2: STIs 2 Flashcards
If symptomatic, when do Hep B symptoms begin?
An average of 90 days after HBV exposure and usually last for several weeks.
How many Hep B patients become chronically infected and how many of those then die from liver cancer or cirrhosis?
Approximately 5% of adults with HBV infection become chronically infected, and 15% to 25% of individuals with chronic HBV infection will die prematurely from liver cancer or cirrhosis.
What is used to mark the progression of Hep B disease?
Serologic markers
T/F There is a Hep B vaccine that also protects against Hep A.
True
Where is the Hep B vaccine injected?
Deltoid muscle
How do you treat someone exposed to Hep B?
Give them hep B immunoglobulin IM in a single dose as soon as possible, preferably within 24 hours of exposure.
What are treatments for acute and chronic Hep B?
No specific treatment for acute. Recovery is usually spontaneous. Chronic can be treated with several antiviral drugs.
Women with Hep B should also receive what vaccination?
Hep A
Can the Hep B vaccine be administered with other vaccines?
Yes
Can pregnant women be vaccinated for Hep B during pregnancy?
Yes
What is treatment protocol for a newborn whose mother has Hep B?
They need to receive immunoprophylaxis after birth.
If symptomatic, average time from exposure to symptoms is 4-12 weeks, but can take as long as 24 weeks.
Hep C
T/F In heterosexual, monogamous partners without HIV infection, sexual transmission of Hep C to a discordant partner is rare.
True
What is the goal of treatment for Hep C?
The goal of treatment is to reduce all-cause mortality and prevent or halt liver injury.
This is defined as the absence of HCV RNA 12 weeks after completion of treatment.
Virologic Cure
T/F Success rate for Hep C treatment is most effective when begun within 6 months of exposure.
False. Treatment is most effective when begun in the ACUTE phase of the infection.
Who is not recommended to receive Hep C treatment?
Those with a short life expectancy.
Can women with Hep C breastfeed?
Most of the time. HCV is not transmitted through breastmilk, but women with cracked and bleeding nipples should avoid this method of feeding until complete healing has taken place.
Women with Hep C should also receive what vaccination?
Hep A and B.
In what poor country were many HIV cases initially diagnosed?
Haiti
_____ women are disproportionately affected by HIV.
BLACK women are disproportionately affected by HIV.
How are most new HIV infections acquired in women?
Heterosexual contact.
How does HIV target the immune system?
- HIV specifically targets CD4 cells, binding to the cell surface protein known as the CD4 receptor.
- The virus affects the cells in two ways:
- The absolute numbers of these cells are depleted.
- Function of the remaining cells is impaired, resulting in a gradual loss of immune function.
- Progressive depletion of CD4 cells in peripheral blood occurs with advancing HIV infection, such that CD4 cell counts are used to estimate the cumulative immunologic damage caused by HIV.
- If its course is unimpeded, HIV can destroy as many as one billion CD4 cells per day.
- In addition to its aggressive destruction of the immune system, HIV is genetically highly variable, mutating with apparent ease.
What are the components of the immune system?
- Humoral immunity: Involved with antibody production.
- Cellular immunity: Effected largely through T-helper lymphocytes (CD4 cells). Central components are macrophages and CD4 cells.
CDC recommends HIV screening be a routine part of care for patients aged _____ in all healthcare settings.
CDC recommends HIV screening be a routine part of care for patients aged 13-64 years in all healthcare settings.
T/F HIV testing is anonymous and confidential.
False. All states offer confidential testing. Only some states offer anonymous testing.
Pre-exposure prophylaxis for HIV is recommended in which populations?
- Injection drug users.
- Women with HIV+ sexual partners.
- Commercial sex workers.
- Inconsistent or absent condom use.
- High number of partners.
What meds/doses are used for pre-exposure prophylaxis to HIV?
PrEP, which is taken every day, is composed of an oral fixed-dose combination of tenofovir disoproxil fumarate (TDF) 300 mg and emtricitabine (FTC) 200 mg.
What are the 6 classes of antiretroviral therapy (ART)?
- Nucleoside reverse transcriptase inhibitors (NRTIs)
- Nonnucleoside reverse transcriptase inhibitors (NNRTIs)
- Protease inhibitors (PIs)
- Fusion inhibitors (FIs)
- CCR5 antagonists
- Integrase strand transfer inhibitors (INSTIs)
What supplements interfere with HIV treatments meds?
- St. John’s Wort
- Garlic
When do you test pregnant women for HIV?
Initial visit and again at 36 weeks if they are high risk.
Should pregnant women with HIV receive treatment?
Yes, as this reduces fetal transmission rates from 30% to as low as 2%.
With which STIs should you wait until 7 days after beginning treatment before resuming sex?
- Chlamydia
- Gonorrhea
- Trichomoniasis
- Molluscum
- Syphilis
