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Week 7 - microbiology > HIV > Flashcards

HIV Flashcards

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Biology 101 flashcards
1
Q

Which populations are at the highest risk of HIV?

A
  • Sub saharan Africa, especially southern africa
  • men who have male sexual partners
  • Children of people living with HIV
  • People who inject drugs
  • People who have transactional sex
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2
Q

Explain HIV testing

A
  • 4th generation testing, tests the p24 antigen/HIV antibody
  • There is a window period of 45 days so if you are testing someone, test them right away but also 45 days after exposure
  • Confirmatory test (different assay)
  • Can do POC testing
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3
Q

What are the symptoms of seroconversion?

A 
•Systemic:
 - fever 
 - rash 
•Pharyngitis 
•Mouth sores and thrush 
•Oesophageal sores 
• Myalgia 
•Enlargement of the spleen and liver 
•Lymphadenopathy 
•Skin rash 
•nausea and vomiting 
•Central: 
- malaise 
- headache 
- neuropathy
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4
Q

What are the differentials in someone with symptoms of seroconversion?

A
  • Infectious mononucleosis
  • Secondary syphilis
  • Drug rash
  • Other viral infections e.g. CMV, influenza
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5
Q

In which respiratory conditions are AIDS-defining?

A
  • Tuberculosis

* Pneumocystis

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6
Q

Which neurological conditions are AIDS-defining?

A
  • Cerebral toxoplasmosis
  • Primary cerebral lymphoma
  • Crytpococcal meningitis
  • Progressive multifocal leucoencephalopathy
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7
Q

What are the dermatological AIDS-defining conditions?

A

Karposi’s sarcoma

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8
Q

What are the gastroenterological AIDS- defining conditions?

A

Persistent cryptosporidosis

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9
Q

What viral load is undetectable?

A

Below 200 copies per ml

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10
Q

How is the CD4 count calculated?

A

From total lymphocyte count

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11
Q

Describe the natural history of HIV infection

A
  • HIV RNA copies rapidly increase in first weeks (acute HIV)
  • Falls down sharply
  • Enters clinical latency for many years
  • Steadily increases then sharply increases
  • CD 4 count is slowly decreasing throughout after an initial sharp dip
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12
Q

What is the aim of HIV treatment?

A

Viral load suppression and CD4 recovery

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13
Q

What is the treatment of HIV

A
  • HAART - highly active antiretroviral treatment

* normally triple therapy with 2 nucleoside reverse transcriptase inhibitors and 1 drug from another class

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14
Q

What are the classes of antiretrovirals?

A
  • Nucleoside reverse transcriptase inhibitors
  • non-nucleoside reverse transcriptase inhibitors
  • Integrase inhibitors
  • Protease inhibitors
  • Other egg, CCR5 entry inhibitor
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15
Q

What are the challenges with ART?

A
  • Good adherence is essential
  • Psychological impact
  • Short term side effects
  • Longer term toxicities
  • Drug-drug interactions
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16
Q

What is the short term toxicities of antiretrovirals?

A
  • Rash
  • Hypersensitivity
  • CNS side effects
  • GI side effects
  • Renal
  • Hepatic
17
Q

What are the longer term toxicities of antiretrovirals?

A
  • Body shape changes: lipoatrophy/lipodystrophy/weight gain
  • Renal (tenofovir disoproxil)
  • Hepatic
  • Lipid
  • Bone
18
Q

What enzyme are antiretrovirals often mediated by?

A

CYP450

19
Q

Name 3 drug classes that have interactions with antiretrovirals

A
  • Proton pump inhibitors
  • Statins
  • Antipsychotics
20
Q

Describe partner notification when there is a new HIV case

A
  • All previous partners
  • Shared needles
  • Children where relevant until the last negative test
  • Should be carried out by the HIV team
21
Q

What is the HIV prevention?

A
  • Condoms
  • Treatment as prevention (TasP)- undetectable viral load
  • Pre-exposure prophylaxis (PrEP)
  • Prevention of mother to child transmission (PMTCT)
  • Harm reduction measures e.g. needle exchange
22
Q

What is PEP?

A
  • Post Exposure Prophylaxis
  • Take within 72 hours
  • Available from sexual health/A&E
  • Based on exposure type and risk of contact
  • normally 2 NTIs and Integrase inhibitors
23
Q

What is PrEP?

A
  • Available from sexual health
  • For people at higher risk of HIV through sexual transmission
  • Cheap
  • In the long term are complications for renal/bone
24
Q

How is mother to child transmission prevented?

A
  • universal antenatal HIV screening is offered
  • Antiretrovirals for mother during pregnancy
  • If not undetectable then minimise the risk at delivery e.g. caesarian
  • PEP for the baby
  • Avoid breast feeding

Week 7 - microbiology (12 decks)

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