HIV Flashcards
Being infected with the human immunodeficiency virus (HIV) is referred to as being HIV positive. True/false?
True
When does AIDS occur?
When HIV is not treated, the disease progresses, and the person becomes immunocompromised.
Immunodeficiency leads to opportunistic infections and AIDS-defining illnesses I.e. HIV-related encephalopathy
What does AIDS stand for?
Acquired immunodeficiency syndrome
What type of virus is HIV?
RNA retrovirus
Types of HIV?
HIV-1 (most common type)
HIV-2 (mainly found in west Africa)
The virus enters and destroys the CD4 T-helper cells of the immune system. True/false?
True
Infection is immediately symptomatic in host. True/false?
False
Initial seroconversion (antibodies produced in response to specific illness) occurs within first few weeks of infection.
Infection then asymptomatic until condition progresses to immunodeficiency.
Disease progression may occur years after initial infection.
Routes of HIV transmission?
Unprotected anal, vaginal or oral sexual activity
Mother to child at any stage of pregnancy, birth or breastfeeding (called vertical transmission)
Mucous membrane, blood or open wound exposure to infected blood or bodily fluids (e.g., sharing needles, needle-stick injuries or blood splashed in an eye)
What are AIDS defining illnesses?
Illnesses associated with end-stage HIV infection
occur where the CD4 count has dropped to a level that allows for unusual opportunistic infections and malignancies to appear.
Examples of AIDS-defining illnesses?
Kaposi’s sarcoma
Pneumocystis jirovecii pneumonia (PCP)
Cytomegalovirus infection
Candidiasis (oesophageal or bronchial)
Lymphomas
Tuberculosis
For HIV, the earlier the patient is diagnosed, the better the outcome. True/false
True
HIV is untreatable. True/false?
False
HIV is a treatable condition, and most patients are fit and healthy on treatment.
What is the 4th gen lab test?
checks for antibodies to HIV and the p24 antigen.
It has a window period of 45 days, meaning it can take up to 45 days after exposure to the virus for the test to turn positive.
A negative result within 45 days of exposure is unreliable. More than 45 days after exposure, a negative result is reliable.
How quickly can point of care tests provide results and what is the duration of window period?
give a result within minutes. They have a 90-day window period.
Examples of HIV home testing kits for those at risk of HIV?
Self-sampling kits to be posted to the lab (fourth-generation tests for antibodies and the p24 antigen)
Point-of-care tests (antibodies only)
How is HIV monitored?
By testing CD4 count through blood test
Testing the CD4 count gives the number of CD4 cells in the blood. These are the cells destroyed by the virus.
The higher the CD4 count, the higher the risk of opportunistic infection. True/false?
False
The lower the count, the higher the risk of opportunistic infection.
CD4 ranges?
500-1200 cells/mm3 is the normal range
Under 200 cells/mm3 puts the patient at high risk of opportunistic infections
What does testing for HIV RNA indicate?
Indicates viral load
An undetectable viral load means the level is below the recordable range (usually 20 copies/ml). The viral load can be in the hundreds of thousands in untreated HIV.
What does treatment of HIV commonly involve?
a combination of antiretroviral therapy (ART) medications.
ART is offered to everyone diagnosed with HIV, irrespective of viral load or CD4 count.
How can genotypic resistance testing aid treatment for HIV alongside ART?
can establish the resistance of each HIV strain to different medications to help guide treatment.
Classes of antiretroviral therapy medications?
Protease inhibitors (PI)
Integrase inhibitors (II)
Nucleoside reverse transcriptase inhibitors (NRTI)
Non-nucleoside reverse transcriptase inhibitors (NNRTI)
Entry inhibitors (EI)
Usual first-line treatment option?
two NRTIs (e.g., tenofovir plus emtricitabine) plus a third agent (e.g., bictegravir).
What is main aim of treatment of HIV?
aims to achieve a normal CD4 count and undetectable viral load.
Why are yearly cervical smears recommended in HIV?
HIV increases the risk of human papillomavirus (HPV) infection and cervical cancer.
Prophylactic (prevents risk) co-trimoxazole is given to HIV positive patients in what scenario?
Patients with CD4 count under 200/mm3 to protect against pneumocystis jirovecii pneumonia (PCP).
To prevent HIV transmission during birth, what will influence the mode of delivery of the baby?
The mothers viral load
Under 50 copies/ml =Normal vaginal delivery
Over 50 copies/ml =Consider a pre-labour caesarean section
Over 400 copies/ml =Pre-labour caesarean section is recommended
What medication is given as an infusion during labour and delivery if viral load unknown or above 1000copies/ml?
IV zidovudine
Prophylaxis given for low and high risk babies?
Low-risk babies (mother’s viral load is under 50 copies per ml) are given zidovudine for 2-4 weeks
High-risk babies are given zidovudine, lamivudine and nevirapine for four weeks
