HIV 2

Question 1

natural history of HIV: 3

Answer 1

1. primary infection - seeding
2. Asymptomatic infection - clinical latency
3. symptomatic infection and AIDS

Question 2

what happens in HIV primary infectio?

Answer 2

massive CD4+ Tcells

Question 3

symptom of primary HIV infection?

Answer 3

lymphadenopathy, fever, thrush

Question 4

HIv kills >50% of what within days?

Answer 4

mucosal T-cells

GALT memory T-lymphocytes (Peyer’s Patches)

Question 5

what else does HIV do to guy besides take out the GALT?

Answer 5

breaks down tight junctions between epithelial cells

Question 6

can you detect primary HIV? How? 2 ways

Answer 6

1. ELISA HIV Ab

2. HIV RNA

Question 7

how long is max seroconversion window?

Answer 7

~35 days

Question 8

what is HIV viral load?

Answer 8

how much HIV RNA in the plasma only

Question 9

why are our initial antibodies to HIV Env protein ineffective? 2 reasons

Answer 9

1. ENV is glycosylated, it’s 50% of gp120’s mass = camouflages it and makes it low immunogenicity
2. mutations

Question 10

Why HIV vaccine so hard?

Answer 10

gp120 trimers highly variable, Abs can’t mutated fast enough

Question 11

how to measure HIV virological set-point?

Answer 11

Reverse Transriptase - PCR

Question 12

undetectable HIV viral load is?

Answer 12

<50 copies /ml

Question 13

what happens in asymptomatic phase/quasi=steady state for HIV?

Answer 13

viral production = viral clearance

Question 14

higher the viral load re: survival

Answer 14

lower the survival years

Question 15

what 3 things down regulate MHC-1?

Answer 15

tat
Vpu
Nef

Question 16

where does HIV like to hibernate?: 3 cells: 1 place

Answer 16

Macrophages
Resting Memory T-cells
Astrocytes
Immunologically privileged site: eye, brain

Question 17

what does chronic immune activation do? how in HIV?

Answer 17

deplete T-cells via lost gut mucosa barrier, constant DAMPS, LPS, inflamm, CD4+ activate and die.

Question 18

HIV increases or decreases antibodies?

Answer 18

increases

risk of autoantibodies

Question 19

when do opportunistic infections in HIV start re: CD4 coutns?

Answer 19

<200 CD4+/ml

Question 20

AIDS defining illnesses?

Answer 20

Fungi
EBV/HSV/CMV reactivation
cachexia
Kaposi’s sarcoma (HHV-8)

Question 21

co-infections with GBV-C (hepatitis G) for HIV results?

Answer 21

protective effect

Question 22

HAART rationale for combo therapy?

Answer 22

minimize drug resistance, improbability of multiple viral changes (10^12)

Question 23

new HIV paradigm?

Answer 23

treatment as prevention