EXAM 4: HIV & Transplant Flashcards
What has HIV infection been, since 1984, known to be derived from?
zoonotic origin
What many are diagnosed with HIV worldwide? in the US?
37 mil and 1.2 mil
How many are believed to be undiagnosed/unaware?
162,500 HIV positive in US are unaware of status
What are CDCs three goals for HIV?
1) prevention 2) early detection, staging, surveillance, 3) treatment!
HIV is a retrOvirus - what is the virus component mean?
an onbligate intracellular parasite
HIV is a retrOvirus - what is the retro component mean?
only had RNA instead of DNA
We know that HIV invades T lymphocyte cells (CD4), macrophages, and some CNS cells - what is the implication?
detroys effective immune functioning against infections and cancer
When a resting infecting CD4 becomes activated against HIV or other pathogens - what two things happen?
1) begins to produce new copies of both viral RNA and viral proteins 2) which leads to destruction of host CD4 & spread of infection
What stage is AIDS in HIV infection?
Stage 3, severly immunocompromised
What is goal in suppressing HIV replication?
get to a level below which drug-resistant mutations do not emerge
In reducing HIV-assoc. morbidity/mortality - what is the goal?
prolong LIFE and improve quality of life
In suppressing HIV to restore and preserve immmunoligic function - what should CD4 count range be?
500-1500 / mm^3
When suppressing HIV viral load, where shoudl the viral load count be in order to be “undetectable”
less than 20-75/ml
For HIV medications, what does ART stand for?
Anti-retrovirus therapy - least aggressive form
For HIV medications, what does cART stand for?
Combination Anti-retroviral therapy - combo therapy to reduce resistance - more aggressive than ART
For HIV medications, what does HAART stand for?
Highly Active Anti-retroviral therapy - the most aggressive combo of ART plus treatment/prevention of secondary infections
4 indications for ART?
1) HIV-infected 2) HIV-infected pregnancy 3) History of AIDS-defining illness 4) serodiscordant couples
List the 6 AntiRetroviral Therapy drugs
1) enfuVIRtide 2) maraVIRoc 3) zidovudine 4) delaVIRdine 5) raltegraVIR 6) ritonaVIR
What are 6 common adverse effects of ART?
1) hepatoxicity 2) nephrotoxicity 3) osteopenia 4) dyslipidemia (early onset coronary diease) 5) fat redistribution syndrome (lipodystrophy) 6) insulin resistance = (DM)
When not adhering to the treatment plan, HIV patients can have: 1) viral ________ 2) immune _________ 3) clinical ___________
1) rebound 2) decompensation 3) deterioration
What percent of patients infected with HIV have suppressed viral load?
76%
Non-adherence is associated with cognitive/psychosocial barriers. Nmae up to 6.
1) neurocognitive impairment 2) depression, denial 3) nondisclosure of HIV serostatus, stigma 4) low health literacy, social support, and stressful life 5) homeless, poverty, access to care 6) substance abuse disorder
What causes the main problem of rejection in a organ transplant?
immune system reaction to the organ
What is the induction therapy drug that produces an intense immunosuppression during the initial transplant period?
basiliximab
