HIV Flashcards

1
Q

What are the two types of HIV?

A

HIV 1
HIV 2

HIV 1 is much more common

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2
Q

What cells do HIV target?

A

Cells that express CD4 - Dendritis cells, macrophages, T helper cells

The CD4 marker helps immune cells communicate

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3
Q

What type of virus in HIV?

A

Singles stranded RNA retrovirus

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4
Q

When does the actue seroconversion illness occur in HIV?

A

Transient illnes 2 - 6 weeks after infection and presents with flu like symptoms.

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5
Q

what are the stages of HIV infection?

A
  1. Acute infection
  2. Serconversion
  3. Chronic infection (after 12 weeks - 2 - 10 years) which is asymptomatic
  4. Constitutional symptoms
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6
Q

describe what T cell levels are like during HIV?

A
  1. Initially low then rise then slowly declines

This is in contrast to the viral levels which are initially very high and then drop and then slowly rise

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7
Q

When do symptoms start occuring in chronic HIV?

A
When T cells are 200 - 500
1. Swollen lymph nodes
2. Hairy leukoplakia 
3. Oral candida
Below 200 T cells (AIDS)
1. fever, fatique
2. Recurrent pneumonia
3. PCP
4. Fungal infections
5. Tumours
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8
Q

What are AIDs defining conditions?

A
Conditions that only occur when the T cells fall below 200 
- recurrent pneumonia 
- PCP
Fungal infections
Kaposi sarcoma 
Brain lymphoma 
PCP, CMV become fatal
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9
Q

What is the best first line screening test for HIV?

A

Combined HIV antibody and p24 antigen test (test for HIV 1, HIV 2 and HIV p24 antigen)

Should be done 4 weeks after exposure but if negative should also be done at 12 weeks to confirm negative result

If positive test should be repeated to confrim.

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10
Q

When after exposure is HIV testing done?

A
  1. 4 weeks after exposure

2. If the exposure was longer than 4 weeks ago test at 4 and 12 weeks.

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11
Q

What do rapid HIV tests look for?

A

HIV antibodies

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12
Q

what are the different classes of HIV drugs?

A

Entry inhibitors
Nucleoside reverse transcriptase inhibitors
Non nucleoside reverse transcriptase inhibitors
Integrase inhibitors

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13
Q

What is pneuomcystis jiroveci?

A

Fungal infection that causes pneumonia in people who are immunosuppressed such as in aids.

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14
Q

How is pneuomcystis jiroveci treated?

A

High dose co trimoxazole

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15
Q

How is the prophylaxis regime for pneuomcystis jiroveci?

A

Co trimoxazole if Cd4 count is below 200

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16
Q

how do you treat oral candida?

A

Nystatin

17
Q

How do you treat oesphageal candida?

A

fluconazole

Itraconozole

18
Q

What is the main inbfection that affects the CNS in HIV

A

Toxoplasmosis

19
Q

What is the treatment for prophylaxis of TB?

A

Isoniazid + Pyroxidine

20
Q

What is the treatment for crptococcal meningitis?

A

Amphoterecin

21
Q

When is post exposure prophylaxis started?

A

Within 72 hours of exposure. Follow up testing done at 12 and 24 weeks

22
Q

What does PCP pneumonia look like on a chest X Ray?

A

Ground glass appearance

23
Q

What is the risk of transmision of HIV to a healthcare worker after a needle stick injury from an HIV positive patient?

A

0.3%

24
Q

If a HIV +ve person with poor compliance has multiple ring enhancing lesions on CT what is the most likely diagnosis?

A

Toxoplasmosis

25
Q

What can cause neurological disease in HIV?

A
  1. Toxoplasmosis
  2. Primary CNS lymphoma
  3. Cryptococcus
  4. Progressive multifocal leukoencephalopathy
  5. AIDS dementia
26
Q

What is progressive multifocal leukoencephalopathy?

A

Widespread demyelination which is due to infection of oligodendrocytes by the JC virus. Presents with subacute changes in behavious, speech, motor and visual function.
CT shows single or multiple lesions with no mass effect which don’t usually enchance. MRI is the best imaging to see lesions.

27
Q

What is the advice regarding HIV in pregnancy?

A
  1. Maternal antiretrovirals
  2. C section if viral load more than 50/ml at 36 weeks
  3. Neonatal antiretrovirals (ziduvodine)
  4. Bottle feeding