Final: HIV/AIDS Flashcards
1
Q
Viruses cause disease to
A
Animals, plants, and bacteria
2
Q
Do viruses have cellular machinery?
A
NO, they need another living organism to reproduce
3
Q
Life cycle of basic virus: Absorption
A
Virus particle attaches itself to a host cell
4
Q
Life cycle of basic virus: entry
A
particle injects its DNA (or RNA) into the host cell
5
Q
Life cycle of basic virus: replication
A
Cellular enzymes start making new virus particles
6
Q
Life cycle of basic virus: assembly
A
Particles of the virus created by the cell come together to form new viruses
7
Q
Life cycle of basic virus: Release
A
Newly formed viruses kill the cell so that they may break free and search for a new host cell
8
Q
The genome of retroviruses consists of
A
RNA, not DNA
9
Q
Reverse transcriptase
A
Polyamerase that uses RNA as its template, that making genetic information flow in the refer direction (RNA to DNA)
10
Q
Can the human body rid HIB completely?
A
NO!
11
Q
HIV 1 comprises four distinct groups
A
M, N, O, P
12
Q
is there a cure for HIV?
A
No, there is not effective cure for HIV, but it can be controlled
13
Q
How to know if one has HIV
A
GET TESTED@
14
Q
AIDS stands for
A
Acquired immunodeficiency syndrome
15
Q
AIDS is
A
Aquired
16
Q
What stage is aids of HIV infection
A
Final stage
17
Q
Does everyone who has HIV has aids>
A
No, not everyone who has HIV has aids
18
Q
Aids is the stage go infection that occurs when
A
Immune system is vulnerable to opportunistic infections
19
Q
Cell count of CD4 for AIDS
A
< 200 cells/ mm^3
20
Q
How many people are living with HIV in 2018
A
35 million!
21
Q
HIV promotes immunodeficiency by attacking
A
CD4 lymphocytes
22
Q
1st HIV
A
1981
23
Q
is HIV1 and HIV2 the same?
A
Differ genetically and in antigenicity, but cause similar disease syndrome
24
Q
Do the same drugs effect HIV1 and HIV2?
A
No, not all drugs effective against HIV1 are effective against HIV2
25
Disease mechanism of HIV/AIDS
Primary event: entrance of HIV into the body's CD4 cells (aka t-helper cells, t4 cells)
26
Once inside the T4 cell, the HIV...
Replicates and signals other cells that produce antibodies, which are essential for immune system function
27
Eventually, the HIV destroys T4 cells, it
Damages their ability to signal for antibody production, thus, deactivates the immune system
28
HIV life cycle
- Fusion
- Reverse transcriptase
- Integrase
- Protease
- New HIV viruses
29
three links in the chain of infection must be present for the transmission of HIV
- An HIV source.
- A sufficient dose (viral load) of the virus
- Access to the loodstream of another person
30
Transmission routes for HIV
- Sex
- Injection
- Vertical transmission (mother to baby in utero)
- Breastfeeding
31
Symptoms of HIV and Aids vary, depending on
The phase of infection
32
Primary infection (acute HIV) S/S
Muscle aches, fever, headache, join pain, rash, sore throat, swollen lymph glands
33
Clinical latent infection (chronic HIV) S/S
No specific symptoms; some have persistent swelling of LNs, it can last around 10 years if not receiving antiretroviral therapy
34
Early symptomatic HIV infection S/S
Fatigue, Fever, Swollen lymph glands, diarrhea, weight loss, oral yeast infection (thrust), shingles (herpes zoster)
35
By the time AIDS develops, the immune system is severely damaged, making the person susceptible to
Opportunistic infections; diseases that wouldn't trouble a person with a healthy immune system
36
Signs and symptoms of the progression fo aids
soaking night sweats; recurring fever; chronic diarrhea; persistent white spots or unusual lesions on tongue/ mouth; persistent, unexplained fatigue, weight loss, skin rashes or lumps.
37
What is the primary cause of AIDS related deaths
Opportunistic infection
38
Triphase clinical course
- Initial infection (acute retroviral syndrome)
- Latency (may last up to 10 years)
- Late phase (CD4 T-cells drop to critical low)
39
A patient is diagnosed with AIDS IF
CD4 T-cell counts it <200
| HIV+ patient has AIDS-defining illness
40
Treatment of HIV
3 or 4 drugs combined in a regiment known as HIGHLY ACTIVE ANTIRETROVIRAL THERAPY
41
Goals of HIV treatment
- suppression of viral load
- restoration/preservation of immune function
- improve quality of life
- reduce HIV – related morbidity & mortality
- does NOT cure HIV infection
42
HAART must be a
Lifelong treament!
43
HIV prevention
Pre-exposure prophylaxis
| Post-exposure prophylaxis
44
Pre-exposure prophylaxis
CDC provides information for the use of daily oral antiretroviral preexposure prophylaxis to reduce the risk of acquiring HIV infection in adults.
45
Post-exposure prophylaxis must be started within
72 hours after recent possible exposer
46
If prescriber PEP, take
Once or twice daily for 28 days
47
Is PEP 100%?
No, it is effective in preventing HIV, but it is not 100%
48
Exposures for which PEP is indicated
-- Break in the skin by a sharp object that is contaminated with blood, visibly bloody fluid, or other potentially infectious material, or that has been in the source patient’s blood vessel
--Bite from a patient with visible bleeding in the mouth that causes bleeding in the exposed worker
--Splash of blood, visibly bloody fluid, or other potentially infectious material to a mucosal surface (mouth, nose, or eyes)
--A non-intact skin (e.g., dermatitis, chapped skin, abrasion, or open wound) exposure to blood, visibly bloody fluid, or other potentially infectious material
49
Types of Antiretroviral treatment
Viral Entry Blockers
Enzyme Inhibitors
Viral Entry Blockers
Enzyme inhibitors
50
types of viral entry blockers
Entry and fusion inhibitors
| CCR5 antagonists
51
types of enzyme inhibitors
- -Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
- -Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
- -Integrase Inhibitors
- -Protease Inhibitors
52
Monotherapy with any antiretroviral can lead to resistance, which is why
they are often given in combination with other antiviral agents
53
Types of viral entry blockers
- Entry and Fusion Inhibitors
| - CCR5 Antagonists
54
Types of enzyme inhibitors
- -Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
- -Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
- -Integrase Inhibitors
- -Protease Inhibitors
55
Entry and fusion inhibitors indications
Tx of advances HIV or resistance to other drugs
56
Entry and Fusion Inhibitors MOA
Prevents fusion of HIV lipid membrane with CD4 TCELL
57
Entry and Fusion Inhibitors
| administration
SQ BID (very expensive, 20k/yr)
58
Entry and Fusion Inhibitors
| effects
injection site irritation, pneumonia (cough, SOA, fever), allergic rxn (chills, fever, hypotension, nausea, ↑ liver enzymes
59
Enfuvirtide drug class
Entry and fusion inhibitor; viral entry blockers
60
Maraviroc drug classification
CCR5 antagonist; viral entry blockers
61
CCR5 Antagonist indication
treatment of HIV1 that binds with CCR5
62
CCR5 Antagonist Moa
Blocks fusion by binding to CCR5 co-receptor
63
CCR5 Antagonist administration
Oral, 150-600mg BID
64
CCR5 Antagonist S/S
- CNS (dizziness, sleep disorders, paresthesias)
- MS pain
- cough and URTIs
- liver damage/ hepatoxicity
65
Nucleoside reverse transcriptase end in
-Vudine
66
Nucleoside Reverse Transcriptase Inhibitors (NRTIs) Indication
treats s/s of HIV in combination with other drugs; prevents maternal HIV transfer to fetus
67
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
| MOA
using the viral reverse transcriptase, this medication incorporates itself into the DNA chain and blocks the addition of further nucleotides, thereby terminating viral replication
68
Nucleoside Reverse Transcriptase Inhibitors (NRTIs) administration
All are administered orally, Zidovundine is available as an IV injection
69
Nucleoside Reverse Transcriptase Inhibitors (NRTIs) S/S
- Bone marrow suppression
- GI (Nausea, vomit, pain)
- CNS (dizziness, insomnia, HA)
- Fever
- Myalgia
70
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) examples
efavirenz (Sustiva)
| delavirdine (Rescriptor)
71
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) indication
treat s/s of HIV in combination with other drugs
72
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) MOA
binds to reverse transcriptase to stop HIV-1 replication by blocking the activity of RNA-dependent and DNA dependent polymerase.
73
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) administration
Oral
74
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) SE
Rash
GI (nausea, vomit, diarrhea)
Increase liver enzyme
75
Raltegravir drug class
Inegase inhibitors
76
Integase inhibitors indications
Treats HIV-1 that I resistant to other drugs
77
Integase Inhibitors Administration
Oral
78
Integase Inhibitors MOA
Stops HIV replication by preventing newly made HIV DNA from becoming integrating into Human DNA
79
Integase Inhibitors SE
GI (N/v/d)
| CNA (dizziness, HA)
80
Protease inhibitor example
Sauinavir
| Ritonavir
81
Protease Inhibitors indiciation
Treats HIV1 AND 2 in combination with other drugs
82
Protease Inhibitors administration
Oral with food
83
Protease Inhibitors MOA
Prevents break up of large poly proteins, keeping new HIV virus immature (must be combine with NRTIs, then extremely effective)
84
Protease Inhibitors SE
hyperglycemia
↑ risk of diabetes
fat redistribution
↑ cholesterol, ↑TGs (leading to atherosclerosis and CV disease)
↓ bone density (leading to osteoporosis)
liver toxicity
GI (n/v/d or constipation, heartburn, abd pain)
85
Drugs that are approved by the FDA as the first successful, single two drug therapy option
Dolutegravir and Rilpivirine (Juluca)
86
Drug that is a new single two drug, fixed dose treatment who are HIV +
dolutegravir and lamivudine (Dovato
87
dolutegravir and rilpivirine (Juluca) indication
- -For people who had already been receiving treatment
- -Essentially a maintenance regimen for those who have achieved an undetectable viral load. (HIV-1 RNA < 50 copies/ ml and on a stable antiretroviral regimen for > 6 months with no history of treatment failure.)
88
dolutegravir and lamivudine (Dovato) Administration
Tablet once a day
89
dolutegravir and lamivudine (Dovato) SE
: HA, diarrhea, nausea, insomnia and fatigue
| Risk of neural tube defects in babies born to women taking dolutegravir
