HIV

Question 1

what are the 2 main types of HIV virus

Answer 1

HIV1 and HIV2

Question 2

what is more virulent HIV1 or HIV2

Answer 2

HIV1

Question 3

what is CD4

Answer 3

a glycoprotein found on the surface of T helper lymphocytes, dendritic cells, macrophages and microglial cells

Question 4

what are CD4 Th lymphocytes needed for

Answer 4

induction of adaptive immune response 
recognition of MHC2 antigen-presenting cell 
activation of B cells 
Activation of cytotoxic T cells (CD8)
cytokine release

Question 5

what is the normal range for CD4

Answer 5

500-1600

Question 6

what in the range increases the risk of opportunistic infections

Answer 6

<200 cells/mm3

Question 7

how does the HIV virus replicate

Answer 7

rapid replication in very early and v late infection

Question 8

how does the infection spread

Answer 8

infection of mucosal CD4 cell (Langerhans and Dendritic cells)
Transport to regional lymph nodes
infection established within 3 days of entry
dissemination of virus

Question 9

what are the presenting features of primary HIV infection

Answer 9

fever, rash (maculopapular), myalgia, pharyngitis, headache/aseptic meningitis)

Question 10

what is the phase after primary infection

Answer 10

asymptomatic infection

Question 11

what are the signs and symptoms of PCP

Answer 11

insidious onset, SOB, dry cough, exercise desaturation

CXR-may be normal interstitial infiltrates, reticulonodualr markings

Question 12

how do you treat PCP

Answer 12

high dose co-trimoxazole

Question 13

what is the CD4 threshold for cerebral toxoplasmosis

Answer 13

<150

Question 14

what is cerebral toxoplasmosis caused by

Answer 14

reactivation of latent infection, multiple cerebral abscess

Question 15

what is the CD4 threshold for CMV

Answer 15

<50

Question 16

how is CMV caused

Answer 16

reactivation of latent infection, so should get ophthalmic screening for individuals CD4<50, reduced visual acuity, floaters, abdo pain, diarrhoea, PR bleeding

Question 17

how can HIV1 affect memory

Answer 17

reduced short term memory +/- motor dysfunction

Question 18

what is the CD4 threshold for PML

Answer 18

<100

Question 19

how does PML present

Answer 19

rapidly progressing, focal neurology, confusion, personality change

Question 20

can you get cachaexia with HIV

Answer 20

yes ‘Slim’s Disease’

Question 21

describe Kaposis sarcoma

Answer 21

Human Herpes Virus 8, vascular tumour, treatment with HAART, local therapies and systemic chemotherapy

Question 22

what cancers can HIV predispose to

Answer 22

non-Hodgkins lymphoma