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House Microbiology > HIV > Flashcards

HIV Flashcards

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Biology 101 flashcards
1
Q

Prevalence rate of HIV in adults aged 15-49?

A

1.3[ 0.9-1.7]

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2
Q

Virology

Genus: _______

Genome:

_____-stranded RNA
(linear or circular?)
_______ -sense, 9–10 kb, ___ploid; genome

four genes required for a replicating retrovirus— _____,_____,____ and _____

A

Lentivirus

Single; linear
Positive ; di

gag, pro, pol, and env

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3
Q

Virology

Proteins: ________________ undergoes antigenic variation; reverse transcriptase enzyme contained inside virions; ______ required for production of infectious virus

Envelope:(present or absent?)

A

Envelope glycoprotein

protease

Present

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4
Q

Virology

Replication:_________ makes DNA copy from genomic RNA; _______ is template for viral RNA.

Genetic variability is (common or rare?) .

A

Reverse transcriptase

provirus DNA

Common

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5
Q

Virology

Maturation: Particles _______ from ______

A

bud

plasma membrane

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6
Q

Virology

Outstanding features:

Infect cells of the _____ system

______ remain permanently associated with cells

_______________ is restricted in some cells in vivo

It Cause (slowly or rapidly ?) progressive, (acute or chronic ?) diseases

Replication is usually _____-specific

A

immune

Proviruses

Viral expression

Slowly ; chronic

species

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7
Q

Lentivirus

Viruses are transmitted by _______

Virus persists _______ in infected hosts, although it may be present at very ____ levels.

A

exchange of body fluids.

indefinitely; low

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8
Q

Lentivirus

Viruses have (low or high?) mutation rates, and __________ will be selected under different conditions (host factors, immune responses, tissue types).

Infected hosts contain “ ______ ” of ______ related viral genomes, known as _______.

A

High

different mutants

swarms; closely

quasispecies

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9
Q

Lentivirus

Cells in the macrophage lineage play ______ roles

It may take ______ for disease to develop.

Infected hosts and usually make _____, but they do not ___________

A

central; years

antibodies

clear the infection, so virus persists lifelong.

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10
Q

Modes of HIV Transmission

Mention 4

A

Sexual Contact

Parenteral
Blood transfusion
Perinatal

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11
Q

Modes of HIV Transmission

Sexual Contact: _________ with infected partner(s)

Parenteral: Contact with HIV-infected _________

A

Unprotected sexual contact

blood products

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12
Q

Modes of HIV Transmission

•Blood transfusion; __________ through needle sharing; needle-stick accidents; unsterilized sharp objects

Perinatal:_________ transmission
In utero; during ______ and ____; through ________

A

Mother-to-child

labour and delivery

breastfeeding

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13
Q

Transmission through Sexual Contact

• ___________ and ———— transmission of HIV most common
• (Receptive or insertive?) sexual partner at higher risk than ( Receptive or insertive?) partner

A

Heterosexual and male-to-male

Receptive

insertive

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14
Q

HIV CAN be transmitted by casual contact, surface contact, or insect bites

T/F

A

F

HIV CANNOT be transmitted by casual contact, surface contact, or insect bites

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15
Q

Molecular Epidemiology of HIV

HIV virus has two types: _____ and ______

A

Type 1 (HIV-1) and Type 2 (HIV-2)

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16
Q

Molecular Epidemiology of HIV
•

HIV-1 has a _______ distribution

HIV-2 is ____________

A

global

limited to West Africa

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17
Q

Molecular Epidemiology of HIV

HIV-___ is still the predominant type in West Africa

HIV-____ has been further divided into groups and subtypes

A

1

1

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18
Q

Primary subtypes of HIV-1

in Nigeria are _____________

A

A, G, and A/G

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19
Q

Virus receptors

Primary receptor is the _____ molecule, which is expressed on ________ and _____

A ________ in addition to ____ is necessary for HIV-1 to gain entry to cells.

A

CD4

macrophages and T lymphocytes.

second coreceptor

CD4

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20
Q

Virus receptors

The virus first binds to _____ and then to the ______.

_______ receptors serve as HIV-1 second receptors.

A

CD4

coreceptor

Chemokine

21
Q

Chemokines are (soluble or insoluble ?) factors with ___________________ properties.

A

Soluble

chemoattractant and cytokine

22
Q

Virus receptors

_____ is the predominant coreceptor for macrophage-tropic strains ofHIV-1

_____ ,the coreceptor for lymphocyte-tropic strains of HIV-1.

A

CCR5

CXCR4

23
Q

Virus receptors

Individuals who possess _____zygous _____ in CCR5 and produce mutant forms of the protein may be protected from infection by HIV-1

Mutations in the CCR5 _______ appear to _____________ .

A

homo; deletions

gene promoter

delay disease progression

24
Q

Major Steps in HIV Lifecycle

•HIV attaches to ____ cell
•Releases ___ and enzymes
•Enzyme _______ makes a ____ copy of viral ____

And this is integrated into CD4 cell ____ using enzyme ____

New viral components produced, using cell’s “machinery” . These are assembled together using enzyme ______ and are released as new viruses

A

CD4; RNA

Reverse Transcriptase ; DNA

RNA; nucleus; integrase

protease

25
Q

Overview of HIV

The duration between primary infection and progression to clinical disease averages about ____ years.

In untreated cases, death usually occurs within ___ years after the onset of clinical symptoms.

A

10

2

26
Q

Overview of HIV

Stages include

the ______________,

dissemination of virus to ______

clinical _______

_______ HIV expression

clinical _________

_______

A

Primary infection

lymphoid organs

latency; elevated

disease

Death

27
Q

Overview of HIV

Following primary infection, there is a ________ period between _____ and ________

the viremia is detectable for about _______. Virus is widely disseminated throughout the body during this time, and the ________ become seeded.

____________ syndrome develops in many patients (50–75%) ____ weeks after primary infection.

There is a significant (drop or rise?) in numbers of circulating _____ cells at this early time.

An immune response to HIV occurs ____-_____ after infection, plasma viremia (drops or rises?) , and levels of CD4 cells rebound.
However, the immune response is _____________________________________________________

A

4- to 11-day

mucosal infection and initial viremia

8–12 weeks.; lymphoid organs

An acute mononucleosis- like

3–6 ; drop; CD4 T

1 week to 3 months ; drops

unable to clear the infection completely, and HIV-infected cells persist in the lymph nodes.

28
Q

Natural History of HIV Infection in Adults
HIV-1 infection has the following phases:

Viral _______
_________ infection
____________
Clinical __________
(Early or late?) symptomatic HIV infection
_____ and severe HIV infection

A

transmission

Primary HIV; Sero-conversion

latent period; early

AIDS

29
Q

AIDS and severe HIV infection

Characterized by Clinical Stage ____ or a CD4 cell count below ____/mm3

A

4

200

30
Q

Primary Infection

During this phase, a person may experience (specific or non-specific?) ‘___-like’ symptoms.

These symptoms do not lead directly to the diagnosis of HIV infection and may not be present in all patients, but commonly include:
Fever
Fatigue
__________
_________
___________

A

flu

Non-specific

Pharyngitis
Lymphadenopathy
Rash

31
Q

Primary Infection (2)

• Pathogenesis of Primary Infection:

Initial infection of _________ and _______ with receptors at site of exposure

Dissemination of infection to _______

Burst of viral replication results in __________

Development of ______ immunity (HIV-specific ______)

Response by ______ immunity (HIV-specific ___________ cells)

A

CD4 T-lymphocytes and macrophages

lymph nodes; intense viraemia

humoral; antibodies

cellular

CD4 and CD8

32
Q

Symptomatic Phase (1)

Presentation depends on CD4 count

At CD4 cell counts over _____ cells/μl, PLHIV may develop complications found in the general population:

_________
Bacterial _______
___________
Minor __________

A

500

Malaria

pneumonia

Tuberculosis

skin conditions

33
Q

Symptomatic Phase (1)

Presentation depends on CD4 count

At CD4 counts between _____ and ______ cells/μl, other conditions, or opportunistic infections, begin to appear:

• Pulmonary ________________
• ____________ candidiasis
•____________

A

200 and 500

Tuberculosis (current)

Oral or vaginal

34
Q

Symptomatic Phase (1)

Presentation depends on CD4 count

The late symptomatic phase is characterized by patients having a CD4 cell count less than ______ cells/μl and conditions such as:

______ syndrome
________ candidiasis
____________-pulmonary TB
___________ pneumonia
Recurrent, invasive herpes simplex virus infections

A

200

Wasting

Esophageal

Atypical and extra

Pneumocystis

35
Q

Severe HIV Infection and AIDS

This phase is characterized by patients having a CD4 cell count less than __ cells/μl and conditions such as:

________ meningitis
_________________
_____________ of the brain
HIV _________ (PML/dementia) CMV retinitis

A

50

Cryptococcal

Cryptosporidiosis

Toxoplasmosis

encephalopathy

36
Q

CD4 Count is an indicator of _________ status (distance to the cliff)

Viral Load is an indicator of the ___________ (speed of the train)

A

immune system

amount of virus in the blood

37
Q

HIV associated Cancers

List 2

A

Kaposi carcinoma
Cervical cancer

38
Q

Key Points (1)

The HIV lifecycle involves the following steps:

Virus _______ and ______

Transcription of ________ into _______

_________ into human genome

New viral components ______ using ______ enzyme.

________ and _________ of virus particles

A

entry into cell and fusion

viral RNA into DNA

Integration; assembled; protease

Assembly and budding off

39
Q

Viral replication persists throughout infection

T/F

A

T

40
Q

HIV manifests the same way in adults and children

T/F

A

F

HIV manifests differently in adults and children

41
Q

HIV disease progression is determined by ________ and _______

A

CD4 count and viral load

42
Q

ARV = _________
ART =________
HAART = _______________

A

Antiretroviral

Antiretroviral Therapy

Highly Active Antiretroviral Therapy

43
Q

Antiretroviral Drugs

Antiretroviral drugs act on different points in the life cycle of the virus to prevent _________

A

viral replication

44
Q

Goals of ART

Virological: ____________ to ___________ (<_______ HIV RNA copies/mL for as long as possible).

Immunologic: Quantitative and qualitative _______ with improved immune function

Clinical: Prolongation and improved quality of life by reducing ___________ and ____________

A

Reduction in viral load to undetectable levels; 400

immune reconstitution

HIV- associated morbidity and mortality

45
Q

Goals of ART

Therapeutic: Appropriate choice of _________ to achieve the goals of therapy while preserving __________, minimising ______________ and promoting excellent ___________

Epidemiologic: ______________________

A

ARV regimen

future therapeutic options

ARV toxicities; adherence

Reduce transmission of HIV

46
Q

Classes of Antiretroviral Drugs

_________________________________ (NRTI)

_____________________________(NNRTI).

____________________ (PIs)

________________

_______ inhibitors (or ______ inhibitors)

_________ inhibitors

A

Nucleoside and nucleotide reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
Protease inhibitors
Integrase inhibitors
Entry ; fusion
Maturation

47
Q

Antiretroviral drugs are broadly classified by the ___________________________________

A

phase of retrovirus lifecycle that the drug inhibits

48
Q

Laboratory Testing for HIV Diagnosis
Antibody Assays:
_________
_________

Confirmatory Assays
—————
_____________

Nucleic Acid-based Test (Virologic tests)
Assays to detect HIV DNA or RNA (PCR)

Other tests:
1. Antigen detection test (_____ antigen)
2. Viral _______

A

Rapid tests
ELISA

p24; isolation

49
Q

Antibody Tests

suitable for use in infants under 18 months

T/F

A

F

Not suitable for use in infants under 18 months (use PCR instead)

House Microbiology (93 decks)

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