HIV

Question 1

What type of virus is HIV?

Answer 1

RNA retrovirus

Question 2

What is the action of the HIV virus?

Answer 2

Enters and destroys C24+ T helper cells

Question 3

What occurs over the course of HIV infection?

Answer 3

CD4 count declines
HIV viral load increases

Question 4

How is HIV transmitted?

Answer 4

Sexual activity
Vertical transmission- mother to child in pregnancy, birth or breastfeeding
Exposure to infected bodily fluids e.g. needle stick injuries, blood splashed in an eye, sharing needles

Question 5

What is the natural history of HIV?

Answer 5

Initial seroconversion flu like illness in first few weeks
Asymptomatic
Progression to AIDS- defining illnesses and opportunistic infections years later

Question 6

What allows for the progression to AIDS?

Answer 6

CD4 count drops to a level that allows for unusual opportunistic infections and malignancies

Question 7

What are some examples of AIDS- defining illnesses?

Answer 7

Pneumocytis jjrovecii pneumonia (PCP)
Cytomegalovirus infection
Candidiasis
Lymphomas
Tuberculosis

Question 8

What is the testing for HIV?

Answer 8

Antibody blood test
p24 antigen test
PCR test for HIV RNA

Question 9

What is the monitoring for HIV?

Answer 9

CD4 count- lower the count the higher the risk of opportunistic infection
viral load (VL)- number of copies of HIV RNA per ml of blood

Question 10

What is CD4 count in AIDS?

Answer 10

Normal CD4: 500-1200
AIDS CD4<200

Question 11

What is the treatment of HIV?

Answer 11

Antiretroviral therapy (ART)
Offered to everyone with HIV diagnosis irrespective of CD4 count or viral load

Question 12

What is the aim of treatment?

Answer 12

Achieve a normal CD4 count and undetectable viral load

Question 13

What are the classes of antiretrovirals?

Answer 13

Protease inhibitors (PIs)
Integrase inhibitors (IIs)
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
Non- nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Entry Inhibitors