HIV Flashcards
sensitivity of EIA as screening test
> 99.5%
detected in EIA
p24 antigen of HIV
confirmatory test HIV
western blot
genes detected in a western blot
gag
pol (p31)**
env
when western blot is indeterminate
-cross reactive or in the process of mounting an antibody response: repeat testing in a month
best indicator the the immediate state of the immunologic competence of the patient with HIV infection
CD4 count
T cell count <200/uL
P jiroveci
CD4 <50uL
CMV
mycobacteria
M avium complex (MAC)**
T gondii
when to perform CD4 count
at the time of diagnosis and every 3-6 month thereafter
When to initiate cART
< 500 T cell count
T cell count decline indication to change therapy
> 25% decline
Comparable to a cd4 count
Tcell of 15
percent of HIV individuals with an acute clinical syndrome
50-70%
median time for latency
10 years
little if any decline in CD4
nonprogressors (low levels of HIV RNA)
prophylaxis P jiroveci
TMP SMX
CD4 less than 200
MAC prophylaxis
Azith or clarith
Toxo gondii
CD4 less than 100
TMP SMX
Rx cryptococcus neoformans, occcidoides
fluoconazole
Rx histoplasma capsulatum
itraconazole 200 BID
Rx salmonella
Ciprofloxacin 500 mg BID
encodes proteins that form core of virion
gag
encodes enzymes responsible for protease processing of viral proteins
pol
encodes envelope glycoproteins
env
natural reservoir of HIV 1 M and N groups
Pan troglodytes troglodytes
Std treatment for PCP
TMP/SMX for 21 days one double strength tab daily
Risk of PCP greatest
with previous bout of PCP
T cell counts less than 200
Alternative treatments for mild to moderate PCP
dapsone/trimethoprim
clindamycin/primaquine
atovaquone
Treatment of choice in severe disease if pt unable to tolerate TMP-SMX
IV pentamidine
most common finding in chest x-ray PCP
normal film or faint bilateral infiltrate
Indications for PCP prophylaxis in patients with HIV
1) prior bout of PCP
2) patient with CD4+ count 2 weeks
5) hx of oropharyngeal candidiasis
when is adjunct GC therapy included in PCP treatment
patients paO2 35 mmHg
most common atypical mycobacterial infection
M avium
M intracellulare
portal of entry MAC
GI tract
respiratory tract
MAC counts
CD4 <50
most common opportunistic protozoa that can infect GI tract and cause diarrhoea in HIV infected patients
Cryptosporidia
Microsporidia
Isospora belli
treatment isospora
TMP SMX
treatment of CMV colitis
ganciclovir
foscarnet
Rx histoplasma and penicillum marneffei
Itraconazole
Antibodoes to HIV
3-6 weeks
Facilitates infection of cells Fc receptor mediated mechanism known as anyibodybenhancement
Abbto gp41
rx for pcp if Gmp/smx is not tolerated
IV pentamidine
Reactivation pulmonary syndrome
Coccidoides immitis
HIV pseudomembranous tracheobronchhitis appearance
Aspergillius
MC form of heart dse in HIV pt
CAD
Treatment of cryptosporidia
Nitazoxamide
Microsporidia main species causing disease in humans
Enterocytozoon bieneusi
Hiv drug assoc with fatal fulminant and cholestatic hepatitis, hepatic necrosis and hepatic failure
Nevirapine
Rx HIV associated nephropathy
ACEI and prednisone
Lipodystrophy ayndrome HiV
Elevations in plasma triglycerides Total cholesterol Apolipoprotein B Hyperinsulinemia Hyperglcemia
Predominant thyroid abnormality in HIV patients
Subclinical hupothyroifism
MC affected joint Hiv assoc arthropathy
Knees and ankles
Characteristic feature of zidovudine rx
Elevated mean corpuscular volume
KSHV associated lymphoproluferatuce disoder seen with increased frequency in HIv infection
Multicentric castlemans disease
CD4 T cell count gor pt with histoplasmosis
33/uL
Neoplastic diseases considered to be aids defining condition
Kaposis sarcoma
Non hodgkins lymphoma
Invasive cervical carcinoma
Leading cause of infectious meningitis in patients with aids
C neoformans