Biomedical prevention against HIV-1 Flashcards
How many people were living with HIV globally at the end of 2017?
> 36.9 million
How have new HIV infections reduced since 1996?
reduced by 47%
How have AIDs-related deaths been reduced since its peak in 2004?
by more than 51%
What is the risk of acquiring HIV if MSM?
27 times higher than general population
What should initial HAART therapy consist of?
2NRTIs + PI/NNRTI
What is the risk of mother-child transmission without therapy?
1 in 4
How adherent to therapy do you need to be to prevent resistance?
95%
How many countiries criminalised same-sex sexual relationships in 2016 June?
74
What is the MOA of gp41 inhibitors?
prevent HIV from fusing with the cell
Waht is the MOA of gp120 and CCR5 antagonists?
prevent HIV from attaching to the cell
What is the function of PIs?
prevent processing of HIV proteins and the development into a mature virion
What is the source of the virus during effective ART?
primarly defined by the half-life of hte cells that were infected before therapy was initiated - after several years, long-lived populations of resting central memory cells become dominant source of HIV persistance
What percentage of all people living with HIV are unaware of their HIV status?
aroudn half
What is the UNAIDs targets for 2020?
90% of people living with HIV know diagnosis; 90% of those are on ART and 90% of those are virologically suppressed by 2020
What are hte challenges to meeting the UNAID targets?
money; drug supply chains; trained staff; capacity; stigma; gender based violence
What are the 4 pillars of HIV prevention?
behavioural change; treatment(ARTs; STIs) ; social justice and human rights; biomedial strategies
What are the behvarioural changes needed for HIV prevention?
partner reduction; condom use; clean IDU equipment
What are the 2 forms of Prep?
oral and topical microbicides eg gels or intravaginal rings
What is the one off the greatest risk factors for HIV globally?
being in a stable relationship (won’t use condoms)
What effect does male circumcision have on HIV transmission?
> 57% reduction- but doesn’t reduce risk of transmitting HIV to women
How does on demand PrEP work?
2 tablets of truvada before sex (2-24h); 1 tablet 24 hours after and 48 hours after
What are some of current issues regarding PrEP?
who will pay for it; who will be eligible; long-term safety; adherence; will it change risk behaviour; if get HIV whilst on PrEP, will have impact on treatment- eg resistnace?
What are the possibilities of sustained release of PrEP?
long acting injectables; implantables; intra-vaginal rings
What was the effect of the PrEP vaginal ring in women >21 years?
protection was 56%
What was the effect of the Thai vaccination RV-144 trial?
protective efficacy at around 31%
What was the vaccination schedule of RV-144
vaccination injections at 4 times over 6 months with gp120 boosters at 12 and 24 weeks
When was the highest protection with RV-144?
first 6-12 months
What was the significant about RV-144 despite not great efficacy?
showed that protection from infection of HIV is possible
Aside from eliciting antibodies through vaccination, what is the other use for broadly neutralising antibodies?
passive immunisation by injecting antibodies or gene transfer through a vector that produces the antibodies for prevention and therapy
What is the kick and kill strategy for getting rid of the reservoir?
activate latently infected cells then kill the cells through immunologic therpay; gene therapy; stem cells transplants (both getting rid of CCR5) and continuing ART to prevent new cells being infected
