Chapter 3.26 Retroviridae, HIV, and AIDS Flashcards

1
Q

What are the characteristics of retroviridae?

A

RNA viruses that infect animals and humans

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2
Q

What are the 3 big concepts unique to the retroviridae group?

A

Retro- carry reverse transcriptase the converts viral RNA into DNA that can integrate into the host DNA
Grow- oncogenic in humans and animals
Blow- cytotoxic to certain cells, blowing them up

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3
Q

How does the Rous sarcoma virus work?

A

oncogenic virus that encodes a protein that phosphorylates tyrosine at ten times the normal rate

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4
Q

What cancers are associated with most retroviridae?

A

leukemia and sarcoma

*sometimes called leukemia sarcoma viruses

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5
Q

What is an acute transforming virus?

A

carry intact oncogenes in their viral genome which can integrate into host DNA and cause malignant trandformation
*use sticky ends and integrase enzyme

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6
Q

What is the most common example of an acute transforming virus?

A

Rous sarcoma virus which has the oncogene src

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7
Q

What are non-transforming viruses?

A

retroviridae that activate host cell proto-oncogenes by integrating viral DNA into key regulatory area
*do not carry oncogenes

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8
Q

What virus is linked to tropical spastic paraparesis?

A

human T-cell leukemia virus (HTLV-1)

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9
Q

What is the shape of human immunodeficiency virus (HIV)?

A

spherical, enveloped virion with cylindrical nucleocapsid

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10
Q

What are the 3 essential retroviral enzymes of HIV?

A

protease, reverse transcriptase, and integrase

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11
Q

What is the major capsid of HIV?

A

p24 - which is measured in serum to detect early HIV infection

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12
Q

What are the surface glycoproteins of HIV?

A

gp120 and gp41

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13
Q

What are the main components of all retrovirus genomes?

A

long terminal repeats, gag gene, pol gene, and env gene

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14
Q

What is the function of long terminal repeats in reverse transcriptases?

A

sticky ends to help insert into host genome and promoter functions to help promote viral DNA transcription

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15
Q

What is the function of gag gene?

A

codes for virion’s structural proteins

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16
Q

What is the function of pol gene?

A

encodes protease, integrase and reverse transcriptase

**protease is essential for HIV

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17
Q

What is the function of env gene?

A

codes for envelope proteins

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18
Q

Where is HIV/AIDS most common globally?

A

developing countries specifically Africa

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19
Q

How is the HIV virus transmitted?

A

parenteral route

  1. Sexual activity
  2. Blood product transfusion
  3. Intravenous drug use
  4. Transplacental (mother to fetus)
  5. Health Care providers
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20
Q

How can HIV spread through sexual activity?

A

HIV is present in seminal fluid and vaginal and cervical secretions
Anal intercourse causing rupture to thin rectal wall

21
Q

What lymphocyte is involved in HIV?

A

T helper cells with CD4 lymphocytes

*with co-receptor CCR5 or CXCR4

22
Q

What are the 3 stages of HIV/AIDS?

A
  1. Actue viral illness
  2. Clinical latency
  3. AIDS
23
Q

What is the clinical presentation of a patient with HIV/AIDS in the acute viral illness phase (1)?

A

*1 month after exposure
Symptoms similar to mononucleosis (fever, malaise, lymphadenopathy)
High levels of blood-borne HIV (viremia) that eventually decreases and resolution of symptoms leading to phase 2

24
Q

What occurs during the clinical latency phase (2) of HIV/AIDS?

A

*median of 8 years

HIV continues to replicate and there is a steady destruction of CD4 T helper cells

25
Q

What occurs during the last phase if HIV/AIDS?

A

*median of 2 years followed by death

AIDS develops

26
Q

What opportunistic infections usually only develop in AIDS patients?

A

Candida esophagitis, Pneumocystis carinii pneumonia, Kaposi’s sarcome

27
Q

What can be used to determine severity of HIV infection and prognosis?

A

CD4 counts and viral load

28
Q

What can viral load determine?

A

risk for opportunistic infection

*the higher the plasma HIV RNA levels the greater risk for opportunistic infection

29
Q

What is the hallmark of HIV?

A

gradual depletion of CD4+ T cells leading to weakened immune system and secondary opportunistic infections

30
Q

Why is destruction of CD4+ T cells so significant in HIV/AIDS patients?

A

Because T cells orchestrate activation and recruiting of B cells, macrophages, and neutrophils

31
Q

What are multinucleated giant cells?

A

T cell to T cell fusion allowing a virus (ex. HIV) to pass to infected cells without contacting blood

32
Q

How does HIV affect B cells?

A
  • causes hypergammaglobulinemia- polyclonal activation of B cells
  • causes inability to produce antibodies in response to new antigens
33
Q

How does HIV affect macrophages and monocytes?

A

HIV doesn’t kill them but uses them as reservoirs and macrophages and monocytes can migrate across the blood-brain barrier
*carrier HIV to the CNS

34
Q

What 2 processes occurs through the HIV virus to promote AIDS?

A
  1. Direct viral disease: widespread symptoms (constitutional) across the body and neurological damage
  2. Disease secondary to immunodeficient state: failure to prevent malignancies and increased opportunistic infections
35
Q

What is the constitutional symptoms of an AIDS patient?

A

night sweats, fever, enlarged lymph nodes, severe weight loss
*referred to as “the wasting syndrome”

36
Q

What are the neurologic symptoms in an AIDS patient?

A

encephalopathy resulting in decline in cognitive function (AIDS dementia), meningeal infection, infect the spinal cord, neuropathy of peripheral nerves

37
Q

What malignancies are commonly seen in AIDS patients?

A

B cell lymphoma- often presenting as a brain mass
Kaposi’s sarcoma- usually in homosexual men using HHV-8 (herpes virus)
Non-Hodgkin’s lymphoma, cervical cancer

38
Q

What is the appearance of a Kaposi sarcoma in an AIDS patient?

A

red to purple plaques or nodules that arise on the skin all over the body

39
Q

What is the most common manifestation of AIDS?

A

secondary infection by opportunists- organisms that normally aren’t present with an intact immune system but appear in the absence of T helper cells

40
Q

What bacterial infections are HIV patients more susceptible to?

A

infection by encapsulated organisms from lack of humoral immunity (ex. Strep pneumo)

41
Q

What mycobacterial infections are HIV patients more susceptible to?

A

mycobacterium tuberculosis and mycobacterium avium-intracellulare

42
Q

What fungal infections are HIV patients more susceptible to?

A
Candida albicans
Cryptococcus neoformans
Histoplasma capsulatum
Coccidioides immitis
Pneumocustis jiroveci pneumonia
43
Q

What viral infections are HIV patients more susceptible to?

A

Herpes zoster- painful vesicles
Epstein-Barr virus- oral hairy leukoplakia (white hairlike projections from tongue)
Herpes Simplex- genital and oral outbreaks
Cytomegalovirus (CMV)- chorioretinitis and blindness

44
Q

What protozoa are HIV patients more susceptible to?

A

Toxoplasma gondii- causes mass lesion in brain

Cryptosporidium, Microsporidia, and Isospora belli- chronic diarrhea

45
Q

How is diagnosis of HIV and AIDS done?

A
  • Viral RNA or antigens can be detected in blood within weeks
  • 3-6 weeks later, antibodies against HIV appear via ELISA
  • Western blot test- light up the antibodies against HIV antigens
  • Rapid testing of blood, plasma, and saliva
46
Q

What clinical presentation occurs in which a physician should suspect HIV/AIDS?

A

when an at-risk individual has constitutional symptoms

*fever, night sweats, generalized adenopathy, recurrent bacterial infections, tuberculosis, skin zoster, or oral thrush

47
Q

What is the CD4+ count when AIDS is diagnosed?

A
48
Q

What are the 3 challenges in developing HIV/AIDS vaccine?

A

rapid mutation of HIV, HIV can transmit from cell to cell, poor animal models