HIV

Question 1

What is the difference between HIV and COVID-19?

Answer 1

HIV
- lentivirus
- targets CD4 surface protein expressed in CD4+ T helper lymphocytes, macrophages and dendritic cells
- transmitted via sexual, parenteral and vertical direct contact
- prevention = post exposure prophylaxis, pre exposure prophylaxis
- treatment = HAART

COVID-19
- beta coronavirus
- targets ACE II receptors expressed in lungs, heart, blood vessels, intestine and kidney
- transmission via air (are air borne)
- prevention = vaccine
- treatment = antiviral, monoclonal antibodies

Question 2

What is lymphadenopathy?

Answer 2

refers to theswelling of lymph nodes which can be secondary to bacterial, viral, or fungal infections, autoimmune disease, and malignancy

lymph nodes are located in many parts of the body, including theneck, armpit, chest, abdomen (belly), and groin

Question 3

What are interventions to prevent HIV?

Answer 3

abstinence
condom use
needle and syringe provision/exchange
HIV testing
treatment as prevention
pre exposure prophylaxis
post exposure prophylaxis
male circumcision

Question 4

What are the types of HIV treatment?

Answer 4

antiretroviral regimen genrally consists of two nucleoside reverse transcriptase inhibitors (NRTIs) in combination with a third ARV drug

• integrase strand transfer inhibitor (INSTI)
• non-nucleoside reverse transcriptase inhibitor (NNRTI)
• protease inhibitor
• pharmacokinetic enhancer

Question 5

What is the mechanism of action of nucleoside reverse transcriptase inhibitors (NRTIs)? What is an example?

Answer 5

prevents the formation of a 3’-5’-phosphodiester bond in growing DNA chains and can prevent replication of the virus
- inhibit RT by causing chain termination after they have been incorporated into viral DNA

tenofovir and abacavir
zidovudine
stavudine

Question 6

What is the mechanism of action of non-nucleoside reverse transcriptase inhibitors (NNRTIs)? What is an example?

Answer 6

bind directly to HIV-1 reverse transcriptase at a hydrophobic site remote from the enzyme’s active site to produce a conformational change that prevents substrate binding.

nevirapine, rilpivirine, and efavirenz

Question 6

What is the mechanism of action of intercase strand transfer inhibitors? What is an example?

Answer 6

inhibits HIV integrase by binding to the active site and blocking the strand transfer step of retroviral DNA integration in the host cell
- prevents HIV from replicating.

bictegravir (BIC), dolutegravir (DTG), and raltegravir (RAL)

Question 7

What is the mechanism of action of protease inhibitors? What is an example?

Answer 7

act by binding to the catalytic site of the HIV protease, thereby preventing the cleavage of viral polyprotein precursors into mature, functional proteins that are necessary for viral replication
- prevent cleavage of essential structural and enzymatic components of the virus.

indinavir, ritonavir, nelfinavir

Question 8

What are the reasons for ART optimisation?

Answer 8

STIFF

simplification - reduce pill burden and/or dosing frequency

tolerability - enhance tolerability and/or decrease toxicity

interactions - prevent or mitigate drug-drug interactions

foods/fluids - eliminate food or fluid requirements

fertility - optimise ART use during pregnancy or where pregnancy may occur

cost - reduce costs