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Sexual Health > HIV > Flashcards

HIV Flashcards

1
Q

What type of virus is HIV?

A

HIV is an RNA retrovirus

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2
Q

What is the most common type of HIV?

A

HIV-1

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3
Q

What type of HIV is mainly found in Western Africa?

A

HIV-2

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4
Q

What is the pathophysiology of HIV?

A

The virus enters and destroys the CD4 T helper cells of the immune system

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5
Q

How can HIV be transmitted?

A

Unprotected anal, vaginal or oral sex
Vertical transmission
Exposure to infected bodily fluids

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6
Q

How does HIV replicate inside the body?

A

Once in the T helper cells, it uses the enzyme reverse transcriptase to convert viral RNA into a DNA copy

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7
Q

What is HIV seroconversion?

A

When the body starts to produce antibodies to HIV
- After seroconversion, HIV can be tested for

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8
Q

What are the symptoms of HIV seroconversion?

A

Flu-like illness symptoms
- Sore throat
- Lymphadenopathy
- Diarrhoea
- Malaise, myalgia
- Maculopapular rash
- Mouth ulcers

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9
Q

How long after infection does seroconversion occur?

A

3-12 weeks

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10
Q

What are the risk factors for HIV infection?

A

IV drug use
Homo and heterosexual unprotected intercourse
Percutaneous needlestick injury
Having another STI

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11
Q

What methods are used to diagnose HIV?

A

HIV antibodies
p24 antigen

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12
Q

How are HIV antibodies used to diagnose HIV?

A

ELISA test and a confirmatory Western Blot assay are used to detect antibodies to HIV

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13
Q

After how long can HIV antibodies be detected in the blood?

A

Most people have antibodies by 4-6 weeks, but 99% of people have antibodies by 3 months

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14
Q

How are p24 antigens used to diagnose HIV?

A

A viral core protein can be detected as RNA viral levels increase in the blood

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15
Q

When can p24 antigens be detected in the blood?

A

Between 1 weeks and 3-4 weeks after infection

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16
Q

How are most people diagnosed with HIV?

A

A test combining p24 antigen testing and HIV antibodies

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17
Q

When should an asymptomatic patient be offered testing after a possible exposure?

A

4 weeks after the exposure
- Repeated at 12 weeks if first test is negative

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18
Q

What are the differentials of HIV infection?

A

Infectious mononucleosis
CMV
Influenza
Viral hepatitis
Secondary syphilis

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19
Q

What is the normal CD4 count range?

A

500-1200 cells/mm3

20
Q

Under what CD4 count puts a patient at risk of opportunistic infections?

A

200

21
Q

What is the main treatment of HIV?

A

Anti-retroviral treatment

22
Q

Who is antiretroviral treatment offered to?

A

All patients regardless of CD4 count - ART should be started as soon as a HIV diagnosis is made

23
Q

What are the classes of ART?

A

Protease inhibitors
Integrase inhibitors
Nucleoside reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
Entry inhibitors

24
Q

What is the usual starting regime for HIV treatment?

A

Two NRTIs plus an additional drug

25
Q

What additional management is required in HIV?

A

Prophylactic co-trimoxazole for patients with CD4 count under 200
Yearly cervical smears
Up to date vaccinations

26
Q

When can a woman with HIV have a normal vaginal birth?

A

If viral load is under 50

27
Q

What drug can be given to a woman in labour to prevent vertical transmission?

A

IV zidovudine

28
Q

What prophylaxis may be given to a baby with a HIV positive mother?

A

Zidovudine, lamivudine and nevirapine for 4 weeks

29
Q

What is the safest advice to breastfeeding mothers that are HIV positive?

A

To avoid breastfeeding - HIV can be transmitted through breast milk

30
Q

What is PEP?

A

Post exposure prophylaxis
- Given within 72 hours to patients who have been exposed to HIV

31
Q

What is the current combination of drugs used in PEP?

A

emtricitabine/tenofovir (Truvada) and raltegravir for 28 days

32
Q

What is PrEP?

A

Pre-exposure prophylaxis for HIV

33
Q

What is the current combination of drugs used in PrEP?

A

emtricitabine/tenofovir (Truvada)

34
Q

What are the most common AIDS defining illnesses?

A

Kaposi’s sarcoma
Pneumocystis jirovecii pneumonia
Cytomegalovirus infection
Candidiasis
Lymphomas
TB

35
Q

When should children be tested for HIV?

A

Babies to HIV positive parents
When immunodeficiency is suspected
Young people who are sexually active and there are concerns
Needle stick injuries
Sexual abuse
IV drug use

36
Q

What eye conditions may be seen in someone with HIV?

A

CMV retinitis
Kaposi’s sarcoma
HSV infection
VSV infection
Tuberculosis

37
Q

What is the presentation of CMV retinitis?

A

Reduced visual acuity
Pizza pie appearance on fundoscopy
- areas of thick white infiltrate accompanied by retinal haemorrhages

38
Q

What is the treatment of CMV retinitis?

A

Intra-ocular ganciclovir
Oral valganciclovir

39
Q

What is Kaposi’s sarcoma?

A

A cancer caused by HSV-8 commonly seen in patients with HIV

40
Q

Where does Kaposi’s sarcoma develop from?

A

Endothelial cells
- It is seen in the skin

41
Q

What is the appearance of Kaposi’s sarcoma?

A

Purple papules or plaques on the skin

42
Q

What is the treatment of Kaposi’s sarcoma?

A

Radiotherapy
Resection

43
Q

What types of cancers is HIV associated with?

A

Anal
Liver
Lung
Hodgkin’s lymphoma
Burkitt’s lymphoma
Kaposi’s sarcoma

44
Q

What is the treatment of pneumocystis jiroveci pneumonia?

A

Co-trimoxazole

45
Q

What are the features of pneumocystis jiroveci pneumonia?

A

Bilateral bihilar interstitial infiltrates
Desaturating on exertion
Non-productive cough
Poorly controlled HIV

46
Q

How should anti-retrovirals be taken?

A

They should be taken at the same time every day

Sexual Health (12 decks)

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