including pneumocystis carinii pneumonia (PCP), mycobacterium avium complex (MAC) disease, cytomegalovirus (CMV), toxoplasmosis, and candidiasis.

candidiasis - MOST COMMON

A

Stage 4

94
Q

STAGES OF THE VIRUS

  • The CD4+ cell count is less than 200 or the percent of CD4+ cells is less than 15% of all lymphocytes.
  • Clinical diagnosis and blood test may be used.
A

Stage 4

95
Q

CLINICAL STAGES OF HIV (WHO)

  • Asymptomatic
  • Generalized lymphadenopathy
  • Normal activity
A

Clinical Stage I

96
Q

CLINICAL STAGES OF HIV (WHO)

  • Weight loss <10%
  • Minor mucocutaneous conditions
  • Zoster <5 years
  • Recurrent upper respiratory infection
A

Clinical Stage II

97
Q

CLINICAL STAGES OF HIV (WHO)

  • Weight loss > 10%
  • Unexplained diarrhea > 1 month
  • Unexplained fever > 1 month
  • Thrush
  • Oral hairy leucoplakia
  • PTB in the past year
  • Severe bacterial infection
  • Bedridden <50% of days in the pastmonth
A

Clinical Stage III

98
Q

CLINICAL STAGES OF HIV (WHO)

  • AIDS defining illness
  • Bedridden for >50% of days in the past month
A

Clinical Stage IV

99
Q

Cardinal feature of HIV infection is the depletion of

A

T helper-inducer lymphocytes

100
Q

HIV co-receptor on lymphocytes includes the

A

CSCR4 chemokine receptor

101
Q

serve as major reservoir
for HIV in the body

A

Monocytes and macrophages

102
Q

which organs play a central role in HIV infection

A

Lymphoid organs

103
Q

HIV is actively replicating in?

A

lymphoid tissues

104
Q

TOF

The macroenvironment of the lymph node is ideal for establishment and spread of HIV infection.

A

F (microenvironment)

105
Q

Cytokines are released activating a large pool of?

A

CD4 (highly susceptible to HIV infection)

106
Q
  • Late stage of the disease characterized by CD4 < 200 cells/mm
  • Development of opportunistic infections, selected tumors, wasting & neurologic conditions
A

AIDS

107
Q

AIDS INDICATOR CONDITIONS

Candidiasis in the esophagus, trachea,
bronchi, lungs

A

16%

108
Q

AIDS INDICATOR CONDITIONS

Cervical cancer, invasive

A

0.6%

109
Q

AIDS INDICATOR CONDITIONS

Coccidioidomycosis, extrapulmonary

A

0.3%

110
Q

AIDS INDICATOR CONDITIONS

Cryptococcosis, extrapulmonary

A

5%

111
Q

AIDS INDICATOR CONDITIONS

Cryptosporidiosis > 1 month diarrhea

A

1.3%

112
Q

AIDS INDICATOR CONDITIONS

CMV other than liver & spleen

A

7%

113
Q

WHO SHOULD BE TESTED FOR HIV?

A
  • Persons with high-risk behaviors (basta sex, pero MSM gay shit marami)
  • Persons with Certain Medical Conditions
  • Persons who have been sexually assaulted
  • Persons who have had occupational exposures (sexual workerss
114
Q

if u see this card

A

pa study ng schematics for HIV DIAGNOSTIC

115
Q

TOF

HIV infection established by detecting antibodies to the
virus, viral antigens, viral DNA/RNA, or by culture

A

T

116
Q

Screening serologic test?

A

ELISA

117
Q

confirmatory testing serologic test

A

Western blot

118
Q

at least how many ELISA reactive test before western blot?

A

at least 2 REACTIVE TEST

119
Q

Western blot always coupled with?

A

Enzyme immunoassay (EIA) due to false positive results - 2%

120
Q

False-negative results occurs if tests were done during the?

A

window period

121
Q

Window period is the time delay from infection to presence of antibodies, average of what days

A

14-22 days

Antibodies present within 6 months

122
Q

WESTERN BLOT INTERPRETATION

No bands

eyy central cee

A

Negative

123
Q

WESTERN BLOT INTERPRETATION

Reactivity to gp41 + gp120/160 or p24 + gp120/160

A

Positive

124
Q

WESTERN BLOT INTERPRETATION

Presence of band pattern that does not meet criteria for positive result

A

Intermediate

125
Q

enumerate the screening process

A
  1. Counselling
  2. Blood sample is taken
  3. Twice positive for screening, do confirmatory test
  4. If 1st screening is negative, no further test done
  5. Post test Counselling
126
Q

5 hospitals in our country that specializes with HIV
counseling and testing

A
  • Research Institute of Tropical Medicine (RITM)
  • San Lazaro Hospital
  • St. Lukes Medical Center
  • Makati Medical Center
  • The Medical City
127
Q

if u see this card

A

read through INITIAL EVALUATION OF AN HIV INFECTED PERSON

128
Q

When to initiate antiretroviral drugs?

A
  • Symptomatic AIDS
  • CD4 < 200 previously
  • WHO: <350 cells/uL
129
Q
  • Provides ART for free to persons living with HIV (PLHIV)
  • Include consultation fee and lab tests
  • P 30,000 paid to the treatment facility where PLHIV is enrolled.
  • Provides financial support and covers the biomedical aspect of the HIV
A

Out-Patient HIV/AIDS Treatment (OHAT) Package

130
Q

what are the ANTI-RETROVIRAL THERAPY

A
  • Lamivudine/Tenofovir TDF/ Efavirenz (LTE)
  • Lamivudine/Tenofovir TDF/ Dolutegravir (TLD)
131
Q

ART

  • One-pill once a day regimen in the Philippines
  • Known to cause neuropsychiatric symptoms such as vivid dreams, severe depression or suicidal ideations
A

Lamivudine/Tenofovir TDF/ Efavirenz (LTE)

132
Q

newer

version which replaces Efavirenz

  • One-pill once a day regimen in the Philippines
  • Started in 2020
  • Officially recommended Dolutegravir-based ART as the first line regimen for PLHIV in 2022
A

Lamivudine/Tenofovir TDF/ Dolutegravir (TLD)

newer version which replaces Efavirenz

133
Q

vaccine is available for HIV?

A

nawp

Vaccine development difficult due to the following reasons:
- HIV mutates rapidly
- Not expressed in all cells that are infected
- Not completely cleared by host response after primary infection

134
Q

RECOMMENDED VACCINES FOR ALL PEOPLE WITH HIV

A
  • Hepatitis B
  • Influenza (flu)
  • Human Papillomavirus (HPV)
  • Pneumococcal (pneumonia)
  • Tetanus, diphtheria, and pertussis
  • COVID vaccine
135
Q

if u see this card

A

study the facts, di naman to lalabas lahat basta

key to remember

  • M2M
  • top 5 regions NCR, 3, 4A, 6, and 7
  • 50% - aged 25-34 y.o
  • OFWs remain vulnerable to HIV
136
Q

use this card rto familliarize stigma

A

gew na sa trans

137
Q

UNAIDS

what are the set global target by 2030?

A

95-95-95

  • know their HIV status
  • are on ART
  • achieved viral load suprresion
138
Q

UNAIDS

Philippines achieved, as of Sept 2022, state the numbers

A

63-65-97

63 - knows their HIV statuse
65 - are on ART
97 - achieved viral load suppression

139
Q
A

Myco-Viro (23 decks)

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