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Immuno Block Mid Term 2 > HIV > Flashcards

HIV Flashcards

1
Q

3 enzymes HIV must have in packaging

A

reverse transcriptase, integrase and protease

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2
Q

HIV Type in USA

A

HIV-1B

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3
Q

Is incidence of disease going up or down?

A

the incidence is decreasing overall, but increasing in places like china and russia

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4
Q

GP41/120 proteins in HIV

A

outer transmembrane membrane proteins, important for attachment and entry of virus

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5
Q

P24 protein in HIV

A

important for capsid of HIV surrounding nucleus

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6
Q

P17 protein in HIV

A

matrix protein

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7
Q

two interactions for HIV entry into cell?

A

CD4 and chemokines (CCR5 and CXCR5)

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8
Q

CD4 interaction

A

primary interaction, with T cells, macrophages and microglial cells

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9
Q

CCR5 interaction and type of HIV

A

usually in macrophages, called M-tropic HIV (M5 virus)

associated with virus transmission

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10
Q

CXCR4 interaction and type of HIV

A

in T cells and called T-tropic HIV (X4 virus)

associated with disease progression…usually later in infection

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11
Q

binding of Dual mixed virus

A

CXCR4 and CCR5

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12
Q

Steps of reverse transcription

A

make ssDNA, destroy RNA, make dsDNA, integrate

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13
Q

classes of antiretroviral meds

A

reverse transcriptase inhibitors
protease inhibitors
fusion/entry inhibitors
integrase inhibitors

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14
Q

Zidovudine information

A

NRTI

drug for infants

IV

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15
Q

Abacavir information

A

NRTI

serious hypersensitivity…blood test prior

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16
Q

Lamivudine and Emtricitabine information

A

NRTI

treats hep B and HIV

combo with Zidovudine

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17
Q

Tenofovir information

A

NRTI, very common, Hep B and HIV

less toxic

given for HIV PREP

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18
Q

Lopinavir/ritonavir information

A

protease inhibitor

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19
Q

Raltegravir information

A

integrase inhibitor

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20
Q

Maraviroc information

A

unique class that inhibits co receptor…may not always work

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21
Q

two types of prophylaxis with HIV

A

pre (prep) and post exposure (PEP)

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22
Q

common classes in HAART treatment of HIV

A

NRTI, integrase and protease inhibitors

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23
Q

correlation between plasma viral load and CD4 levels?

A

if high plasma HIV load…typically lowering CD4 count

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24
Q

Cells that encounter HIV first

A

langerhans in vagina and foreskin

macrophages, dendritic and NKs in subepithelium

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25
Q

Components of adaptive response to HIV

A

antibodies develop against core antigens
CD8 t cells become activated
CD4 cells activated, but lose these

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26
Q

what happens when HIV virus has tons of mutations?

A

fitness of the host and virus actually decreases so it decreases the likelihood of transmission

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27
Q

What cells have the CCR5 receptors?

A

mainly dendritic, macros, and T cells in GALT, other T cells only about 20-30% have the CCR5

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28
Q

DC sign

A

on dendritic cells…can recognize HIV too

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29
Q

What do APCs do once they have the HIV virus?

A

present to CD4 cells around it and travel to nodes to present

30
Q

acute HIV infection has what effect on mucosal CD4 cells?

A

knocks these out!!!

31
Q

acute HIV infection effect on CD4 cells?

A

causes a large decrease in CD4 cells

32
Q

AIDs effect on CD4 cells?

A

causes large decrease in CD4 cells

33
Q

asymptomatic HIV phase effect on CD4 cells?

A

CD4 cells are actually increasing during this time

34
Q

how do CD4 cells increase during asymptomatic HIV?

A

CD8 cells are activated and killing of virus

35
Q

Viral load changes in acute, asymptomatic phase of HIV and AIDs

A

high in acute, decline and steady in asymptomatic, then increases again in AIDs

36
Q

Acute HIV presentation and onset

A

usually symptomatic with fever sore throat lymphadenopathy and rash

couple weeks after infection

37
Q

What is the best test for early acute phase HIV diagnosis?

A

P24 antigen testing

38
Q

What is the HIV viral set point? and what does it mean for progression of AIDs?

A

it is the viral load of a patient

the higher it is, the more likely for the progression to AIDs

39
Q

Two main adaptive T cells for HIV immune response

A

CD4 HIV specific, need for presentation with APCs and CD8 activation

CD8 HIV specific,

40
Q

3 ways CD8 HIV specific cells can fight HIV

A
  1. lead to lysis of infected cells before virus released
  2. inhibit viral reproduction with IFN-gamma
  3. inhibit viral entry into surrounding cells by blocking CCR5
41
Q

Two main steps in CD4 cell loss in HIV?

A

virus leads to lysis of the CD4 cells….virus prevents replacement of CD4 cells by inhibiting thymus, bone marrow

42
Q

Which leads to AIDS faster, CXCR4 or CCR5 or Dual?

A

dual and CXCR4 lead to AIDs faster because all T cells have the CXCR4 receptor whereas not all T cells have the CCR5 receptor

43
Q

Chronic latency or asymptomatic period of HIV characteristics

A

clinical latency, but no viral latency…the virus is still replicating inside cells and killing some CD4 cells

44
Q

up to date HIV test name

A

4th generation HIV 1/2 immunoassay

tests for HIV Antigen and antibody comobination

45
Q

HIV tests for HIV antibody

A

ELISA and western blot

46
Q

best test for acute inflammation? When to test?

A

avoid latent period of about a week, but after that test for p24 antigen

47
Q

is there an oral rapid HIV test?

A

yea, and actually not a bad test but has concerns

48
Q

what is HIV DNA PCR important for and why?

A

diagnosing infant, and because you cant do the antibody testing in an infant because will have Moms

49
Q

characteristics of Initial T cell response to HAART?

A

rapid increase in T cells, mainly memory cells, so will have forgotten pathogens

50
Q

characteristics of later T cell response to HAART?

A

more naive T cell growth, can develop new T cell repertoires and specificities, unlike initial response

51
Q

IRIS name

A

immune reconstitution inflammatory syndrome

52
Q

IRIS disease progression

A

usually right after HAART treatment was started and as immune system is recovering you have an increased inflammatory response to a pathogen

53
Q

Most common way of perinatal transmission of HIV, a big risk for it, and how to prevent?

A

during delivery

if mother contracts disease during pregnancy

HAART is best way to prevent transmission

54
Q

common clinical signs and symptoms of HIV/AIDS

A

recurrent bacterial and viral infections, thrush, hepatomegaly and splenomegaly, lack of growth, developmental delay, lymphadenopathy, opportunistic infections

autoimmune disease and malignancy

55
Q

Why are herpes simplex virus and Zoster rashes more recurrent in HIV?

A

because the T cells are diminished and they can come back easily

56
Q

infections in individuals with CD4 count over 200?

A

have more true pathogen infections than usual…

57
Q

common true pathogen infections in HIV

A

strep pneumo, M tuberculosis, Herpes simplex, shingles, syphilis, salmonella, staph aureus

58
Q

TB and HIV presentation

A

often an abnormal presentation…nothing in chest X ray, PPD test may be negative because diminished immune response

59
Q

Pneumocystis Jirovecu pneumonia in HIV

A

most common opportunistic AIDS pathogen

shortness of breath and low Oxygen saturation

CD4 count less than 200

60
Q

fungal infections in AIDS patients

A

PJP, candida, and cryptococcus

61
Q

common viral infections with AIDS patients

A

cytomegalovirus, herpes simplex 1/2, human herpes 8, JC virus

62
Q

CMV and AIDS presentation

A

very low CD4 count less than 50, leads to retinitis!!

63
Q

Kaposis Sarcoma and HIV

A

these are vascular nodules in skin in immune suppressed individuals with CD4 counts less than 200

64
Q

Causative agent of Kaposis Sarcoma

A

Human Herpes Virus 8…sex spread

65
Q

Other common infections with AIDS

A

toxoplasma, cryptosproidia, mycobacterium avium complex

66
Q

Mycobacterium Avium complex presentation in AIDS

A

low CD4 count,

fevers and night sweats with diarrhea and weight loss

also anemia!

67
Q

3 AIDS infections with CNS effects

A

toxoplasmosis, primary CNS lymphoma, and JC virus

68
Q

drug to prevent pneumocystis pneumonia?

A

bactrim and septra

69
Q

drug to prevent mycobacterium avium?

A

azithromycin

70
Q

NABC clinical diagnosis of HIV

A

N is asymptomatic
A is mild
B is moderate
C is severe

71
Q

123 clinical diagnosis of CD4 cell count

A

1 is no suppression (greater than 25)
2 is mild (15-25)
3 is extreme (less than 15)

72
Q

Should you give HIV kids vaccines?

A

they do have lower CD4 cell counts, and likely less antiibodies and CD8 cells but still thought to be effective

Immuno Block Mid Term 2 (10 decks)

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