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Year 2 Infectious Disease and Public Health > Diagnosis and management of HIV I > Flashcards

Diagnosis and management of HIV I Flashcards

1
Q

HIV is what type of virus?

A

lentivirus (retrovirus)

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2
Q

HIV-1 features

A
  • infects and depletes CD4+ T cells
  • high genetic mutation rate
  • evades antibody and cellular immunity
  • defies traditional vaccine strategies
  • hides in resting memory CD4+ T cells
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3
Q

AIDS = CD4+ T cell count under what value? what is the other definition of AIDS?

A

200

or AIDS indicator disease

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4
Q

what is the viral load “set point / inflection point”?

A

point when the viral load stabilizes

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5
Q

what is a normal CD4+ T cell count?

A

over 750

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6
Q

at what CD4+ T cell count does Kaposi’s sarcoma present?

A

400

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7
Q

at what CD4+ T cell count does AIDS dementia present?

A

~250

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8
Q

at what CD4+ T cell count does wasting present?

A

~150

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9
Q

at what CD4+ T cell count does toxoplasmosis and cryptococcosis present?

A

100

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10
Q

at what CD4+ T cell count do CMV and mycobacterium avium complex present?

A

50

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11
Q

what group constitutes the highest % of new HIV diagnoses?

A

MSM

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12
Q

what is the rationale for using PREP (pre exposure prophylaxis)? is it successful?

A

targeting high risk groups (MSM, heterosexual contact, injection drug use)

it has been shown to be successful in these groups

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13
Q

what age group has the highest HIV diagnoses?

A

25-34

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14
Q

what ethnic group represents the highest amount of new HIV diagnoses?

A

African Americans

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15
Q

what % of people with HIV do not know they have it? what % of new infections do they account for?

A

20%

52%

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16
Q

what is critical in the management and especially prevention of HIV? what is the goal?

A

retention in care - likely to get patients on HIV meds and keep them on them

goal is to get viral load undetectable

17
Q

persons with acute HIV infection are likely to have

A. no symptoms
B. positive HIV western blot
C. high level of HIV RNA in blood
D. delta 32 CCR5 homozygosity

A

asdf

18
Q

in acute retroviral syndrome, flu- or mono-like syndrome is present in what % of cases?

A

75%

19
Q

when are symptoms usually seen in HIV infection?

A

burst in viremia

20
Q

in acute retroviral syndrome, pharyngitis, rash, and/or headache is present in what % of cases?

A

50%

21
Q

what do diagnostic tests look for to detect HIV?

A
  • look for presence of virus (PCR)
  • look for presence of antigen (p24)
  • look for presence of antibody (anti-p24)
22
Q

what is the viral antigen detected in HIV testing? what part of the virus is it? when is it detected?

A

p24 (capsid protein)

detected 1 week before HIV antibody

23
Q

when is HIV RNA detected? does this require confirmation?

A

1-3 weeks before detection of HIV antibody

yes, requires confirmation

24
Q

does the antibody / antigen test require confirmation?

A

yes

25
Q

what is the gold standard screening test for HIV?

A

ELISA

26
Q

what are the HIV confirmatory tests?

A
  • HIV-1 western blot

- multispot HIV-1 / HIV-2 test (becoming gold standard)

27
Q

what is the two step testing for screening and confirmatory testing?

A
  1. reactive HIV Ag/Ab screening test
  2. multispot HIV-1 and HIV-2 discriminatory assay
  3. if POSITIVE multispot HIV-1 and HIV-2 discriminatory assay = report as HIV positive
  4. if NEGATIVE multispot HIV-1 and HIV-2 discriminatory assay = HIV-1 nucleic acid testing
  5. if POSITIVE HIV-1 nucleic acid testing = HIV positive
28
Q

USPSTF screening protocol

A
  • persons age 15-65

- grade A recommendation

29
Q

what is opt-out testing for routine HIV testing?

A
  • repeat testing based on risk

- all pregnant women MUST get tested (Iowa law)

30
Q

what are the HIV coreceptors?

A

CCR5

CXCR4

31
Q

which virus is typically transmitted via sexual contact?

A

R5 tropic virus

32
Q

which HIV coreceptor is essential for transmission from person to person ?

A

CCR5

33
Q

which HIV coreceptor is associated with more rapid disease progression?

A

CXCR4

34
Q

can the tropism of HIV infection change? how does it relate to AIDS progression?

A

yes

shift from CCR5 to CXCR4 indicates a faster progression to AIDS

35
Q

what are the benefits of the delta 32 CCR5 mutation?

A

does not cause human disease

normal CCR5 ligands are beta-chemokines

Year 2 Infectious Disease and Public Health (18 decks)

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