HIV Flashcards
In 2019 how many people were living with HIV?
38million
- 8 children
- 7 new infections
68000 AIDS related deaths
In 2019 what were the stats on the 95-95-95 HIV figures?
81% know status
67% on ART
59% suppressed VL
What are the UNAIDS 10-10-10 goals?
Less than 10% countries have punitive legal systems
<10% PLHIV and key pops should experience stigma
<10% women should report inequality
What are the 2 HIV viruses?.
HIV 1- main one, divided into M,N,O and P. M is main one
HIV2- West Africa, usually co-infected. Intrinsically resistant to NNRTIs
Describe the features of seroconversion syndrome.
Occurs in 50%
2-5wks post infection
Non specific, flu like, macpap rash over arms and trunk
Potential for significant Immunosuppression and therefore present with OI but negative HIV test
Without ART how long does it take to get AIDS?
9yrs
What are signs of HIV if CD4>500?
Candida vaginitis Generalised LN GBS Aseptic meningitis TB
What are the signs of HIV if CD4 200-500?
Bacterial pneumonia Pulmonary TB Shingles Oral thrush Oral hairy leukoplakia Cryptosporidiosis Kaposi Lymphomas Cervical Ca
What are the signs of HIV if CD4 <200?
PCP Disseminated histoplasmosis or coccidioidomycosis Extrapulm TB PML Wasting syndrome Dementia Non Hodgkin Lymphoma
What are the signs of HIV when CD4 <100?
Disseminated herpes Toxoplasmosis Cryptococcus Chronic cryptosporidiosis Oesophageal thrush
What are the signs if HIV if CD4<50?
Disseminated CMV
Disseminated MAC
PCNSL
What is HIV wasting syndrome?
Weight loss >10% plus
- unexplained diarrhoea over 1month or
- chronic weakness + unexplained fever over 1 month
What are the WHO’s 5 Cs of HIV testing?
Consent Confidentiality Counselling Correct test results Connection to care
What tests are available to diagnose HIV?
HIV viral DNA/RNA PCR- mainly for early infant
ELISA/RDTs of p24antigen and antibodies
When should you retest following a negative HIV result?
If inconclusive -retest after 14d
Pregnant and breastfeeding- if in high incidence setting then at labour and every 3months
Key populations
This using PrEP
When should you test fit HIV VL?
3-6months after ART start and then annually
When should you test for CD4 count in HIV?
At ART start p, if interruption to ART and if new WHO stage 3 or 4 or OIs
What investigations should be done when starting ART?
CD4 count CrCl HBsAg HCV antibodies Hb Clinical screening for TB, OIs and NCDs
When do you delay ART start?
TB- start ART within 2weeks
TBM- delay by 4-8wks
Cryptococcal meningitis- delay 4-6wks
When do you give cotrimoxazole prevention in PLIHIV?
Lifelong for all in high prevalence of malaria and severe bacterial infections
WHO stage 3/4 or CD4 <351
When do you give TB preventative treatment in PLHIV?
All with no clinical evidence of active TB
Isoniazid with pyridoxine for 6 months or
Rifapentine plus isoniazid for 3 months
When do you give cryptococcal prevention therapy in PLHIV?
Treat if serum CrAg positive
If no CrAg and CD4 <100 then fluconazole prophylaxis
Name the NRTIs and their SEs
Tenofovir- renal failure, active against HepB Abacavir- hypersensitivity Zidovudine- BM suppression Emtricitabine- active against HepB Lamivudine- active against HepB
Name the NNRTIs and their SEs
Nevirapine- rash and Hepatitis
Efavirenz- rash and Hepatitis, psychiatric Sx
