EBV and HIV

Question 1

Name 3 conditions EBV is associated with

Answer 1

Hodgkin’s lymphoma
Burkitt’s (NHL)
Nasopharyngeal carcinoma

Question 2

What age group are particularly at of EBV?

Answer 2

15-24 y/o

Question 3

How does EBV spread?

Answer 3

In saliva or bodily fluids

Question 4

What are symptoms of EBV?

Answer 4

Varied mild symptoms:
sore throat
hepatosplenomegaly

Question 5

True of false: EBV is self-limiting?

Answer 5

True, normally 2-4 weeks

Question 6

How do you diagnose EBV?

Answer 6

Blood film:
Atypical lymphocytes

Question 7

What are other names for EBV?

Answer 7

Glandular fever
Infectious mononucleosis

Question 8

What type of virus is HIV?

Answer 8

retrovirus (RNA virus with reverse transcriptase so can make complementary DNA copy of the viral RNA to integrate into host cell’s DNA)

Question 9

How is HIV spread?

Answer 9

Sharing needles
Needle stick injury
MSM
unprotected anal sex

Question 10

Is HIV-1 or HIV-2 more common?

Answer 10

HIV-1, it’s more virulent

Question 11

What is the pathophysiology of HIV?

Answer 11

HIV gp120 binds to CD4 on T helper cell

Endocytoses RNA and enzymes

Reverse transcriptase makes RNA to DNA

Integrase integrates the viral DNA into the hosts.

Protein synthesis

Viral proteins and RNA exocytose and take part of CD4 and cell surface membrane

Therefore have increasing viral copies and decreasing CD4+ cells.

Question 12

What is gp120 found on HIV?

Answer 12

Viral envelope glycoprotein

Question 13

What cell does HIV bind to via receptors and gp120?

Answer 13

CD4 cells

Question 14

Which enzyme is used inside the CD4 cell to reverse transcribe the RNA into DNA?

Answer 14

reverse transcriptase

Question 15

What does the enzyme integrase do?

Answer 15

Integrates the viral DNA into the host cell’s genome

Question 16

Integrated viral DNA directs the host cell to produce…

Answer 16

new viral RNA and proteins.
Viral particles are assembled in the cell before being released in the bloodstream

Question 17

True or false: the host’s immune system doesn’t recognise HIV infected cells

Answer 17

False
Attempts to mount an immune response but HIV evades it. Can lie dormant in certain cells.

Question 18

Overtime, the continuous cycle of viral replication and immune response leads to…

Answer 18

depletion of CD4 cells , weakening the hosts immune system.

Question 19

How many CD4+ cells counts as AIDS?

Answer 19

<200 / mm^3

Question 20

What are some AIDS defining conditions?

Answer 20

CMV
Pneumocystitis sinovecci pneumonia (PCP)
cryptosporidium infection
TB
Kaposi sarcoma
Toxoplasmosis
Lymphomas

Question 21

What is CMV?

Answer 21

Cytomegalovirus giving flu like symptoms. Type of herpes virus.

Question 22

What is PCP?

Answer 22

Pneumocystis pneumonia
Lung infection caused by fungus Pneumocystis jirocevii

Question 23

What is a cryptosporidium infection?

Answer 23

A waterborne GI illness caused by a parasite causing diarrhoea

Question 24

What is Kaposi sarcoma?

Answer 24

Cancer from lining of blood vessels or lymphatic vessels caused by human herpes virus 8. Can involve skin (raised purply-red-brown patches), mucous membranes and internal organs

Question 25

What is toxoplasmosis?

Answer 25

Flu-like illness caused by parasite often spread through undercooked meat.

Question 26

What are common symptoms of HIV within a few weeks of initial infection?

Answer 26

Flu-like: Fever, fatigue, muscle aches, swollen lymph nodes, sore throat, rash May have no noticable symptoms

Question 27

What is the viral load like during the primary infection?

Answer 27

Typically very high

Question 28

How long does the asymptomatic chronic HIV infection last?

Answer 28

Can last for several years HIV continues to replicate but immune system keeps it in check

Question 29

What is the viral load like during the chronic stage of HIV?

Answer 29

Can fluctuate but tends to be lower than acute phase with relatively stable CD4 count

Question 30

What are symptoms of symptomatic HIV infection (advanced HIV)?

Answer 30

Chronic fatigue Weight loss Recurrent fevers Night sweats Opportunistic infections Oral thrush Chronic diarrhoea Skin conditions

Question 31

What happens to the viral load and CD4 count during symptomatic HIV (advanced HIV)?

Answer 31

Viral load may increase CD4 count starts to decline

Question 32

With no effective treatment, what may HIV develop into?

Answer 32

AIDS

Question 33

When is AIDS diagnosed?

Answer 33

When CD4 cell count falls below 200 cells / mm^3 or when AIDS-defining illnesses occur

Question 34

What are some AID-defining illnesses?

Answer 34

CMV infection PCP Candidiasis of oesophagus, trachea, bronchi or lungs TB Kaposi's sarcoma Cryptococcal meningitis Toxoplasmosis of the brain HIV encephalopathy (dementia) HIV-associated wasting syndrome

Question 35

What treatment is used for HIV?

Answer 35

ART antiretroviral therapy Helps to maintain a low viral load and preserve the CD4 count

Question 36

How do you diagnose HIV?

Answer 36

Take history Use ELISA testing for anti-HIV Ig and the p24 antibody (the p24 antigen is a viral protein) Monitor progression of HIV RNA copies and CD4 cell counts

Question 37

What is the HAART treatment for HIV?

Answer 37

Highly Active Antiretroviral Therapy Combo of 3 drugs that are reverse transcriptase inhibitors. Aims to maintain CD4 count and decrease HIV RNA copies