HIV Flashcards
what is HIV
depletion CD4 lymphocytes- progressive immunosuppression, susceptibility to opportunistic infections and cancer
what is HIV
depletion CD4 lymphocytes- progressive immunosuppression, susceptibility to opportunistic infections and cancer
when does seroconversion occur
2-4 weeks after infection
what CD4 is when AIDs occurs
where does HIV bind
via gp120 glycoprotein to CD4 receptors on T helper, monocytes, macrophages, neural cells
signs seroconversion
primary infection. transient illness. fever, malaise, myalgia, pharyngitis, maculopapular rash, meningoencephalitis
what follows seroconversion
asymptomatic infection. 30% have persistent generalised lymphadenopathy
definition of AIDs
HIV + indicator of disease
definition of AIDs
HIV + indicator of disease
when does seroconversion occur
2-4 weeks after infection
what CD4 is when AIDs occurs
where does HIV bind
via gp120 glycoprotein to CD4 receptors on T helper, monocytes, macrophages, neural cells
If recent infection what tests can be done (if HIV Ab -ve)
HIV RNA or core p24 antigen; or check at 6 weeks and 3 months
what follows seroconversion
asymptomatic infection. 30% have persistent generalised lymphadenopathy
first line treatment TB
isoniazid, pyrazinamide, rifampicin, ethambutol
definition of AIDs
HIV + indicator of disease
time scale HIV to AIDs
8 years
timescale ARC to AIDs
2 years
time scale AIDs to death
2 years
diagnosis
serum or salivary HIV-Ab by ELISA
other pathogens affecting lungs in HIV
M avium intracellulare, CMV,HHV8 (Kaposis sarcoma), lymphoid intersititial pneumonitis
in patient who is HIV +ve and cough, fever, night sweats, weight loss what is it until proven otherwise
TB
first line treatment TB
isoniazid, pyrazinamide, rifampicin, ethambutol
treatment CMV retinitis
ganciclovir containing intra ocular implants
CNS complications
acute- transient menongoencaphelitis, myelopathy, neuropathy. chronic- dementia, encephalopathy
treatment pneumocystis jiroveci
co trimoxazole
diagnosis pneumocystis jiroveci
sputum or bronchoscopy and bronchoalveolar lavage
primary prophylaxis pneumocystis jiroveci
if CD4
other pathogens affecting lungs in HIV
M avium intracellulare, CMV,HHV8 (Kaposis sarcoma), lymphoid intersititial pneumonitis
gut complications
candidiasis, HSV, aphthous ulcers, tumous, oesophageal dysphagia and retrosternal discomfort, anorexia, incr LFTs, hepatosplenomegaly, chronic diarrhoea, perianal disease, Kaposis sarcoma, lymphoma
eye complications
CMV retinitis- fundoscopy- mozzarella pizza signs
PEP
Truvada tab, 2 Kaleta tabs
CNS complications
acute- transient menongoencaphelitis, myelopathy, neuropathy. chronic- dementia, encephalopathy
indications for beginning antiretroviral therapy
CD4 200; pregnant women; if co infected with hep B and having treatment for hep B
treatment toxoplasmosis
pyrimethamine
benefits of earlier anti retrovirals
preservation immune function, prolonged survival, fewer adverse events, decreased transmission
when should you start PEP
48-72hours after
how long should PEP be given
28 days (4 weeks)
follow up with PEP
12 and 24 weeks
PEP
Truvada tab, 2 Kaleta tabs
typical regimen for HIV1
efavirenz with 2 NRTIs- lamivudine and tenofovir disoproxil fumarate
indications for beginning antiretroviral therapy
CD4 200; pregnant women; if co infected with hep B and having treatment for hep B
potential risks of earlier anti retrovirals
drug toxicity, drug resistance, exhaustion of drug options
benefits of earlier anti retrovirals
preservation immune function, prolonged survival, fewer adverse events, decreased transmission
which virus is responsible for most HIV infections
HIV1
what are the main classes of antiretrovirals
NRTIs (nucleoside reverse transcriptase inhibitor), PIs (protease inhibitor), NNRTIs (non nucleoside reverse transcriptase inhibitors)
what can is HAART and what can it cause
highly active antiretroviral therapy- renal failure and insulin resistance
what can PIs and NNRTIs interact with
drugs metabolised by cytochrome p450
typical regimen for HIV1
efavirenz with 2 NRTIs- lamivudine and tenofovir disoproxil fumarate
example of NRTI
tenofevir, lamivudine, zidovudine
example PI
lopinavir
example NNRTI
efavirenz
