HIV Flashcards
HIV BASICS
i) what type of virus is it? what is the most common type? which type is rare outside west africa?
ii) which cells does the virus enter? what is seroconversion? how long does this last?
iii) name three principal ways HIV can be spread?
iv) what is an AIDS defining illness? name four examples
i) RNA retrovirus - HIV1 is most common and HIV2 is rare outside west africa
ii) enters CD4 cells
seroconversion is a flu like illness that occurs within a few weeks of HIV infection - then infection is asymptomatic again
iii) spread through unprotected anal/vaginal/oral sex, vertical traansmission (birth, breastfeed, pregnant), mucus mem/blood/open wound eg needle sharing
iv) AIDS defining is assoc with end stage HIV - CD4 has dropped low enough to allow opportunisitc infections
eg kaposi sarcoma, PCP, CMV, oes/bronchial candida, lymphoma, TB
HIV SCREENING AND TESTING
i) how long after exposure can antibody test be negative for?
ii) what is the typical test used in hospital? which antigen test can give an earlier result?
iii) what tests for quantity of HIV virus and gives viral load?
iv) what is normal range for CD4 count? what is considered end stage HIV/AIDS?
v) what is viral load? what is undetectable?
i) 3 months
ii) antibody test
p24 antigen test can directly check spec HIV antigen in blood - positive earlier than antibody
iii) PCR testing tests HIV RNA and shows viral load
iv) CD4 normal is 500-1200
< 200 is end stage
v) viral load is copies of HIV RNA per ml of blood
undet is usually < 50-100
HIV TREATMENT
i) who is tx offered to? what is the starting regieme? how many tablets are usually taken?
ii) what is the aim of tx? name four classes of medication used
iii) what abx is given to patients with CD4 < 200? what does this protect against?
iv) what disease are HIV pts more likely ro develop? how often should women have a smear test?
v) name four vaccs that should be given? should a patient have live vaccs?
i) anyone who is HIV positive regardless of CD4 or viral load
start with 2 NRTIs plus a third agent - usually take one pill
ii) aim is to make CD4 count normal and undet viral load
protease inhibitors, integrase inhibitors, nuceloside rev transcrip inhibs (NRTI), non nucleo RTI (NNRTI), entry inhibitors
iii) give co trimoxale (septrin) to patients with low CD4 to protect against PCP
iv) inc risk of CV disease so close monitor
women should have yearly smear
v) vaccs - flu, pneumococcal, hep A, B and DTP
dont have live vaccines
REPRODUCTIVE HEALTH and PEP
i) what should newborn to HIV positive mothers have after birth?
ii) what mode of delivery can be considered if undet? when may breastfeeding be considered?
iii) how quickly should post exposure prophylaxis be given? what is it?
iV) how long is PEP given for? when should HIV test be done to confirm negative status? how long should sexual activity be abstained from?
i) newborn - ART for 4 weeks after birth
ii) vaginal if undet, may consider breastfeeding but still risks
iii) give PEP within 72 hours
ART combo of truvada and raltegravir for 28 days
iv) do HIV at time of PEP and then 3 months later to confirm negative - avoid unprotected sex in this time
