HIV Flashcards

1
Q

HIV refers to

A

Human Immunodeficiency Virus

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2
Q

HIV is an

A

RNA retrovirus that causes acquired immunodeficiency syndrome (AIDS)

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3
Q

HIV primarily targets the

A

CD4+ T cells, a type of cell known as T helper cells and uses them to replicate itself

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4
Q

What cells does the virus use as a host to replicate

A

T helper cells

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5
Q

Most common HIV

A

HIV 1

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6
Q

what does the virus do to the CD4 T-helper cells

A

enters and destroys them

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7
Q

how does the HIV first present

A

an initial seroconversion flu-like illness occurs within a few weeks of infection

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8
Q

after the seroconversion flu what happens

A

The infection is then asymptomatic until the condition progresses to immunodeficiency.

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9
Q

immunodeficiency causes

A

AIDS- defining illnesses and opportunistic infections. This progression occurs potentially years after the initial infection.

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10
Q

Transmission

A

Unprotected anal, vaginal or ora; sexual activities

Vertical transmission - Mother to child at any stage of pregnancy, birth or breast feeding

Mucous membrane, blood or open wound exposure to infected blood or bodily fluids

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11
Q

Name 4 Aids defining illnesses

A

Kaposi’s sarcoma

PCP

Lymphomas

Tuberculosis

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12
Q

Why do AIDs defining illnesses occur

A

The CD4 count has dropped to a level that allows unusual opportunistic infections and malignancies to appear

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13
Q

Is HIV treatable

A

Yes, most patients are fit and healthy after treatment

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14
Q

How long does it take to develop antibodies for the virus

A

up to three months

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15
Q

Testing 3 ways

A

Antibody testing is the typical screening test for HIV = simple blood test.

p24 antigen test = checks directly for the specific HIV antigen in the blood. This can give a positive result earlier in the infection.

PCR testing for the HIV RNA levels = tests directly for the number of viral copies in the blood, giving the viral load

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16
Q

What needs monitoring

A

CD4 count and Viral load

17
Q

What is the CD4 count

A

the number of CD4 cells in the blood. These are the cells destroyed by the virus. The lower the count, the higher the risk of opportunistic infection.

18
Q

CD4 count for:
Normal range and end stage HIV

A

500-1200 cells/mm3 is the normal range

< 200 cells/mm3 is considered end-stage HIV (aids) (high risk infection)

19
Q

What is the viral load

A

the number of copies of HIV RNA per ml of blood

20
Q

Undetectable refers to a viral load below the labs recordable range, what is this range?

A

usually 50 - 100 copies/ml

21
Q

What does treatment involve

A

a combination of antiretroviral therapy (ART) medications.

22
Q

What do the BHIVA guidelines (2015) suggest

A

starting regime f two NRTIs (tenofovir and emtricitbine) plus a third agent

23
Q

What can specialist blood tests establish

A

the resistance of each HIV strain to different medications and help tailor treatment.

24
Q

What do some treatment regimes involve

A

a single combination tablet taken once daily, with the potential to suppress the virus completely

25
Q

What are the treatment aims:

A

achieve a normal CD4 count

Undetectable viral load

26
Q

What other medication can be used

A

Highly Active Anti-Retrovirus Therapy (HAART)

27
Q

Management: what medication is given to patients with a CD4 under 200/mm3 and why

A

Prophylactic co-trimoxazole (Septrin) to protect against pneumocystis jirovecii pneumonia PCP

28
Q

Management: increased risk of which chronic diseases

A

cardiovascular disease

human papillomaviruss (HPV)

Cervical cancer

29
Q

What vaccines should patients avoid

A

Live vaccines

30
Q

What vaccines should they have

A

influenza, pneumococcal, hep A and B, tetanus, diphtheria and polio vaccines

31
Q

Preventing vertical transmission: viral load determine mode of delivery, what are the they

A

vaginal birth < 50 copies / ml

Caesarean section > 50 copies / ml and in all woman with > 400 copies / ml

IV zidovudine should be given during caesarean if the viral load is unknown or there are > 10000 copies / ml

32
Q

What can be used straight away after exposure to HIV

A

Post-exposure prophylaxis (PEP) within 72hrs