HIV Flashcards
Describe the common clinical characteristics of HIV infection
Non-specific seroconversion illness after 2-8 weeks post exposure.
Latency for around 7 years until AIDS develops
Name some infections/ illnesses that may occur in HIV patients
- Oesophageal candidiasis
- Pneumococcal pneumonia (recurrent)
- Cerebral toxoplasmosis
- PML (due to JCV)
- Tuberculosis
- Kaposi’s sarcoma
What might a FBC in a person with HIV show?
Low leukocytes
What might happen to the lymphocyte count of a person with HIV?
Reduced
How might a person with HIV’s immunoglobulin levels be affected?
Raised
Wha do 4th generation HIV tests detect?
Both HIV antibodies and p24 antigen
Nearly all cases within 4 weeks of infection
All cases within 3 months
Post diagnosis, what blood tests are regularly performed?
CD4 count and viral load
What is the prognosis of a person with untreated AIDS?
1-3 years life expectancy
What is the prognosis of a HIV person compliant with treatment?
Almost normal life expectancy
What are the principles of treatment for HIV?
Treatment of opportunistic infections
Prophylaxis of opportunistic infections (toxoplasmosis, cryptococcosis, PCP, MAC)
Antiretroviral drugs in combination:
- Highly active anti-retroviral therapy (HAART)
Name some anti-viral drugs used for HIV infections
Nucleoside reverse transcriptase inhibitors (NRTIs)- Tenofovir
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)- Efavirenz
Protease inhibitors (PIs)- Lopinavir
Integrase inhibitors (INSTIs)- Dolutegravir
Fusion inhibitors (FIs)- Enfurvitide
Chemokine receptor antagonists (CCR5 antagonists)- Maraviroc
Entry inhibitors (CD4-directed post-attachment inhibitors)
When is post-exposure prophylaxis (PEP) indicated?
Exposure to a HIV +ve patient where the viral load is >200 copies/ml (or unknown)
What are the post-exposure prophylaxis regimens?
Tenofivir 245mg and emtricitabine 200mg combined tablet OD.
AND
Reltagravir 400mg BD
Treatment for 28 days followed by HIV test
What class of drug is Efaverenz?
What is its mechanism of action?
What are its side effects?
Non-nucleoside reverse transcriptase inhibitors (NNRTI).
Used in HIV: Blockade of viral reverse transcriptase function for viral genetic replication.
Side effects: rash, Stevens-Johnson syndrome
What class of drug is Tenofivir?
What is its mechanism of action?
What are its side effects?
Nucleoside reverse transcriptase inhibitor (NRTI)
Used in HIV: Blockade of viral reverse transcriptase function for viral replication
Side effects: rash, Stevens-Jonhson syndrome
What class of drug is Lopinavir?
What is its mechanism of action?
What are its side effects?
Viral protease inhibitor
Used in HIV infection: Blockade of viral protease required for virus particle assembly
Side effects: GI bleeding
What class of drug is Dolutegravir?
What is its mechanism of action?
Integrase inhibitors
Used in HIV: Disrupts integration of HIV genome into host chromosomes
What class of drug is Enfuvirtide?
What is its mechanism of action?
What are its side effects?
Viral fusion inhibitors
Used in HIV: Blockade of virus fusion to target cell membrane
Side effects: possible pancreatitis
What class of drug is Maraviroc?
What is its mechanism of action?
What are its side effects?
Chemokine receptor/CCR5 antagonist
Used in HIV: Blockade of HIV binding to cofactor for cell entry
Side effects: nausea, diarrhoea
