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HIV Flashcards

1
Q

what type of virus is HIV?

A

an RNA retrovirus

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2
Q

what enzyme do retroviruses use to replicate?

A

reverse transcriptase

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3
Q

what are the two broad groups of HIV?

A

HIV 1

HIV 2

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4
Q

what group of HIV is responsible for the global epidemic?

A

HIV 1 group M

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5
Q

how long does it take for a new generation of HIV to be produced?

A

6-12 hours

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6
Q

what is infected in HIV?

A

CD4 cells

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7
Q

how long does it take for HIV infection to be established?

A

three days

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8
Q

what is the target site for HIV?

A

CD4+ receptors

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9
Q

what cell types are CD4+ receptors found on?

A

t helper cells
dendritic cells
macrophages
microglial cells

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10
Q

what are HIV patients susceptible to?

A

viral, fungal and mycobacterial infections

infection induced cancers

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11
Q

what is a normal CD4 cell count?

A

500 - 1600

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12
Q

at what CD4 count is there the highest risk of opportunistic infection?

A

<200

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13
Q

what is the average time to death without treatment in HIV?

A

9-11 years

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14
Q

when does the onset of primary HIV infection occur?

A

2-4 weeks post infection

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15
Q

how does primary HIV infection present?

A 
fever
rash 
myalgia 
pharyngitis 
headache
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16
Q

what is risk of transmission like in primary HIV infection?

A

very high

massive viral load

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17
Q

what is an opportunistic infection?

A

an infection caused by a pathogen that does not normally produce disease in a healthy individual

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18
Q

what organism causes pneumocystis pneumonia?

A

pneumocystis jiroveci

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19
Q

what is the CD4 threshold for pneumocystis pneumonia?

A

<200

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20
Q

how does pneumocystis pneumonia present?

A

insidious onset
SOB
dry cough

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21
Q

what sign can be seen in pneumocystis pneumonia?

A

exercise oxygen desaturation

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22
Q

what can be seen on CXR in pneumocystis pneumonia?

A

interstitial infiltrates

reticulonodular markings

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23
Q

how is pneumocystis pneumonia diagnosed?

A

bronchoalveolar lavage (BAL)
immunofluorescence
PCR

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24
Q

how is pneumocystis pneumonia managed?

A

high dose co-trimoxazole +/- steroid

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25
what is the prophylaxis given for pneumocystis pneumonia?
low dose co-trimoxazole
26
who is given prophylaxis for pneumocystis pneumonia?
everyone with CD4 count <200
27
what organism causes cerebral toxoplasmosis?
toxoplasma gondii
28
what is the CD4 threshold for cerebral toxoplasmosis?
<150
29
what does cerebral toxoplasmosis cause ?
formation of multiple cerebral abscesses
30
how does cerebral toxoplasmosis present?
``` headache fever focal neurological symptoms seizures reduced consciousness raised ICP ```
31
what is the CD4 threshold for cytomegalovirus?
<50
32
what does cytomegalovirus cause?
retinitis colitis oesophagitis
33
how does cytomegalovirus present?
``` reduced VA floaters abdominal pain diarrhoea PR bleeding ```
34
what type of screening should all individuals with CD4 <50 receive and why?
ophthalmic screening complications of cytomegalovirus
35
what organism causes HIV associated neurocognitive impairment?
HIV 1
36
what causes increased incidence of HIV associated neurocognitive impairment?
reduced CD4 count
37
how does HIV associated neurocognitive impairment present?
reduced short term memory +/- motor dysfunction
38
what organism causes progressive multifocal leukoencephalopathy (PML)?
JC virus
39
what is the CD4 threshold for PML?
<100
40
how does PML present?
rapidly progressive focal neurological symptoms confusion personality changes
41
what skin infections can be seen in HIV patients?
herpes zoster herpes simplex HPV
42
name three AIDS related cancers
kaposi's sarcoma non Hodgkin's lymphoma cervical cancer
43
what organism is associated with kaposi's sarcoma in HIV?
human herpes virus 8
44
what is kaposi's sarcoma?
a vascular tumour
45
how is kaposi's sarcoma managed?
anti retrovirals local therapies systemic chemo
46
what organism is associated with non-hodgkin's lymphoma in HIV patients?
EBV
47
what test should be offered to all patients with complicated HPV disease?
HIV testing
48
what are the three possible methods for transmission of HIV?
sexual parenteral mother to child
49
what is the most common mode for transmission of HIV?
sexual transmission
50
what factors can increase risk for sexual transmission of HIV?
anoreceptive sex trauma genital ulceration concurrent STIs
51
what are three possible methods of parenteral transmission of HIV?
injecting drugs infected blood products iatrogenic
52
when can mother to child transmission of HIV occur?
in utero delivery breast feeding
53
what three markers can be used to detect HIV infection?
viral RNA p24 antigen HIV antibody
54
what is the first marker to become positive in HIV?
viral RNA
55
when is the p24 antigen positive in HIV?
around 6 weeks
56
when is the HIV antibody detectable in HIV?
can take three months
57
what do third generation HIV tests test for?
antibody
58
what do fourth generation HIV tests test for?
antibody and antigen
59
what is needed to perform a rapid HIV test?
finger prick blood specimen or saliva
60
how long does a rapid HIV test take?
20-30 mins
61
how long is the window period in which you can have HIV but have negative test?
45 days this is for 4th generation tests
62
when should HIV treatment be started?
ASAP at all CD4 counts
63
what are the four groups of available anti-retroviral drugs?
reverse transcriptase inhibitors integrase inhibitors protease inhibitors entry inhibitors
64
what are the two types of reverse transcriptase inhibitors?
nucleoside analogues | non nucleoside analogues
65
what does HAART stand for?
highly active anti-retroviral therapy
66
what is HAART?
a combination of three drugs from at least two drug classes to which the virus is susceptible
67
what are the four possible groups of anti-retroviral drugs?
reverse transcriptase inhibitors integrase inhibitors protease inhibitors entry inhibitors
68
what are the two types of reverse transcriptase inhibitors?
nucleoside analogues | non nucleoside analogues
69
what does HAART stand for?
highly active anti-retroviral therapy
70
what is HAART?
a combination of 3 drugs from at least 2 classes to which HIV is susceptible
71
what does PrEP stand for?
pre exposure prophylaxis
72
who is given PrEP?
high risk individuals
73
what are the possible dosing schedules for PrEP?
daily or on demand
74
what drugs are given as PrEP?
tenofovir or emtricitabine
75
what is PEP?
post exposure prophylaxis
76
when should PEP be started?
within 72 hours of a high risk exposure
77
how long is PEP given for?
four weeks
78
what is given as PEP?
tenofovir/emtricitabine raltegravir
79
what should be given to pregnant women with HIV?
HAART during pregnancy
80
how can a mother with HIV deliver if she has an undetectable viral load?
vaginally
81
how can a mother with HIV deliver if she has a detectable viral load?
c section
82
how long should neonates born to HIV positive mothers receive PEP?
two to four weeks
83
how can HIV positive mothers feed their babies?
exclusively formula feeding

Y3 Reproduction (49 decks)

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