HIV Flashcards
what is HIV
RNA retrovirus
how quickly does HIV replicate
fast - new generation every 6-12 hours
what are the target sites for HIV
CD4+ receptors
what effect does HIV infection have on the immune response
Reduced circulating CD4+ cells
Reduced proliferation of CD4+ cells
Reduction CD8+ (cytotoxic) T cell activation
-Dysregulated expression of cytokines
Reduction in antibody class switching
-Reduced affinity of antibodies produced
Chronic Immune Activation (microbial translocation)
what are normal CD4+ levels
500-1600 cells/mm3
how long does HIV take from exposure to establish itself as an infection
up to 72h
what percentage of patients with primary HIV infection present with symptoms?
80%
primary HIV infection symptoms
Fever
Rash (maculopapular)
Myalgia
Pharyngitis
Headache/aseptic meningitis
when is average symptom onset in primary HIV infection
2-4 weeks after infection (up to 3mths)
what does AIDS stand for
acquired immunodeficiency syndrome
opportunistic infections definition
an infection caused by a pathogen that does not normally produce disease in a healthy individual
pneumocystis pneumonia treatment
high dose co-trimoxazole (+/- steroid)
cerebral toxoplasmosis CD4 threshold
<150
cytomegalovirus CD4 threshold
<50
ophthalmic screening for patients with CD4 under ___?
50
HIV-associated neurocognitive organism
HIV-1
progressive multifocal leukoencephalopathy (PML) organism
JC virus (reactivation)
skin infections in HIV
herpes zoster
herpes simplex
HPV
HIV muscle wasting aetiology
chronic immune activation
anorexia
diarrhoea
hypogonadism
AIDS related cancer
Kaposi’s sarcoma
Non-Hodgkins lymphoma
Cervical cancer
cervical cancer organism
HPV
Non-AIDS symptomatic HIV symptoms
Mucosal candidiasis
Seborrhoeic dermatitis
Diarrhoea
Fatigue
Worsening psoriasis
Lymphadenopathy
Parotitis
Epidemiologically linked conditions
-STIs
-Hepatitis B
-Hepatitis C
most common mode of transmission of people living with HIV (PLWHIV) in UK
sexual
factors increasing HIV transmission risk
Anoreceptive sex
Trauma
Genital ulceration
Concurrent STI
mother to child HIV transmission
0.5% of new diagnoses in England
In utero/trans-placental
Delivery
Breastfeeding
what % of all new HIV diagnoses in UK are diagnosed late (CD4<350 cells/mm3)
40%
who should be tested for HIV?
Universal testing in high prevalence areas
Opt-out testing in certain clinical settings
Screening of high risk groups
Testing in the presence of “clinical indicators”
where is opt out HIV testing used
termination of pregnancy services
sexual health services
addiction and substance misuse services
HIV screening of high risk groups
- men who have sex with men
- female partners of MSM
- people from endemic areas
- incarcerated people
- trans women
- people who inject (have injected) drugs
- partners of people living with HIV
Which markers of HIV can be used by labs to detect infection?
- antibody (only positive after 3mths)
- antigen (p24)
- viral RNA (first one of the tests to pick up HIV)
rapid HIV tests
fingerprick blood specimen or saliva
results within 20-30 mins
HIV clinical care
medical care
anti-retroviral treatment
holistic care
does a mum with HIV need a c section
yes if detected viral load.
If undetected then can have vaginal delivery
