Antivirals Flashcards
Why do few antivirals exist?
Virus has to get into the cell to replicate which occurs before s/s develop, and often we don’t know to take them. Can take away ability to rep, then bodily response takes over.
Virus
parasitic microbe that needs cells to replicate; no cell wall of their own; insert own DNA/RNA into healthy cell
HSV 1
herpes above the waist
HSV 2
herpes below the waist
Herpes zoster
shingles
HIV 1
more prevalent
Hiv 2
less pathogenic, confined to W africa
AIDS
acquired immune deficiency syndrome; sometimes follows HIV
Highest risk population for HIV
Black, men who have sex with other men
Retrovirus
Uses reverse transcriptase to translate genetic information into DNA; attacks CD4 receptors on T cells, inserts own genetic material and takes over that cell
CD4/helper T function
Long term immune memory
Characteristics of HIV pt
- infected for life
- virus present in blood and body fluids
- antibodies are makers of infx
- immunocomp
Stage 1 of HIV
- early acute infection
- rapid replication, not detectable
- seroconversion then occurs–very infectious, antibodies detectable, flu-like sx for weeks
Stage 2 of HIV
- chronic clinical latency
- can last 3-12Y w/o tx
- virus level stabilizes
- rapid virus production, CD4 T cell count decreases
HIV sx
ulcers, fatigue, sore throat, rash, muscle aches, fever, swollen lymph nodes, night sweats
AIDS diagnosis
AIDS defining condition or CD4 count less than 200 cell
AIDS defining conditions
- HIV-related encephalopathy
- Kaposi’s sarcoma
- AIDS dementia
- invasive cervical cancer
- pneumocystis Jirovecii pneumonia
- wasting sx
- TB
- pervasive candidiasis
Oral manifestations of AIDS
caused by dec CD4 counts (neutropenic)
- periodontal disease
- oral hairy leukoplakia
HIV transmission
- blood and body fluids
- sex w/o condoms
- blood transfusion and organ transplant
- mother to baby (perinatal)
- sharing IV equipment
Risk behaviors for AIDS
- man sex with man
- injection drug use
- parenteral transmission
- duration/frequency of contact
- blood exposure
- perinatal nutrition
What is the best way to give ARTs
Combinations of 2 NRTIs and another drug
How do all ARTs work?
decrease viral load so body can make more CD4
ART principles
- begin ASAP
- get tested if possible contamination
- goal is to decrease viral load to undetectable level
- tx guided by CD4 count, viral load, pt pref
- usually CD4 low when viral load is high
PrEP
- pre-exposure prophylaxis
- taken if want relations with HIV-pos partner
- not for all–screened
- condom use
PEP
- post exposure prophylaxis
- recommendation based on exposure and barriers (non-occupational and HC probs)
- take for 28 days
- HIV test at 6 ad 12W after exposure
