Dental relevance of HIV

Question 1

Who was patient 0 or zero

Answer 1

a flight attendant with approx 250 partners/year​

affected with Kaposi’s in June 1980​

linked by sexual contact to 40 patients​

characterised as promiscuous and irresponsible​

died of AIDS in 1984

Question 2

What did GRID stand for

Answer 2

Gay related Immuno Deficiency

Question 3

What does AIDS stand for

Answer 3

Aquired Immunodeficiency Syndrome

Question 4

What animal does HIV stem from

Answer 4

Chimpanzees

Question 5

When do scientists and researchers believe the first transmission of SIV to HIV in humans was

Answer 5

1920

Question 6

How is HIV transmitted

Answer 6

Unprotected sex
Drug addicts (needles)
Blood transfusion
Pregnancy
Non-sterile instruments

Question 7

What methods DO NOT transmit HIV

Answer 7

Touching
Through foood
Kissing
Insects

Question 8

What tests are there for HIV

Answer 8

Oral fluid tests
Direct blood spot
Lab testing
Blood tests

Question 9

What is the window period for HIV

Answer 9

The point between potential exposure and the point where an accurate test result can be acheived

Question 10

How can the HIV window period be shortened

Answer 10

Antigen tests and methods to detect viral RNA

Question 11

Can a person exposed to HIV still test negative during the window period even if they have contracted the disease

Answer 11

Yes

Question 12

How long is the HIV window period

Answer 12

2-3 weeks

Question 13

What is ART

Answer 13

Antiretroviral treatment

First version introduced in the 1987​

Long term medical treatment (not cure)​

Suppresses the virus​

Prevents disease from progressing​

Saved millions of lives

Question 14

What is PrEP

Answer 14

Pre exposure profillaxis
Taken by those who dont have HIV but are at risk (sexually active gay men)

Question 15

What is UNAIDS targets for countries

Answer 15

Requires >95% of people living with HIV to be aware of their status

> 95% with HIV on treatment

> 95% on HIV treatment to be virally supressed

Question 16

What family of virus does HIV 1 and 2 stem from

Answer 16

Retroviruses

Question 17

What 2 glycoproteins on HIV attach to the host cell

Answer 17

gp41 and gp120

Question 18

Where are the glycoproteins found in HIV

Answer 18

In the lipid membrane of envelope

Question 19

What is the main attachment receptor for HIV

Answer 19

CD4 molecule on macrophages and microglia cells

Question 20

What are the key stages of the HIV lifestyle

Answer 20

HIV releases genetic material into CD4 cell​

Reverse transcriptase copies RNA – DNA​

Viral DNA inserted in cell DNA​

Many copies of the viral RNA and proteins made​

New viral particles assemble and bud from cell

Question 21

How many HIV particles are produced per day on infection

Answer 21

10 billion

Question 22

What is the pathology of HIV when untreated

Answer 22

Decline in peripheral blood CD4 lymphocyte count
Wasting disease
Neurological disease

Question 23

What is the definition of AIDS

Answer 23

AIDS is currently defined as the presence of one of 25 conditions indicative of severe immunosuppression​

OR​

HIV infection in an individual with a CD4+ cell count of <200 cells per cubic mm of blood

Question 24

What does having AIDS signify

Answer 24

AIDS is therefore the end point of an infection that is continuous, progressive and pathogenic

Question 25

What oral lesions are associated with HIV

Answer 25

Oral Candidosis​

Hairy Leukoplakia​

Kaposi’s sarcoma​

Non-Hodgkin’s lymphoma​

Periodontal disease

Question 26

Why are Oral lesions associated with HIV

Answer 26

Severity depends on levels of CD4 count

Question 27

When should paients be prompted test for HIV

Answer 27

Those not on medication or preventitive messures
Presenting with oral lesions associated with disease
Not already known to have HIV
Patient on immunosuppresant therapy

Question 28

How Prevelant is HIV in scotland (high risk groups)

Answer 28

5.9% (MSM)
0.7% (PWID)

Question 29

What regulation was introduced to reduce risk of HIV transmission in dental setting

Answer 29

Health and safety (sharp instruments in healthcare) regulations 2013

Question 30

What should dental professionals do to prevent spread of HIV

Answer 30

possess adequate knowledge about HIV infection and the significance of oral lesions associated with HIV which may help identify those who would benefit from HIV testing​

provide HIV patients with oral healthcare of the highest standards. A focus on routine and preventative care will maintain and improve the quality of life for patients with HIV​

Infection control measures should be strictly followed​

Dental professionals have a legislative duty to report all sharps injuries and seek appropriate follow up and management as per local policies.