HIV

Question 1

What was the term first used to describe AIDS?

Answer 1

Gay-related Immune Deficiency

Question 2

What is the overall trend in new infections across the global population?

Answer 2

Decreasing

Question 3

List the transmission routes of HIV

Answer 3

Sexual intercourse
Vertical transmission
Sharing needles
Needlestick injury
Blood transfusion
Organ transplant

Question 4

What does HIV virus attach to?

Answer 4

Cells with CD4, resulting in reduced CD4+ T cells

Question 5

What category of virus is HIV?

Answer 5

A lentivirus (type of retrovirus)

Question 6

What is the envelope protein that mutates in HIV, and therefore limits effective vaccine production?

Answer 6

GP120

Question 7

What are the chemokine receptors essential for entry of HIV into CD4+ cells?

Answer 7

CCR5 or CXCR4

Question 8

What is the window period?

Answer 8

The time during which markers of infection are not detectable

Question 9

What are some tests for HIV?

Answer 9

Antibody
Antigen
Then:
Viral Load
CD4 Count
Typing
Avidity 
Tropism
Resistance tests
Drug levels

Question 10

What is the current window period for antibody/antigen testing using 4th gen ELISA?

Answer 10

1 month

Question 11

What is viral load measuring (PCR) used for?

Answer 11

Monitor effectiveness of HIV treatment

Diagnosis in presence of maternal antibody

Question 12

What is HIV Resistance testing used for?

Answer 12

Baseline at diagnosis
Suboptimal treatment response
Treatment failing
Want to change treatment for another reason

Question 13

What is tropism testing used for?

Answer 13

Detect which co-receptor does the virus use to enter CD4 cells, required before using a CCR5 antagonist

Question 14

What happens to CD 4 count with antiretroviral treatment?

Answer 14

It rises

Question 15

What happens to HIV viral load with antiretroviral treatment?

Answer 15

It falls

Question 16

What is the risk of percutaneous exposure of HIV positive blood?

Answer 16

1 in 300 risk (0.3%)

3% for HCV, 30% for HBV

Question 17

What body fluids need to be handled with same precautions as blood?

Answer 17

CSF, 
Pleural, peritoneal, pericardial fluid, 
Breast milk, 
Amniotic fluid, 
Vaginal secretions, semen.
Synovial fluid.
Any fluid containing visible blood.
Unfixed tissues and organs.
Saliva – dental procedures
Exudate/tissue fluid from burns or skin lesions

Question 18

When should PEP be commenced?

Answer 18

Within 72 hours of exposure (continued for 28 days)

Question 19

Who should PrEP be offered to?

Answer 19

High-risk patients (MSMs, sex-workers, partner of HIV positive patient)