HIV Flashcards
TRUE/FALSE even with treatment LE is significantly decreased
FALSE- Can have normal LE (may actually be longer due to increased contact with the NHS)
What diseases can be described as a preventable retrovirus?
HIV
What does retrovirus mean?
When the RNA is transcribed the reverse transcriptase enzyme is used
What is the end result of HIV
AIDS, causes death
Which strain of HIV is responsible for the global pandemic
HIV-1
What strain of HIV originated in west Africa, is less virulent and less common?
HIV-2
What is the target site of r HIV (via gp120)
CD4+ receptors
Name 4 cells that CD4+ glycoproteins are found on
T helper cells
Dendritic cells
Macrophages
Microglial cells
What 3 effects does HIV infection have on immune response?
Sequestration of cells in lymphoid tissues
Reduced proliferation of CD4+ cells
Reduced CD8+ T cell activation
At what level CD4+ in the body is there risk of opportunistic infections?
<200 cells/mm3
With HIV viral replication- how often is there a new generation?
Every 6-12 hours
Without treatment average time to death is ………
10 years
How long after entry is infection established
3 days (therefore 3 days to establish prophylaxis)
How long is the average onset after infection
2-4 weeks
How might HIV present
Fever Rash (maculopapular) Myalgia Pharyngitis Headache
Pneumocystis Pneumonia (fungal infection of the lungs) is caused by
Pneumocystis jiroveci
What is the most common opportunistic infection in HIV/AIDS
Pneumocystis pneumonia
Diagnosis in Pneumocystis Pneumonia is by?
BAL and immunofluorescence +- PCR
Treatment for Pneumocystis Pneumonia
High dose Co-Trimoxazole (+- steroid)
Prophylaxis: Low dose co-trimoxazole
What is cerebral toxoplasmosis caused by
Toxoplasma gondii (from cats)
In order to get CMV the CD4 count has to be
<50
What is the preventative treatment for CMV?
Ophthalmic screening for all individuals with CD4+ <50
HIV associated neurocognitive impairment has increasing incidence with
increasing Immunosupression
The opportunistic infection progressive multifocal leukoencephalopathy can look like which other disease?
MS
What are 3 AIDS related cancers?
Kaposi’s sarcoma
Non-Hodgkin’s lymphoma
Cervical cancer
What causes Non-Hodgkin’s lymphoma?
EBV
TRUE/FALSE
HIV itself is neurotoxic, multiple presentations are due to this in addition to the immunocompromised
TRUE
Why do people with HIV tend to lose wt?
Chronic immune activation wastes energy
DDx for mucosal candidiasis
Inhalers
Diabetes
HIV
Skin lesions that may occur with HIV inc
Opportunistic - Herpes Zoster - Herpes Simplex -HPV Non Opportunistic -Seborrheic dermatitis
Psoriasis may get worse if someone has HIV, why is this?
It is a CD8 mediated disuse, therefore will get worse
What condition may get better if someone is diagnosed with HIV?
RA (as it is a CD4+ medicated disease)
What is the cause of 95% of the HIV transmission?
Sexually transmitted
What are the high- risk groups for HIV
- MSM
- F partners of bisexual men
- People who inject drugs
- Partner of people living with HIV
- People from endemic areas (Sub-saharan Africa, Caribbean, Thailand)
Who are the most likely group to be transmitting HIV?
Undiagnosed ( most likely Hetrosexual men)
HIV life expectancy is – years lower in those diagnosed late as compared to those who are receiving prompt treatment
10 years
When testing for HIV what is the antibodies that you are testing fro?
HIV1 and HIV2 antibodies
When testing for HIV what is the antigen that you are testing for?
p24
How many weeks into the infection do the IgM antibodies peak?
1-2 weeks
IgG in contrast to IgM antibodies ……
increase slowly over several months, maintained during chronic infection
What is the rapid HIV test?
POCT
Fingerprick specimen or saliva
What can the recent infection testing algorithm be used for?
Can be used to identify is an infection occurred within the preceding 4-6 months
What does RITA measure?
HIV-1 antibody
What is HAART?
A combination of 3 drugs from at least 2 drug classes to which the virus is susceptible
What are the 3 purposes of therapy in HIV
- Reduce the viral load
- Restore Immunocomprimise
- Minimise Toxicity
DRUG-DRUG INTERACTIONS. Be aware that protease inhibitors and NNRTIs are generally….
potent liver enzyme inhibitors
With HIV there is no risk by casual/household contact but what should not be shared?
Razors/toothbrushes
In HIV patients when is a c-section delivery preferred?
If the viral load is detected (Can have vaginal delivery if the viral load is undetected)
What is PrEP?
A way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day
What is contained within the PrEP pill?
Tenofovir
Emtricitabine
What is PEPSE?
Post exposure prophylaxis after sexual exposure to HIV
to reduce the risk of infection
