E2- HIV and AIDs

Question 1

When is AIDs (stage 3 HIV infection) diagnosed?

Answer 1

When severe damage to immune system is evident

CD4 T cell < 200

Question 2

What is considered a fast HIV course class?

Answer 2

3 yrs or less to AIDs

Question 3

What is considered an intermediate HIV course class?

Answer 3

AIDs emergence lags about one decade after infection

Question 4

What is considered a long-term/non-progressive HIV course class?

Answer 4

AID emergence occurs more than 10 yrs after infection
(under 5% of cases)

“Elite controllers”

Question 5

What conditions are associated with AIDs? “AIDs-Defining conditions”

Answer 5

Kaposis sarcoma, pneumocystis pneumonia, MAC infection, cytomegalovirus, cryptosporidiosis, candidiasis

appear in clusters, and are rare in immunocompetent pts

Question 6

What is the MOA of HIV?

Answer 6

RNA virus that makes DNA copy of itself and inserts it into the host for replication

Question 7

What is the first target of HIV?Why is this beneficial?

Answer 7

First target is the reverse transcriptase (RNA dependent DNA polymerase)

Human cells do not have it

Question 8

Where is it believed that AIDs came from?

Answer 8

Zoonosis that entered human populations via contact with primates (bushmeat)

Question 9

What are three unproven HIV mythologies?

Answer 9

Polio vaccination as a source of HIV-1
Patient zero (Gaétan Dugas)
Deliberate spread

Question 10

HIV produces ___ cell loss and profound immunosupression.

Answer 10

T(H) cell

Question 11

Why are combination therapies essential to HIV treatment?

Answer 11

Virus is able to mutate rapidly, combo therapy is used to prevent swift virus inhibition escape

Question 12

How is HIV transmitted?

Answer 12

Sexual contact
Parenteral
Perinatal
Organ transplants

Question 13

What greatly enhances sexual HIV infection probability?

Answer 13

HSV lesions or psyphilis

Question 14

Can HIV be spread by insect bites?

Answer 14

No

Question 15

Where are HIV-1 and HIV-2 more common?

Answer 15

HIV-1 more common worldwide

HIV-2 more common in West Africa

Question 16

Which HIV subtype is less easily transmitted, exhibits slower progression to AIDs and is resistant to NNRTIs?

Answer 16

HIV-2

Question 17

What is the HIV progression pattern?

Answer 17

Virus replicates freely
Patient exhibits antibody response
Virus eventually defeats the antibodies

Question 18

What is the 2 step process of HIV antibody detection/diagnosis?

Answer 18

1. EIA screen

2. Western blot for confirmation

Question 19

What is donated blood always screened for?

Answer 19

The presence of HIV antigens and/or RNA

Question 20

According to the Red cross, what designates a positive HIV test?

Answer 20

One WB band (blood is discarded)

Question 21

According to the CDC, what designates a positive HIV test?

Answer 21

Two cross reacting bands

Question 22

Why do you never solely rely on antigen test to diagnose HIV?

Answer 22

Response lag (use direct test)

Question 23

What is seen on PCR with an HIV positive pt?

Answer 23

Antigen p24 or RNA genome

Question 24

How can HIV be diagnosed?

Answer 24

HIV antibody test (EIA and Western blod)
Direct tests (Nucleic acid test)
PCR
Rapid HIV test (new 20 min test)

Question 25

What is the key to HIV treatment?

Answer 25

Combinations!

Question 26

Can HIV therapy cure the infection?

Answer 26

No

Question 27

Combinations of what has made a remarkable difference in the clinical condition of HIV patients; virus sinks to undetectable levels

Answer 27

Reverse transcriptase inhibitors with Protease inhibitors

Question 28

Most viral load tests have a limit of detection around what?

Answer 28

50 copies/mL

Question 29

How does HIV integrate into the host chromosomes?

Answer 29

Using viral integrases

Question 30

A substantial portion of HIB patients meet the criteria for what?

Answer 30

HIV- associated neurocognitive disorder
Neurovascular function may be influenced by HIV and therapies
Assess ability of patient to comply with complex drug regime

Question 31

Anti-retroviral therapies can drive virus levels to undetectable levels. What does this mean?

Answer 31

Patients in viral suppression state are not contagious

Undetectable = untransmissible