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MID Exam 3 > Exam 3 - Retroviruses > Flashcards

Exam 3 - Retroviruses Flashcards

1
Q

Retroviruses

Endogenous definition

A

-8% of human genome, carried
40 million yrs
-transmiss via germ cell line

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2
Q

Retroviruses

Exogenous definition

A
  • from primates
  • lentiretroviruses (HIV 1 and 2)
  • deltaretroviruses (HTLV 1 and 2)
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3
Q

Retroviruses

Morphology, general

A
  • enveloped (bud from host)

- 2 copies + sense RNA

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4
Q

Retroviruses

path, general

A
  • use reverse transcriptase to make DNA provirus
  • DNA integrates in host genome w/ integrase
  • transcription by host cell
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5
Q

Retroviruses
lentiretrovirus (HIV)
transmiss/epi

A
  • sex, blood, True Blood on HBO, sin
  • most primates (cpz, sm) act as asx viremic res
  • cross-species transmission
  • rhesus macaques are symptomatic
  • SIVcpz (chimp) ->HIV1 (worldwide)
  • SIVsm( mangabey) ->HIV2 (W. Africa, India)
  • HiV entered human in early 1900s
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6
Q

Retroviruses
lentiretrovirus (HIV)
strains

A
  • US: Group M, Clade B
  • Other: Groups M, N, O
  • Clades: regional gene variants
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7
Q

Retroviruses
lentiretroviruses (HIV)
gene products

A
  • hopefully don’t hafta know these…
  • tat: elongation
  • rev: export
  • nef: downregs host CD$ and MHC1 expresssion
  • vif: infectivity
  • vpu: downregs CD4 expression, increase release
  • vpr: promotes nuclear import of DNA pro-virus
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8
Q

Retroviruses
lentiretrovirus (HIV)
path

A

attachment, fusion, entry, reverse transcription,
nuclear translocation, integration, transcription,
RNA processing, translation, assembly, budding,
maturation

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9
Q

Retroviruses
deltaretrovirus (HTLV)
transmiss/epi

A
  • sex, blood. vert tranmiss rare.
  • HTLV1 endemic in Japan, Caribbean
  • HTLV2 US, EU, SEAsia, Amerindians, C. Africa
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10
Q

Retroviruses
deltaretrovirus (HTLV)
path

A
  • infects T, endothelium, fibroblasts
  • oncogenesis
  • lymphoma, myelopathy (paraesis)
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11
Q

Retroviruses
HIV
epi

A
  • 35 mil worldwide, 1.3 mil N. America
  • most HIV is HIV1
  • worldwide
  • US higest prev in DC! Look around!
  • on the rise again in MSM
  • disproportionate prev in black women
  • stop glancing at Kristian and Cristal
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12
Q

Retroviruses
HIV
transmision

A
  • sex, blood, True Blood, sin
  • being friends with gay people
  • vertical (maternal-fetal) 30% w/o anti-HIV
  • breast feeding
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13
Q

Retroviruses
HIV
risk factors

A

-besides the obvious:
-genital ulcer dz, uncircumcised,
traumatic sex, anal sex, cervical
ectopy, CCR5 phenotype

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14
Q

Retroviruses
HIV
immune response

A
  • CD8 most imp’t immune response,
  • antibodies
  • innate host defenses
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15
Q

Retroviruses
HIV
path

A

-trapped in lymph nodes by follic dendritic cells
-infect lympocytes and macrophages
-lymph node decompensation
-CD4 depletion via: cytopathicity, apoptosis,
syncitia, CD8 and NK recruitment
-opportunistic infxns

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16
Q

Retroviruses
HIV
dx

A
  • prelim ELISA
  • confirmatory Western Blot or Multispot
  • PCR for recent (<2 wks) infxn
17
Q

Retroviruses
HIV
acute/primary sx

A
  • 50-90% of infected
  • 2-4 wks after exposure
  • mono-ish, poss meningitis
18
Q

Retroviruses
HIV
AIDS dx

A
  • CD4 count <200 cell/uL

- avg onset 10 yrs after infxn, untreated

19
Q

Retroviruses
HIV
AIDS clinical pres

A
  • HIV encephalopathy/dementia
  • peripheral neuropathy, vacuolar myelopathy
  • a milli secondary infxns
  • reemergence of latent infxns
20
Q

Retroviruses
HIV
AIDS 2* infxns

A
  • pneumocystic jirovecii pneumonia (CD4<100)
  • esphoageal candidiasis (varies directly w/ immunosupression)
  • chronic mucocutaneous HSV
  • histoplasmosis
  • progressive multifocal leukoencephalopathy
  • TB
  • bacterial pneumonia
  • cryptosporidosis, isosporiasis
  • extraintestinal strongyloidiasis
21
Q

Retroviruses
HIV
AIDS 2* malignancies

A
  • Kaposi’s sarcoma (HHV8)
  • lymphoma (non-hodg, burkitts, CNS; EBV)
  • cervical (HPV)
  • rectal squamous cell carcinoma (HPV)
22
Q

Retroviruses
HIV
AIDS other clin

A
  • wasting syndrome
  • thrombocytopenia
  • renal dz
  • cardiomyopathy
23
Q

Retroviruses
HIV
AIDS surrogate markers

A
  • CD4 count
  • systemic sx (fever, chills, night sweats)
  • oral candidiasis, oral hairy leukoplakia
24
Q

Retroviruses
HIV
tx

A
  • begin tx when CD4100,000
  • reverse transcriptase inhibitors
  • protease inhibitors
  • integrase inhibitors
  • CCR5 receptor antagonists
  • inhibitors of HIV entry
25
Q

Retroviruses
HIV
resistance

A
  • high mutation fx (reverse transcriptase dysfxn)
  • mutations (shape, size, active site of rev transcriptase or integrase)
  • genotypic vs phenoptypic vs clinical resistance
26
Q

Retroviruses
HIV
tx complications

A
  • IRIS (imm. reactivation inflamm. response)
  • compliance, side fx, inconvenience
  • P450 drug interactions
27
Q

Retroviruses
HIV
prevention

A

-(duh) condoms, education
-post exposure tx
-circumcision (i have a lot more to say about this,
ask me)
-antiretrovial prophylaxis in discordant couples
-microbicides

MID Exam 3 (13 decks)

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