HIV Flashcards
MCC of HIV disease
HIV1
2 major envelope proteins of HIV
gp120
gp41
Hallmark of RNA virus
Reverse transcription of genomic RNA to DNA by reverse transcriptase
Replication cycle of HIV
gp120 > CD4 > CCR5, CXR4 > fusion with gp41 > reverse transcription
Responsible for most HIV infections in the world
HIV1 Group M
MC mode of HIV transmission
Heterosexual transmission
Chief predictor of heterosexual transmission
Level of plasma viremia
ARV of choice in the perinatal period
Zidovudine by 2nd trimester of pregnancy through delivery + infant for 6 weeks after birth
Hallmark of HIV disease
Profound immunodeficiency due to progressive quantitative and qualitative deficiency of T helper cells
(chronic persistent infection)
Primary cellular receptor for HIV
CD4
Major factor in the establishment of a chronic and persistent infection
Dissemination of virus to lymphoid organs, particularly the GALT
CD4 count patient becomes highly susceptible to opportunistic disease
<200 (AIDS defining)
esp P jiroveci
<50 MAC, CMV, Toxo
Major anatomic sites for the establishment and propagation of HIV infection
Lymphoid tissues
level of plasma viremia directly reflects virus production in lymphoid tssue
Autoimmune-like phenomenon manifesting as paradoxical deterioration of clinical condition usually compartmentalized to a particular organ system seen after initiation of ARV
Immune Reconstitution Inflammatory Syndrome (IRIS)
commonly seen in MTB and cryptococcosis
Cytokines indcers of HIV
TNF a
IL 1B
IL 6
Cytokines that suppress HIV
IFN a and B
Standard blood SCREENING test
ELISA
CONFIRMATORY test
Western blot
Positive Western Blot
(+) antibodies to 2 of 3: p24, gp41, gp 120/160
MC patterns of cross-reactivity
Antibodies that react with p24 and/or p55
If indeterminate for western blot
Repeat 4-6 weeks and do
p24 antigen capture assay
or HIV1 RNA
or HIV1 DNA PCR + serologic HIV2
Gold standard for diagnosis of HIV
positive EIA + confirmatory Western blot
Best indicator of the immediate state of immunologic competence of the patient and ith HIV infection
CD4 T cell counts
CD4 count for initiation of ARV
<350
Guideline for initiating therapy based on HIV RNA
> 100,000 copies
Goal <50 copies
First CCR5 antagonist
Maraviroc
MC manifestation of pulmonary disease in HIV
Pneumonia
MC clinically significant cardiac finding in HIV
Dilated CMP with CHF
Hallmark of HIVAN
proteinuria
Renal biopsy finding in HIVAN
FSGS
MC hematologic abnormality in HIV
Anemia
Persistent generalized lymphadenopathy (PGL)
LN >1cm >2 extrainguinal sites >3mos
Leading infectious cause if meningitis with AIDS
C.neoformans
CD4 <100
MC peripheral neuropathy
Distal sensory polyneuropathy
MC abnormal finding on fundoscopy
Cotton-wool spots
