HIV Flashcards
How is HIV tested?
Self test
- dried blood spot
- 98.8% work
offered in community settings
Drugs used to treat HIV (4)
Nucleotide/nucleoside reverse transcriptase inhibitors (NRTI and NtRTI)
Non-nucleoside RTIs
Integrase inhibitors
Protease inhibitors
MoA and example:
Nucleotide/nucleoside reverse transcriptase inhibitors (NRTI and NtRTI)
- phosphorylated to 5’ triphosphate form
- incorporated into cDNA and stop synthesis
e.g. zidovudine
MoA and example:
Non-nucleoside RTIs
- direct binding and inactivation of RT catalytic suite
e.g. efavirenz
MoA and example:
Integrase inhibitors
- binding and misaligning of integrase and DNA, preventing incorporation
e.g. raltegravir
MoA and example:
Protease inhibitors
- peptide mimics, preventing cleavage of poly protein
e.g. ritonavir
What drugs are a patient with a new HIV diagnosis given?
2 NRTIs and a third agent
NRTIs are usually:
- Tenofovir DX or AF
- Emtricitabine
Third agent usually:
- Integrase inhibitor
E.g. dolutegravir
ultimately:
- Tenofovir AF
- Emtricitabine
- Bictegravir
(Single-pill form)
What is the aims for HIV treatment?
Reduce viral load to undetectable (<20 copies per mL)
- promote CD4+ cell recovery
- stop risk of complications
- stop risk of transmission
undetectable = cannot transmit HIV
Pre-Exposure Prophylaxis (PrEP):
Who?
Considerations?
What drug?
Who?
- partners of people currently unable to tolerate ART
- sex workers
- anyone of high risk HIV exposure
Things to consider:
- adherence
- renal/liver function
- STI screen
- stigma
- pregnancy test
What drug?
- Truvada (1 daily)
- tenofovir (heterosexual)
Post-exposure prophylaxis (PEP):
Who?
Considerations?
What drug?
Who?
- receptive partner of those with unknown or dectable viral loads
- occupational exposure
- IVDU
Things to consider:
- Timings (within 72 hours)
- renal/liver function
- sti screen
- baseline HIV status
What drug?
- truvada- 1 daily + rategravir
