HIV Flashcards
What type of virus is HIV?
A retrovirus
What does HIV target?
CD4+ receptor sites
What cells carry CD4+ receptors?
T helper lymphocytes
Dendritic cells
Macrophages
Microglial cells
What effects does HIV have on the immune response?
Sequestration of cells in lymphoid tissues - reduces circulating CD4+ cells. Reduced proliferation of CD4+ cells. Reduced CD8+ T cell activation. Reduction in antibody class switching . Chronic immune activation .
What does chronic immune activation make you more susceptible to?
Viral infections
Fungal infections
Mycobacterial infections
Infection-induced cancers
How long after entry is infection established?
3 days
Roughly when does primary HIV infection present?
2-4 weeks after infection
Presentation of primary HIV infection?
Fever Rash - maculopapular Myalgia Pharyngitis Headache/ aseptic meningitis
Conditions related to HIV?
Pneumocystis pneumonia (pneumocystis jiroveci) TB cerebral toxoplasmosis Cytomegalovirus Skin infections Associated neurocognitive impairment
Presentation of pneumocystis pneumonia?
SOB
Dry cough
Exercise desaturation
Intestinal infiltrates and reticulonodular markings (CXR)
Treatment of pneumocystis pneumonia ?
High dose co-trimoxazole
What TBs are more common with HIV?
Symptomatic primary infections Re activation of latent TB Lymphadenopathies Miliary TB Extrapulmonary TB Multi-drug resistant TB Immune reconstitution syndrome
What is cerebral toxoplasmosis caused by?
Toxoplasma Gondii
Symptoms and signs of cerebral toxoplasmosis?
Headache Fever Focal neurology Seizures Reduced consciousness Increased ICP
Causes of cytomegalovirus?
Retinitis
Colitis
Oesophagitis
Presentation of cytomegalovirus?
Decreased visual acuity Floaters Abdo pain Diarrhoea PR bleeding
What gets offered to any individual with CD4 <50?
Ophthalmic screening
Skin infections associated with HIV?
Herpes zoster Herpes simplex HPV Penicilliosis Histoplasmosis
What HIV causes HIV associated neurocognitive impairment?
HIV 1
Presentation of HIV associated neurocognitive impairment?
Declining short term memory +/- motor dysfunction
What is HIV associated wasting called?
Slims disease
Cancers related to AIDS?
Kaposis sarcoma
Non-hodgkins lymphoma
Cervical cancer
What causes kaposis sarcoma?
Human herpes virus 8 (HHV8)
What is kaposis sarcoma and how does it present?
It is a vascular tumour
Cutaneous, mucosal, visceral-pulmonary, GI
Treatment of kaposis sarcoma?
HAART
Local therapies
Systemic chemo
Haem manifestations due to HIV and drugs etc
Anaemia
Thrombocytopenia
HIV transmission?
Sexual
Parenteral - IVDU, infected blood products, iatrogenic
Mother to child - in utero/ transplacental, delivery, breast feeding
Where is HIV most prevalent ?
Sub-Saharan Africa
Caribbean
South East Asia
What group of people are most at risk of HIV?
MSM
What different things can be detected for HIV in the lab?
Viral RNA
Antibody
Antigen (p24)
What does the antibody test for 3rd generation detect?
IgM and IgG - HIV 1 and 2 antibodies
What does the antibody test for 4th generation detect?
Combined antibody and antigen (p24)
HIV treatment?
Highly active Antiretroviral therapy (HAART)
What is involved in HAART?
3 drugs, from at least 2 drug classes
How do you prevent mother to child transmission?
HAART during pregnancy
Vaginal delivery If undetected viral load - caesarean if detected viral load
4/52 PeP for neonate
Exclusive formula feeding
HAART aside effects?
GI rash, hypersensitivity, Stevens-Johnson syndrome Mood, psychosis Proximal renal tubulopathies Osteomalacia Increased MI risk Anaemia Transaminitis, fulminant hepatitis
