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HIV Flashcards

1
Q

What is the target site for HIV?

A

CD4+ receptors

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2
Q

What is the function of CD4+ T cells?

A

Recognise the antigen-presenting cell and activate the adaptive immune response

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3
Q

Give some effects of HIV infection on immune response

A

Reduced circulating CD4+ cells
Dysregulated CD8+ cell activation
Reduced antibody class switching

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4
Q

CD4+ T cells should always be above what value?

A

500 cells/mm

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5
Q

At what level of CD4+ T cells is there risk of opportunistic infections?

A

<200 cells/mm

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6
Q

What occurs in the primary infection stage of HIV?

A

Huge amount of virus causes a rapid depletion in CD4 count

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7
Q

After primary infection, why does CD4 count start to rise?

A

As immune cells are produced against HIV

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8
Q

What is the average time to death if not treated for HIV?

A

9-11 years

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9
Q

Give some symptoms seen in primary HIV infection

A 
Fever
Rash
Myalgia
Pharyngitis
Headache
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10
Q

What occurs in asymptomatic HIV infection?

A

Ongoing viral replication causes CD4 to reduce

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11
Q

Give some examples of opportunistic infections seen in HIV

A 
Pneumocystic pneumonia
TB (certain types)
Cerebral toxoplasmosis
CMV
Herpes simplex/zoster
Progressive multifocal leukoencephalopathy
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12
Q

What is the most common opportunistic infection in HIV?

A

Pneumocystis pneumonia

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13
Q

How is pneumocystis pneumonia treated?

A

Co-trimoxazole

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14
Q

Give some signs of cerebral toxoplasmosis

A 
Headache
Fever
Focal neurology
Seizures
Raised ICP
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15
Q

How does CMV present?

A

Reduced visual acuity
Floaters
Abdo pain, diarrhoea and PR bleeding

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16
Q

Which virus causes progressive multifocal leukoencephalopathy?

A

JC virus

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17
Q

Give some examples of AIDS-related cancers

A

Kaposi’s sarcoma
Non-Hodgkins lymphoma
Cervical cancer

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18
Q

How does Kaposi’s sarcoma present?

A

Cutaneous/mucosal vascular tumour

19
Q

Which virus causes non-Hodgkins lymphoma?

A

Epstein-Barr virus

20
Q

Why does cervical cancer commonly occur in AIDS?

A

As there is persistence of HPV infection

21
Q

Give some clinical features seen in “asymptomatic” HIV

A 
Mucosal candidiasis
Seborrhoeic dermatitis
Diarrhoea
Fatigue
Lymphadenopathy
Worsening psoriasis
22
Q

What is the main mode of transmission of HIV?

A

Sex

23
Q

Give some factors which increase transmission risk?

A

Anoreceptive sex
Trauma
Genital ulceration
STI

24
Q

How else may someone acquire HIV?

A

Injection drug use
Infected blood products
Mother-to-child

25
Q

What is the risk of mother to child transmission of HIV in the UK when viral load is undetectable?

A

<0.1%

26
Q

Which population group have the highest % of people living with undiagnosed HIV?

A

Heterosexual men

27
Q

Which population group have the highest proportion of HIV?

A

MSM

28
Q

What markers of HIV are tested for?

A

Viral RNA
Antigen
Antibody

29
Q

How is HIV most commonly tested for?

A

Test for combined antibody-antigen

30
Q

Why is it better to test for combined antibody-antigen rather than antibody?

A

As it shortens the window period where infection may not be detected

31
Q

What test can be used to test for HIV rapidly?

A

POCT

32
Q

Give some targets for anti-retroviral drugs

A

Reverse transcriptase
Integrase
Protease

33
Q

What strategy is used to treat HIV?

A

HAART - highly active anti-retroviral therapy

34
Q

What is HAART?

A

A combination of 3 drugs from at least 2 drug classes to which the virus is susceptible

35
Q

How can a patient prevent drug resistance in HIV?

A

Adherence
Lifestyle changes
Avoiding drug-drug interactions

36
Q

Give some common side effects of HAART therapy

A 
Diarrhoea
Rash
Psychosis
Proximal renal tubulopathy
Osteomalacia
Anaemia
37
Q

What effect does protease inhibitors have on liver enzymes?

A

They inhibit them

38
Q

What effect does NNRTIs have on liver enzymes?

A

They induce them

39
Q

Are HIV patients legally required to notify their partner?

A

No

40
Q

What are the best ways to prevent onward HIV transmission sexually?

A

Condom use
STI screening
Pre/post-exposure prophylaxis

41
Q

An undetectable viral load means the virus is still transmissible. True/false?

A

False - undetectable viral load = untransmissable virus

42
Q

What method of delivery is done if viral load is detected in a pregnant mother?

A

Caesarean section

43
Q

Why are all HIV patients treated even if they are not symptomatic?

A

As it means they cannot transmit the virus

44
Q

Which patients are eligible for pre-exposure prophylaxis?

A

HIV+ partner with detectable viral load

MSM or transwoman that has UPAI >2 partners in last year

Reproduction (33 decks)

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