HIV 2 Flashcards
natural history of HIV: 3
- primary infection - seeding
- Asymptomatic infection - clinical latency
- symptomatic infection and AIDS
what happens in HIV primary infectio?
massive CD4+ Tcells
symptom of primary HIV infection?
lymphadenopathy, fever, thrush
HIv kills >50% of what within days?
mucosal T-cells
GALT memory T-lymphocytes (Peyer’s Patches)
what else does HIV do to guy besides take out the GALT?
breaks down tight junctions between epithelial cells
can you detect primary HIV? How? 2 ways
- ELISA HIV Ab
2. HIV RNA
how long is max seroconversion window?
~35 days
what is HIV viral load?
how much HIV RNA in the plasma only
why are our initial antibodies to HIV Env protein ineffective? 2 reasons
- ENV is glycosylated, it’s 50% of gp120’s mass = camouflages it and makes it low immunogenicity
- mutations
Why HIV vaccine so hard?
gp120 trimers highly variable, Abs can’t mutated fast enough
how to measure HIV virological set-point?
Reverse Transriptase - PCR
undetectable HIV viral load is?
<50 copies /ml
what happens in asymptomatic phase/quasi=steady state for HIV?
viral production = viral clearance
higher the viral load re: survival
lower the survival years
what 3 things down regulate MHC-1?
tat
Vpu
Nef
where does HIV like to hibernate?: 3 cells: 1 place
Macrophages
Resting Memory T-cells
Astrocytes
Immunologically privileged site: eye, brain
what does chronic immune activation do? how in HIV?
deplete T-cells via lost gut mucosa barrier, constant DAMPS, LPS, inflamm, CD4+ activate and die.
HIV increases or decreases antibodies?
increases
risk of autoantibodies
when do opportunistic infections in HIV start re: CD4 coutns?
<200 CD4+/ml
AIDS defining illnesses?
Fungi
EBV/HSV/CMV reactivation
cachexia
Kaposi’s sarcoma (HHV-8)
co-infections with GBV-C (hepatitis G) for HIV results?
protective effect
HAART rationale for combo therapy?
minimize drug resistance, improbability of multiple viral changes (10^12)
new HIV paradigm?
treatment as prevention
