HIV

Question 1

Being infected with the human immunodeficiency virus (HIV) is referred to as being HIV positive. True/false?

Answer 1

True

Question 2

When does AIDS occur?

Answer 2

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

Question 3

What does AIDS stand for?

Answer 3

Acquired immunodeficiency syndrome

Question 4

What type of virus is HIV?

Answer 4

RNA retrovirus

Question 5

Types of HIV?

Answer 5

HIV-1 (most common type)
HIV-2 (mainly found in west Africa)

Question 6

The virus enters and destroys the CD4 T-helper cells of the immune system. True/false?

Answer 6

True

Question 7

Infection is immediately symptomatic in host. True/false?

Answer 7

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.

Question 8

Routes of HIV transmission?

Answer 8

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)

Question 9

What are AIDS defining illnesses?

Answer 9

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.

Question 10

Examples of AIDS-defining illnesses?

Answer 10

Kaposi’s sarcoma
Pneumocystis jirovecii pneumonia (PCP)
Cytomegalovirus infection
Candidiasis (oesophageal or bronchial)
Lymphomas
Tuberculosis

Question 11

For HIV, the earlier the patient is diagnosed, the better the outcome. True/false

Answer 11

True

Question 12

HIV is untreatable. True/false?

Answer 12

False

HIV is a treatable condition, and most patients are fit and healthy on treatment.

Question 13

What is the 4th gen lab test?

Answer 13

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.

Question 14

How quickly can point of care tests provide results and what is the duration of window period?

Answer 14

give a result within minutes. They have a 90-day window period.

Question 15

Examples of HIV home testing kits for those at risk of HIV?

Answer 15

Self-sampling kits to be posted to the lab (fourth-generation tests for antibodies and the p24 antigen)

Point-of-care tests (antibodies only)

Question 16

How is HIV monitored?

Answer 16

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.

Question 17

The higher the CD4 count, the higher the risk of opportunistic infection. True/false?

Answer 17

False

The lower the count, the higher the risk of opportunistic infection.

Question 18

CD4 ranges?

Answer 18

500-1200 cells/mm3 is the normal range

Under 200 cells/mm3 puts the patient at high risk of opportunistic infections

Question 19

What does testing for HIV RNA indicate?

Answer 19

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.

Question 20

What does treatment of HIV commonly involve?

Answer 20

a combination of antiretroviral therapy (ART) medications.

ART is offered to everyone diagnosed with HIV, irrespective of viral load or CD4 count.

Question 21

How can genotypic resistance testing aid treatment for HIV alongside ART?

Answer 21

can establish the resistance of each HIV strain to different medications to help guide treatment.

Question 22

Classes of antiretroviral therapy medications?

Answer 22

Protease inhibitors (PI)
Integrase inhibitors (II)
Nucleoside reverse transcriptase inhibitors (NRTI)
Non-nucleoside reverse transcriptase inhibitors (NNRTI)
Entry inhibitors (EI)

Question 23

Usual first-line treatment option?

Answer 23

two NRTIs (e.g., tenofovir plus emtricitabine) plus a third agent (e.g., bictegravir).

Question 24

What is main aim of treatment of HIV?

Answer 24

aims to achieve a normal CD4 count and undetectable viral load.

Question 25

Why are yearly cervical smears recommended in HIV?

Answer 25

HIV increases the risk of human papillomavirus (HPV) infection and cervical cancer.

Question 26

Prophylactic (prevents risk) co-trimoxazole is given to HIV positive patients in what scenario?

Answer 26

Patients with CD4 count under 200/mm3 to protect against pneumocystis jirovecii pneumonia (PCP).

Question 27

To prevent HIV transmission during birth, what will influence the mode of delivery of the baby?

Answer 27

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

Question 28

What medication is given as an infusion during labour and delivery if viral load unknown or above 1000copies/ml?

Answer 28

IV zidovudine

Question 29

Prophylaxis given for low and high risk babies?

Answer 29

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