HIV

Question 1

How is HIV transmitted?

Answer 1

1. direct contact between infected body fluid (blood, semen, vaginal/rectal secretions, and breast milk)
2. direct contact with mucous membranes or open wounds (IV drug use)
3. mother-to-child/ vertical transmission through pregnancy, childbirth, or breastfeeding

Question 2

How often is HIV testing recommended for all patients 13-64 y/o?

Answer 2

once unless other RF

Question 3

What patients should have HIV screening annually?

Answer 3

1. history of other STIs, hepatitis, or TB
2. those engaging in high-risk activities (sex with multiple partners/unknown sexual history, MSM, anal/vaginal sex with someone who has HIV, sharing needles/syringes for IV drugs)

Question 4

What are the symptoms of acute HIV infection?

Answer 4

1. non-specific flu-like symptoms few days to several weeks (fever, myalgia, headache, lymphadenopathy, pharyngitis, rash)
2. asymptomatic
3. no antibody response for weeks -months

Question 5

When is AIDs diagnosed?

Answer 5

CD4 count <200 cells/mm3
OR
Aids defining condition:
1. opportunistic infection
2. cancers (Kaposi’s sarcoma)
3. HIV wasting syndrome

Question 6

What medications can be utilized to treat HIV wasting syndrome?

Answer 6

1. dronabinol (Marinol, Syndros)
2. megestrol (a progestin)

Question 7

How is HIV diagnosed?

Answer 7

1. initial screening for antibodies or antigens
2. confirmatory test
3. nucleic acid test detecting HIV RNA viral load (if confirmatory test is negative/ indeterminant)

Question 8

How long does it take for HIV antibodies to be detected?

Answer 8

4-12 weeks after infection; up to 6 months

Question 9

What OTC HIV test detects the presence of antibodies and provides immediate results?

Answer 9

OraQuick In-Home HIV Test

Question 10

What are counseling points for OraQuick In-Home HIV Test?

Answer 10

1. swab upper and lower gums with the test stick then insert into a test tube containing liquid
2. result can be read in 20 minutes
3. 1 line (control) is a negative result; 2 lines is a positive result
4. testing <3 months after exposure can lead to false negative due to a lag in antibody production
5. positive result must follow up for a confirmatory test

Question 10

What type to virus is HIV?

Answer 10

RNA retrovirus that uses host cell processes to replicate

Question 11

What are the 8 stages of HIV replication?

Answer 11

1. blinding and attachment
2. fusion
3. reverse transcriptase
4. nuclear import
5. integration
6. transcription/translation
7. assembly
8. budding and maturation

Question 12

Why is it important that patients with HIV are adherent to ART (antiretroviral therapy)?

Answer 12

prevent resistance and prolong life

Question 13

What is tested as an indicator of immune function and will determine the need to prevent OIs?

Answer 13

CD4 count

Question 14

What is tested as an indicator of ART response?

Answer 14

HIV RNA viral load

Question 15

What should happen to CD4 count and HIV viral load as a result of starting ART?

Answer 15

1. increased CD4
2. decreased HIV viral load

Question 16

What should be monitored if someone is diagnosed with HIV?

Answer 16

1. vaccines
2. CMP (LFTs and SCr)
3. CBC with differential
4. lipid panel
5. random/fasting BG
6. UA
7. Hepatitis B and C screening
8. pregnancy test