HIV Flashcards
Story? HIV
Patient in their 40s Dry cough and fever for 3 weeks Sore mouth - oral candidiasis Lesions on skin - kaposi's sarcoma Noticeable weight loss Deterioration in breathing Athlete food
Why would a patient with HIV have athlete’s foot and oral candidiasis?
Low immune system - more susceptible to fungi infections.
What are some late and early complications of HIV?
Early: Candida, herpes
Late: TB, PCP, Lymphoma
Viral structure of HIV?
Protective capsid shell Rod or spherical Enveloped SsRNA Viral specific antigens
What receptors does the free HIV virus bind to?
CD4+ and 2 co receptors
Once inside the cell - how the HIV virus integrate itself?
RNA to DNA reverse transcriptase via reverse transcriptase enzyme
Integrase enzyme bind viral DNA into genome
Is transcribed and proteins are made
Virus ‘buds’ off and circulates in the blood as a working virus
Transmission? HIV
Sexual contact
Transfusion
Contaminated needles
Perinatal - 25% chance of passing on
HIV Stage 1 -4 after first infected. Give level of CD4+, how infectious and how unwell the patient is.
Stage 1 - infected - high CD4+ count- very infectious and acutely unwell
Stage 2 - high CD4+, asymptomatic
Stage 3 - lower CD4+, unwell e.g. Skin infections
Stage 4 - V low CD4+ (all infected) - AIDS
Investigations? HIV
Serology - detects Ag antibody and antigen - 4 weeks
PCR - detects HIV nucleic acid
Rapid test - finger prick - low cost - good in communities - but needs conformation
Name 4 targets for anti-retroviral HIV drugs.
Inhibit maturation
Stop CH4+ binding
Inhibit reverse transcriptase
Inhibit integration
What combination of treatment is usually offered to HIV pos patients?
A nucleoside reverse transcriptase inhibitor (NNRTI)
PLUS
A Non - NNRTI or a protease inhibitor
What is offered to partners of HIV patients?
PEP and PrEP - precaution if unprotected sex
Condoms
