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4th Year > HIV > Flashcards

HIV Flashcards

1
Q

What receptor does HIV use to enter immune cells?

A

CD4

T-helper cells

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2
Q

What is the course of HIV?

A 
Infection
Seroconversion
Asymptomatic
HIV-related illness
AIDS
Death
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3
Q

Which group has the highest prevalence of HIV?

A

MSM

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4
Q

What are the risk factors for HIV? (5)

A 
MSM
Unprotected sex
High-Prevalence areas eg. sub-Saharan Africa
IVDU
CSW
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5
Q

When does seroconversion occur?

A

About 2-6 weeks post-exposure

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6
Q

What are the features of seroconversion?

A

Similar to glandular fever eg. sore throat, LNs, fever, malaise
Maculopapular rash
Mouth/penile ulcers

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7
Q

What often co-exists with Primary HIV?

A

Early syphilis

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8
Q

What are 3 AIDS-related malignancies?

A

Kaposis sarcoma
Non-Hodgkin Lymphoma
Invasive cervical cancer

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9
Q

What are some non-AIDS-related malignancies?

A 
Hodgkins Lymphoma
Anal cancer
Hepatocellular carcinoma
ENT cancers
Lung cancer
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10
Q

Which cancer requires everyone to be HIV tested?

A

Non-Hodgkin Lymphoma

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11
Q

What are the two tests for HIV?

A

HIV antibodies

p-24

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12
Q

When are HIV antibodies detectable?

A

4-8 weeks

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13
Q

When are p-24 antigens detectable?

A

2-4 weeks

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14
Q

What is the recommended test for HIV?

A

Combination of both HIV antibodies and p-24

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15
Q

When will the majority of individuals with HIV be detectable?

A

4 weeks post-exposure

Negative result is highly likely to exclude HIV

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16
Q

When should a repeat test at 8 weeks be done?

A

If there is a high-risk infection event

17
Q

What is a rapid POC test?

A

Quick test, takes 30sec to 20mins

All positive tests confirmed with additional tests

18
Q

Who gets tested?

A

Everyone during STI screen

Pregnancy booking visits

19
Q

What is pre-exopsure prophylaxis (PREP)?

A

Truvada (2 drugs)
Prevents 86% infections
Can be taken daily or before sex

20
Q

What is post-exposure prophylaxis (PEPSE)?

A

Prevents the virus multiplying and entering host cells

Taken within 72hrs of exposure - earlier the better

21
Q

Who gets PEPSE?

A

Anyone who has had unprotected sex with a high-risk individual in the last 72hrs
Needle stick injuries

22
Q

How is mother-child transmission of HIV prevented?

A

Suppress viral load with HAART
Can have vaginal birth in viral load is suppressed
Neonatal PEP for 4 weeks
Avoid breast feeding unless mother wants

23
Q

What are some other factors that may reduce the risk of exposure?

A

Condoms

Needles exchange

24
Q

What does HAART stand for?

A

Highly Active Anti-Retroviral Therapy

25
Q

What is HAART?

A

3 anti-HIV drugs from 2 different classes

3 drugs in 1 pill

26
Q

What is the typical drugs combination for HAART?

A

2x nucleotide/side reverse transcriptase inhibitors +

One of non-nucleotide reverse transcriptase inhibitor OR boosted protease inhibitor

27
Q

When is HAART offered?

A

CD4 <350

Pregnancy, regardless of CD count

28
Q

When should HAART be considered?

A

CD4 350-500 with other feature:

  • Hep B/C infection
  • Low %age CD4 cells vs CD8 cells
  • High risk of CVD
29
Q

When is viral load said to be undetectable?

A

VL <50

30
Q

What are the side effects of HAART?

A

Hypersensitivity
Anaemia
Liver/kidney toxicity
Pancreatitis

31
Q

What is important about Ritonavir and Cobicistate?

A

CYP3A4 inhibitor -> interacts with statins and steroids

Can cause iatrogenic Cushing’s

32
Q

What is important about Rilpvirine and Atazanavir?

A

PPIs are contraindicated

33
Q

Why must viral load be continually monitored?

A

HIV can mutate and develop resistance to ARVs

34
Q

What are the future targets for HIV therapy by 2020?

A

90% know their status
90% on sustainable ART
90% on treatment have durable suppression

4th Year (15 decks)

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