HIV Flashcards

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1
Q

Self Genes that inhibit HIV propogation

A
- TRIM5a
	○ Destabilisation of viral capsid
- APOBEC3G
	○ Lethal hyper-mutations
- Thethrin
	○ Inhibition of virus release
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2
Q

Proteins that inhibit MCHI on surface of CD4 cells

A

Three genes tat, vpu and Nef will prevent the expression of MHCI on the surface of Tcells. Tat inhibits MHCI transcription, Vpu will direct MHCI to the proteosome and nef and vpu will promote MHCI to the lysosome.

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3
Q

Three functions of Vpu

A
  • Degarde CD4
  • Antagoniised tethrin
  • Inhibits surface expression of CD1d (lipid antigens to T cells from DCs)
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4
Q

What does APOBEC3G do and what HIV protein degrades it

A

Will introduce G-A lethal hypermutations into the ssDNA genome of HIV. Vif protein will degrade it

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5
Q

What are the three phases of HIV infection

A

Primary, asymptomatic and then symptomatic

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6
Q

Initial infection progression of the HIV

A

Transmission to DCs, which will then transport to lymph nodes and expose to CD4+. Now the virus in HIV will replicate in CD4+ cells and will disseminate in the blood to seed other lymph nodes to maintain a position/location for their latency stage. in this stage CD4+ cells will deplet for around 6-9 weeks before returning to higher levels by 12 weeks

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7
Q

What are the mechanisms by which we can test for HIV

A

RT-PCR for the RNA of HIV by around 20 days, from 24 days we can test for proteins via ELISA nd we can detect a HIV antibody by 40 days

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8
Q

What are the mechanims by which HI escapes immune evasion

A

They have a very error prone Reverse Transcriptase and hence 1:10,000 NT are not inserted correctly and hence there is a large probability of postive mutations arising, this leads to change in antigen targets on envelope proteins such as gp120

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9
Q

What are the features of the asymptmatic phase

A

lasts for around 6 years in which the CD4+ population will decline. When the CD4+ count reaches lower than 200/ul

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10
Q

Symptoms of Primary phase

A

Will typically present with fever, myalgia, nausea and vomiting, weightloss and lymphadenopathy with transient CD4+ depletion

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11
Q

What are the mechanisms by which CD4+ cells decline

A

§ Indirect
□ Cytolysis of infected CD4+ cells by CD8+ cells
□ Incoproation into giant multiinucleated cells
□ Immune activation of CD4+ cells leading to death
§ Direct
□ Direct destruction of the infected cells

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12
Q

WHat is the affect of HIV on B cells

A

They increase their antibody secretion but they are typically auto-antibodies

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13
Q

What are some of the AIDS defining illnesses

A
□ Karposi's Sarcome (Herpes virus 8)
			□ Cryptococcus
			□ Histoplasma
			□ TB
			□ Pneumocystis carnii/jerovicii pneumonia
			□ Mycosis
			□ CMV
			□ M avium complex
			□ Candida Albicans (Severe head infections)
			□ Lymphomas
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14
Q

What are some viral factors that determine virulence

A

○ Attenuated strain
○ R5 or X4 phenotype
○ Co-oinfection with HepG

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15
Q

What are some host factors that determine virulence

A
○ CCR5 delta 32 mutation
	○ CCR5 promoter region
	○ HLA type
		§ B 13,27,51 and 57
	○ Immunology
		§ Grade of immune response
Age
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16
Q

What is currently the best vaccine

A

Prevention of spread

17
Q

What are some entry inhibitors

A

Inhibit the entry of the HIV, and include Enfuvirtide (gp41) and Maraviroc (CCR5)

18
Q

How to nucleosides treatements work

A

They work by not havig phosphates attached (dependent on HIV to incorporate the phosphates) aand then not having a 3’OH to propogate the DNA chain during RT cDNA production

19
Q

What are some current NRTIs

A

AZT (thymine) and Zalcitabine (cytosine)

20
Q

What is atripla

A

Is combination HAART therapy containing efavirenz(NNRTI), tenofovir (NtRTI) and emtricitabine (NRTI)

21
Q

How did they design the protease inhibitors

A

Took the natural structure of the substrate and modified it to inhibit protease mediated cleavage

22
Q

Examples of protease inhibitors

A

Saquinavir or any drg ending in ‘navir’

23
Q

What is the funtion of integrase inhibitors

A

Integrase inhibitors prevent the incorporation of HIV DNA into the hosts DNA and includes Raltegravir and Elvitegravir

24
Q

What are current problems that HIV carriers suffer

A

Increased risk of

	- CVD
	- Cancer
	- Bone fractures
	- Liver and kidney failure
	- Cognitive decline
	- Fragility