E2- HIV and AIDs Flashcards
When is AIDs (stage 3 HIV infection) diagnosed?
When severe damage to immune system is evident
CD4 T cell < 200
What is considered a fast HIV course class?
3 yrs or less to AIDs
What is considered an intermediate HIV course class?
AIDs emergence lags about one decade after infection
What is considered a long-term/non-progressive HIV course class?
AID emergence occurs more than 10 yrs after infection
(under 5% of cases)
“Elite controllers”
What conditions are associated with AIDs? “AIDs-Defining conditions”
Kaposis sarcoma, pneumocystis pneumonia, MAC infection, cytomegalovirus, cryptosporidiosis, candidiasis
appear in clusters, and are rare in immunocompetent pts
What is the MOA of HIV?
RNA virus that makes DNA copy of itself and inserts it into the host for replication
What is the first target of HIV?Why is this beneficial?
First target is the reverse transcriptase (RNA dependent DNA polymerase)
Human cells do not have it
Where is it believed that AIDs came from?
Zoonosis that entered human populations via contact with primates (bushmeat)
What are three unproven HIV mythologies?
Polio vaccination as a source of HIV-1
Patient zero (Gaétan Dugas)
Deliberate spread
HIV produces ___ cell loss and profound immunosupression.
T(H) cell
Why are combination therapies essential to HIV treatment?
Virus is able to mutate rapidly, combo therapy is used to prevent swift virus inhibition escape
How is HIV transmitted?
Sexual contact
Parenteral
Perinatal
Organ transplants
What greatly enhances sexual HIV infection probability?
HSV lesions or psyphilis
Can HIV be spread by insect bites?
No
Where are HIV-1 and HIV-2 more common?
HIV-1 more common worldwide
HIV-2 more common in West Africa
Which HIV subtype is less easily transmitted, exhibits slower progression to AIDs and is resistant to NNRTIs?
HIV-2
What is the HIV progression pattern?
Virus replicates freely
Patient exhibits antibody response
Virus eventually defeats the antibodies
What is the 2 step process of HIV antibody detection/diagnosis?
- EIA screen
2. Western blot for confirmation
What is donated blood always screened for?
The presence of HIV antigens and/or RNA
According to the Red cross, what designates a positive HIV test?
One WB band (blood is discarded)
According to the CDC, what designates a positive HIV test?
Two cross reacting bands
Why do you never solely rely on antigen test to diagnose HIV?
Response lag (use direct test)
What is seen on PCR with an HIV positive pt?
Antigen p24 or RNA genome
How can HIV be diagnosed?
HIV antibody test (EIA and Western blod)
Direct tests (Nucleic acid test)
PCR
Rapid HIV test (new 20 min test)
What is the key to HIV treatment?
Combinations!
Can HIV therapy cure the infection?
No
Combinations of what has made a remarkable difference in the clinical condition of HIV patients; virus sinks to undetectable levels
Reverse transcriptase inhibitors with Protease inhibitors
Most viral load tests have a limit of detection around what?
50 copies/mL
How does HIV integrate into the host chromosomes?
Using viral integrases
A substantial portion of HIB patients meet the criteria for what?
HIV- associated neurocognitive disorder
Neurovascular function may be influenced by HIV and therapies
Assess ability of patient to comply with complex drug regime
Anti-retroviral therapies can drive virus levels to undetectable levels. What does this mean?
Patients in viral suppression state are not contagious
Undetectable = untransmissible
