HIV 2

Question 1

Describe the natural history of HIV infection

Answer 1

• Primary Infection… Blood and Body CD4 high! Right after WIDESPREAD of virus!! Seeding in organs!!
• Clinical Latency… decreasing CD4 cells.. CD4 in blood goes down.. then increases a bit then drops significantly!
• Constitutional Symptoms… CD4 dropped to around 400
• Opportunistic Diseases … happens later on
• Death

Question 2

Recognize indications for starting antiretroviral therapy

Answer 2

• Treat ALL people! Especially if they are pregnant or have an infection!
• Drugs to take Stribild, Genova, Complera, Atripla.
• Don’t give if history of cardiac disease

Question 3

Identify the principles, strengths, and limitations of HIV therapy

Answer 3

• Can suppress HIV replication
• Can prevent CD4 depletion!
• Cannot Cure the infection since latently infected CD4 T cell reservoirs are inaccessible to therapy

Question 4

Recognize the presentation of common opportunistic infections and malignancies

Answer 4

• TB!!!! Atypical Chest xray features and extrapulmonary disease
• Candida! Oral Thrush… vaginal infection…
• Pneumocystis pneuomonia
• Pneumocystis Jiroveci… check CD4, HIV, and O2 saturation, and LDH level
• Kaposi’s Sarcoma… lesions! entire GI tract!!
• Lymphoma… malignant B cells
• HPV related cervical cancer and anal cancer

Question 5

HIV patients die from…

Answer 5

• die of complications
• Cancer
• Suicides

Question 6

AIDS is?

Answer 6

HIV(+) PLUS CD4 below 200cells/uL OR AIDS definiing illness