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GOSH > HIV > Flashcards

HIV Flashcards

1
Q

What is HIV

A

Blood-borne virus
Human immunodeficiency virus
Life-long
Effective treatment but no cure

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2
Q

How is HIV treated?

A

HAART
Highly active anti-retroviral therapy
Uses at least 3 anti-HIV drugs from at least 2 different drug categories

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3
Q

How is HIV monitored?

A

Plasma HIV viral load

CD4 cell count

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4
Q

Why is it important for a person with HIV to take there full medications regularly?

A

The ability of HIV to mutate & reproduce itself in the presence of ARV drugs – HIV drug resistance. Anything that lowers ARV drug concn allows the virus to replicate with low drug levels can lead to drug resistance.

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5
Q

What are the risk factors for HIV?

A 
Sharing needles
STIs
Sexual intercourse with an affected individual (esp receptive anal sex)
Sex without a condom
Multiple sexual partners
Risk taking behaviour
High viral load in a known HIV positive
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6
Q

Who should be offered a HIV screen?

A

All pts diagnosed with an STI
All sexual partners of a HIV +ve pt
All patients presenting where HIV is a differential
All male-male sex
All female contacts of those who have male-male sex
IVDUs
All M&F who have sex abroad in a country with a high prevalence
Blood donors
Dialysis pts
Organ donors & recipients

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7
Q

How often can people be tested for HIV?

A

-ve test with possible exposure has occurred within the window period should be retested
Male-male intercourse annually/frequently with ongoing high-risk exposure
IVDUs annually/frequently
Antenatal care: Refuse reoffer at 36week

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8
Q

What clinical oral syndromes would give a differential of HIV?

A 
Candida/thrush
Kaposi's sarcoma
Gingivitis
Aphthous ulcers
Oral hairy leukoplakia
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9
Q

What clinical dermatology syndromes would give a differential of HIV?

A 
Acne/Psoriasis diagnosed at an old age
Impetigo
Itchy folliculitis
Fungal infections
Seborrhoea dermatitis
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10
Q

What infections would give a differential of HIV?

A 
Recurring HSV
Recurrent HZV/chicken pox
Crusted scabies
Severe viral warts
Molluscum contagiosum on the face & large
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11
Q

What clinical respiratory syndromes would give a differential of HIV?

A

Atypical pneumonia
TB
Recurrent bacterial pneumonia

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12
Q

What clinical GI syndromes would give a differential of HIV?

A

Oesophageal candida

Chronic diarrhoea

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13
Q

What clinical haematological syndromes would give a differential of HIV?

A

Lymphoma
Lymphopenia
Thrombocytopenia

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14
Q

What methods can be used to test for HIV?

A
  • Blood assay: First line, tests for Abx (4-8weeks) & p24 antigen (2-4weeks)
  • Rapid point of care test: Fingerpick, 30secs-20mins, not as specific/sensitive as blood test, all +ve results confirmed by serology
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15
Q

How is a diagnosis of HIV confirmed?

A

Confirmatory assays & 2nd sample testing

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16
Q

What are the patient barriers to testing for HIV?

A 
Ignorance
Denial
Stigma
Fear
Access
Needle phobia
Confidentiality
17
Q

What are the HCP barriers to testing for HIV?

A 
Stigma
Fear of causing offence
Compartmentalisation
'Not my job'
Historically a protected skill
18
Q

How is HIV transmission prevented?

A 
Condoms
Abstinence
Needle exchange programs
Circumcision
Anti-retroviral therapy
PREP
19
Q

What is PREP?

A

Pre-exposure prophylaxis
2drugs combined
Taken before sex
Highly effective (86%)

20
Q

What is PEP?

A

Post-exposure prophylaxis
PEPSE following sexual exposure
Taken within 72hours (unprotected sex or condom failure)

21
Q

Why is there a 72hour window for PEP?

A

HIV may take 48-72hours to become established in the body after exposure therefore works best the earlier it is given

22
Q

What is the main role of anti-retrovirals?

A

Anti-retrovirals prevent virus multiplying & entering host cells

23
Q

How is mother-child transmission of HIV prevented?

A

HAART to mother to suppress viral load
Avoid breastfeeding
Consider mode of delivery
Neonate post-exposure prophylaxis for 4weeks

24
Q

What is HAART made up of?

A

-2 nucleoside reverse transcriptase inhibitors
EITHER:
- Non-nucleoside reverse transcriptase inhibitor
- Boosted protease inhibitor
- Integrase inhibitor

25
Q

What are the SE of each drug class found in HAART?

A
  • NRTI: Lactic acidosis, lipodystrophy, hyperL
  • nNRTI: Neuropsych, rash, liver toxicity, abnormal lipids
  • PI: GI intolerance, glucose & lipid abnormalities
26
Q

What are the complications of HIV?

A
  • Acute seroconversion
  • AIDS
  • HIV associated hypotestosteronism
  • Immune suppression
  • HIV related opportunistic infections
27
Q

What are the symptoms of HIV?

A
  • Fever & night sweats
  • Weight loss
  • Skin rashes & post-inflammatory scars
  • Oral ulcers/thrush
  • Diarrhoea >1month unexplained
  • Changes in mental status
  • TB
  • Lymphadenopathy
28
Q

What are the main types of PEP?

A

Truvada once daily

Raltegravir BD 12hours apart

GOSH (17 decks)

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