HIV

Question 1

What dies HIV stand for?

Answer 1

Human Immunodeficiency Virus

Question 2

What is the incidence of HIV?

Answer 2

5million/yr

255 asymptomatic

Question 3

What are the 3 most common routes of spread of HIV?

Answer 3

Sexual transmission - Vagan and anally
IVDU
Vertical transmission

Question 4

What is the transmission of HIV compared to Hep C and Hep B

Answer 4

1/300
1/30
1/3

Question 5

What re the 2 types of HIV?

Answer 5

HIV 1 = most common in europe

HIV 2 = longer latency period

Question 6

Describe the Pathophysiology of HIV?

Answer 6

HIV binds to the CD4+ T helper cells, migrates to the lymphoid tissue and reproduces here creating new VIRONS, this causes the decrease in the CD4+ count and increase in viral load

Question 7

What is the ethical consideration of HIV, can someone who is unconscious be tested for it?

Answer 7

Yes, is it is in the best interest of the patient

Question 8

What type of organism is HIV?

Answer 8

RNA retrovirus

Question 9

What is the the CD4 count in the following groups of people?
Normal
HIV
AIDS

Answer 9

Over 500
Less than 350
Less than 200

Question 10

What are the 2 stages of HIV?

Answer 10

Seroconversion

Asymptomatic Infectin

Question 11

What are the symptoms of a seroconversion disease?

Answer 11

2-6weeks post exposure
General symtoms such as:
Flu, fever, malaise, lethargy, pharyngitis, lymphadenopathy and rash

Question 12

Describe the asymptomatic infection stage

Answer 12

This can last for years with no symptoms other than lymphadenopathy
Other symptoms can include night sweats, diarrhoea, weight loss, minor opportunistic infections

Question 13

What are the 4 stages of HIV - describe each

Answer 13

1 = asymptomatic and lymphadenopathy 
2 = Weight loss of less than 10%, mucotaneuous manifestations, HSVm recurrent URTI
3 = weight loss over 10%, unexplained chronic diarrhoea, fever, oral thrush, leukoplakia, TB, or other severe infections 
4 = CMV, HSV, Toxoplasmosis, candida of the lungs or trachea, septicaemia

Question 14

What are the 2 key diagnostic tests for HIV?

Answer 14

Serum HIV test - Serum or salivary HIV-Ab eg OraQuick

CD4 count

Question 15

What investigations should you consider for someone with stage 4 HIV?

Answer 15

TB test, syphillis tests, Hep B/C test and CXR

Question 16

What are the monitoring investigations for HIV?

Answer 16

HIV RNA Levels - predictor of progression to aids
CD4 count
Viral load

Question 17

What are the 2 prophylaxis options for HIV?

Answer 17

Pre-exposure propylaxis = PrEP

PERSE = post-exposure prophylaxis for sexual exposure

Question 18

What is the 1st line treatment for a patient with HIV?

Answer 18

HAART =Highly Active Anti -retroviral Therapy -
2 NRTI(nucleoside analogue reverse transcriptase inhibitors PLUS
Wither a PROTEASE INHIBITOR or
NNRTI - Non-nucleipside reveries transcriptase inhibitor

Question 19

What is the main side effect of HAART?

Answer 19

LIPODYSTROPHY
Also neuropathy
anaemia
Marrow toxicity

Question 20

What are the indications for HAART?

Answer 20

When CD4 <350 or Rapidly falling

Question 21

How long does it take for the levels to become undetectable with HAART?

Answer 21

4 months

Question 22

Give 2 examples of NRTI

Answer 22

ZIDOVUDINE

LAMIVUDINE

Question 23

Give 1 example of NNRTI’s

Answer 23

EFARVIRINEZ

Question 24

What is AIDS defined as?

Answer 24

CD4 count under 200, with stage 4 HIV

Question 25

What malignancy is associated with HIV?

Answer 25

Kaposi’s sarcoma