HIV

Question 1

Briefly describe the pathophysiology of HIV

Answer 1

HIV binds via gp120 to CD4 (expressed on Th Cells, monocytes, macrophages)

CD4+ cells migrate to lymphoid tissue where virus
replicates → infection of new CD4+ cells

Depletion and impaired function of CD4+ cells →
immune dysfunction.

Question 2

What are the stages of HIV progression?

Answer 2

Incubation

Asymptomatic/seroconversion

Latent period/asymptomatic,

symptomatic HIV infection

AIDS

Question 3

What is the CD4 count of HIV patient?

Answer 3

<200

Question 4

Three effects/complications of HIV?

Answer 4

osteoporosis
dementia
neuropathy
nephropathy

Question 5

Two diagnostic tests for HIV?

Answer 5

ELISA
Western blot
PCR
rapid antibody tests

Question 6

List three opportunistic infections/complications of HIV= major AIDS-defining illnesses

Answer 6

1. TB
2. Candidiasis
3. Cryptococcal meningitis
4. Kaposi’s sarcoma
5. Pneumocystis pneumonia
6. Toxoplasmosis

Question 7

Two classes of HIV antiretrovirals?

Answer 7

1. fusion inhibitors 2. CCR5 inhibitors 3. NRTI, NNRTI 4. Integrase inhibitors 5. Protease inhibitors

Question 8

Three populations who are at highest risk of contracting HIV?

Answer 8

sub saharan Africans, gay men, children of people who have HIV, people who inject drugs, sex workers

Question 9

After how many weeks is HIV detectable?

Answer 9

4 weeks

Question 10

What is the presentation of primary HIV infection/seroconversion?

Answer 10

fever, weight loss, myalgia, nausea, vomiting, lymphadenopathy, headache, sores, rash (flu presentation)

Question 11

What is the differential diagnosis for primary HIV?

Answer 11

infectious mono, secondary syphilis, drug rash, other viral infections e.g. influenza

Question 12

Which dermatological condition is strongly associated with HIV infection?

Answer 12

Kaposi’s sarcoma

Question 13

Two side effects of antiretroviral therapy?

Answer 13

rash, hypersensitivity, CNS side effects- sleep disturbance, mood changes, GI side effects, renal, hepatic

Question 14

Name one class of drug that antiretroviral drugs (HIV) interfere with?

Answer 14

PPIs, statins, antipsychotics

Question 15

Three strategies to prevent HIV transmission?

Answer 15

1. Condoms 2. Treatment as prevention 3. Pre-exposure prophylaxis 4. Post-exposure prophylaxis 5. Prevention mother to child transmission 6. Harm reduction measures e.g. needle exchange

Question 16

Two goals of HIV treatment?

Answer 16

Increase CD4 count and reduce viral load

Question 17

Which virus causes kaposi’s sarcoma?

Answer 17

HHV-8