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Clinical Micro > Bloodborne viruses > Flashcards

Bloodborne viruses Flashcards

1
Q

Whats the morphology/genome of HIV like?

A

Envelopped with linear, dimeric, ssRNA(+) genome

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2
Q

How many species of HIV are there?

A

2 - HIV-1 and HIV-2

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3
Q

How many groups are there in HIV-1

A

4: M, N, O, and P

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4
Q

Which strain of HIV is the one responsible for the global epidemic?

A

HIV-1 strain M

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5
Q

What is the dominant HIV-1 subtype in the americas?

A

HIV-1, group M, subtype B

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6
Q

Where is the greatest diversity and prevalence of HIV found?

A

Africa

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7
Q

How many out of 100 sexually active adults are infected with HIV worldwide

A

1/100

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8
Q

What are the 3 ways in which HIV can get transmitted? When is each more common?

A
  1. Sexually is most common (90%)
  2. IV drug use is also a method (%8)
  3. Vertical transmission in developing countries (25%)
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9
Q

What are the 3 stages in the progression of HIV?

A
  1. Primary infection
  2. Clinical latency
  3. AIDS
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10
Q

How long does the primary infection with HIV last?

A

3-6 weeks

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11
Q

What are the symptoms of the acute phase of HIV?

A

Mono-like symptoms: fever, maculopapular rash, oral ulcers, lymphadenopathy, malaise, weight loss, arthralgia, night sweats

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12
Q

What is the general patten of CD4 cell and antibody against HIV virus as the disease progresses?

A

both decrease as the viral load increases

- ultimately end at the wasting stage before death

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13
Q

What are kinds of opportunistic infections that can occur with HIV? Why?

A

Occur because the CD4 count drops

TB, HZV, pneumocystis, candida infections…

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14
Q

When is risk of sexual transmission highest?

A

during acute and late stage infection (higher viral loads)

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15
Q

What can be given to someone who may have been exposed to HIV?

A

post exposure prophylaxis (PEP)

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16
Q

How soon does PEP need to be given?

A

within 72 hours to be effective

-within 2 hours is best

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17
Q

What is the name for the kind of ARV therapy currently in use for HIV?

A

Highly active antiretroviral therapy (HAART)

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18
Q

What are the 4 general types of lab tests used for HIV

A
  1. HIV screening assays
  2. Confirmatory testing
  3. Viral loads to monitor treatment
  4. Antiviral resistance testing
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19
Q

What needs to be done if you get a positive result for an HIV screening assay? a negative result?

A

EIA positive: requires confirmatory testing

EIA negative: repeat over time (window period)

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20
Q

Why are the 4th gen EIAs for HIV so much better?

A

because they detect both HIV antigen and antibodies made against it

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21
Q

What is the window period?

A

the time between infection and when it can be detected in the lab

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22
Q

What is the window period for HIV using the 4th generation EIA?

A

2 weeks

23
Q

What is seroconversion?

A

generation of antibodies against a particular pathogen/virus

24
Q

Why do you need to perform multiple tests over time for HIV ?

A

because by 2-3 weeks, only 50% of people have seroconverted

25
Q

What test is used as a confirmatory method for HIV? How does it work?

A

Western blot

HIV viral proteins separated by electrophoresis and transferred to nitrocellulose membrane

Will detect anti-HIV antibodies in serum

26
Q

What is the HIV-1/HIV-2 immunoblot? what are the advantages?

A

Small card that you put blood and buffer on to.

Advantages: rapid, specific, and will detect both HIV-1 and HIV-2

27
Q

When are 5 instances where you would use molecule methods for HIV detection?

A
  1. Monitor therapy (quantitative - viral loads)
  2. Earlier diagnosis during window period? - EIA over time…
  3. Supplemental test for problematic Western or immunoblot results (ex: persistent indeterminate)
  4. Testing of babies born to HIV-positive mothers
    - Maternal antibody in babies persist up to 24 months
  5. Late in disease (wasting) - seroreversion
28
Q

What kind of test specifically is used to monitor viral load/ARV therapy?

A

quantitative RT-PCR

29
Q

The most common HIV drugs are __ because they benefit from the presence of ___

A

Nucleoside and non-nucleoside reverse transcriptase inhibitors (NRTIs and NNRTIs)
- because HIV has a viral RT

30
Q

What are the 5 drug targets of HIV ARVs?

A
  1. Fusion inhibitors
  2. CCR5 co-receptor antagonists
  3. NRTIs and NNRTIs
  4. Integrase inhibitors
  5. Protease inhibitors
31
Q

How does HIV resistance arise/why is it so common?

A

Because the RT lacks proofreading ability and so much viral replication is going on, you can get millions of variants per day

32
Q

What is HIV resistance testing? How does it work?

A

test serum or plasma and do a RT PCR and amplify the sequence – then look for mutations in the sequences that are targets for the ARVs

33
Q

What kind of genome/morphology is Hepatitis C virus? many types of genotypes or just one?

A

ssRNA (+), envelopped

multiple genotypes

34
Q

approx. how many HCV carriers are there worldwide?

A

about 170 million

35
Q

What are 6 symptoms of an infection with HCV?

A
  1. Abdominal pain
  2. Jaundice
  3. Nausea/vomiting
  4. Swollen abdomen
  5. itchy skin
  6. weight loss
36
Q

What % of people develop a chronic HCV infection after the acute stage? what % of those patients will develop cirrhosis of the liver? what % of THOSE peeps will get ESLD and die?

A

60-85%

5%

25% will die

37
Q

Why is the main method for testing HCV serology and not molecular methods?

A

Because the viral RNA load stays relatively constant over time

EIAs and confirmatory assays are used instead

38
Q

What marker is used to monitor liver damage?

A

Alanine aminotransferase (ALT) = marker for liver damage

39
Q

What is the flow of testing for HCV?

A
  1. EIA
    - if negative test over time
  2. NAAT test if EIA positive
    - if positive = HCV pos
  3. if NAAT negative -> do RIBA
    - RT-PCR or recombinant immunoblot (RIBA)
  4. If RIBA positive = HCV positive
    - if negative then you repeat HCV EIA in a month
40
Q

How does RIBA work?

A

confirms EIA through serology by testing anti HCV in serum

41
Q

What is the point of doing HCV genotyping? How is it done?

A

will help determine treatment and duration

done doing a line probe assay

42
Q

What are 3 types of direct acting antivirals (DAA) used in the treatment of HCV?

A
  1. RNA replicase inhibitors
  2. Protease inhibitors
  3. NS5A inhibitors
43
Q

What kind of genome/morphology does Hep B have? Does it have a RT?

A

Enveloped, partially dsDNA

Yes has a viral RT

44
Q

How many carriers of HBV are there worldwide?

A

About 350 million

45
Q

How is HBV transmitted?

A

Can be vertical or horizontal

- horizontal from sexual contact, blood transfusion, sharing needles etc.

46
Q

What is the difference between people who become chronically infected from a vertical vs. horizontal transmission?

A

90% of infants will become chronically infected where only 6% of people over the age of 5 become chronically infected

47
Q

Who is more likely to enter the chronic stage of HBV infection?

A

children (90%) vs only 5% of adults

48
Q

What % of children with chronic HBV infections go on to develop cirrhosis?

A

about 30%

- some of which will go on to develop ESLD

49
Q

How can you prevent HBV?

A

Vaccination

50
Q

What are 2 current treatments available for HBV?

A

alpha-interferon, lamivudine

- some other newer treatments as well

51
Q

Vaccines against HBV are based on what antigens?

A

surface antigens

52
Q

antibodies made against the core HBV viral protein tells you someone has been..?

A

infected and then become immune

53
Q

Describe the difference between the acute and chronic graphs of HBV

A

for acute (that resolves): titre of surface antigen increases and then decreases, then Ab to the surface protein develops and tapers off. Ab to core antigen increases and remains constant

for chronic: while Ab to core antigen remains high, no Ab to surface protein develops and so the titre of surface protein remains high

Clinical Micro (28 decks)

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