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Infection > HIV > Flashcards

HIV Flashcards

1
Q

What is the 90-90-90 plan for HIV

A

By 2020

  • 90% of HIV infected people will be diagnosed
  • 90% of people diagnosed will be on ART
  • 90% of those on ART will have virus suppression
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2
Q

Give examples of the possible transmission routes of HIV

A
  • Sexual intercourse (anal and vaginal)
  • Vertical transmission (pregnancy, childbirth or breastfeeding)
  • Sharing needles
  • Needlestick injury
  • Blood transfusion
  • Organ transplant
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3
Q

Which type, group and subtype of HIV is the most common?

A 
Type 1 (1-2)
Group M (M-P)
Subtype H (A-K)
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4
Q

Describe the basic virology of HIV

A
  • HIV attaches to cells with CD4 on T-helper lymphocytes and cells with CCR5 or CXCR4 chemokine receptors
  • HIV is a lentivirus (type of retrovirus) which causes slow infections with long incubation periods
  • RNA to DNA using reverse transcriptase
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5
Q

What are the tests for HIV?

A
  • Antibody and antigen

- Then: viral load, CD4 count, typing, avidity, tropism, resistance tests and drug levels

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6
Q

Which tests can be used as an alternative to antibody tests during the first month/ window period?

A

p24 antigen test or PCR assay (viral load)

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7
Q

What can viral load be used for in HIV?

A
  • Detection of HIV RNA
  • Monitoring the effectiveness of HIV treatment
  • Diagnosis in presence of maternal antibody
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8
Q

What is HIV resistance testing?

A
  • Sequencing of the polymerase and protease genes

- Identification of specific mutations that confer resistance to antiretroviral drugs

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9
Q

What can HIV resistance testing be used for?

A
  • Baseline at diagnosis
  • Suboptimal treatment response
  • Treatment failing
  • Want to change treatment for another reason
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10
Q

What is the use of tropism testing?

A

Works out which co-receptor the virus uses to enter the CD4 cells - required before using a CCR5 antagonist

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11
Q

Why might drug levels be tested?

A

Compliance

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12
Q

What happens to CD4 count and viral load when antiretroviral treatment is started?

A

CD4 count will rise and viral load will fall

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13
Q

What are the two ways of occupational exposure to BBVs?

A

Percutaneous (needlestick/other sharps)

Mucocutaneous (blood/body fluid splashes into eyes, mouth or broken skin)

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14
Q

Which BBV has the highest risk in percutaneous exposure and which has the lowest?

A

Highest -HBV

Lowest - HIV

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15
Q

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

A
  • CSF
  • Pleural peritoneal and pericardial fluid
  • Breast milk
  • Amniotic fluid
  • Vaginal secretions and semen
  • Synovial fluid
  • Any body fluid containing visible blood
  • Unfixed tissues and organs
  • Saliva: dental procedures
  • Exudate/tissue fluid from burns/skin lesions
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16
Q

What steps need taken after exposure?

A
  • Wash off splashes with soap and running water
  • Exposed mucous membranes should be irrigated copiously with water
  • Encourage bleeding
  • Involve Occupational Health
  • Send BBV screen for storage
  • Try to obtain information on source patient - consent for testing
17
Q

How does HIV PEP work?

A
  • Truvada and Raltegravir
  • If high risk blood/body fluid
  • Commence within 72hrs of exposure
  • Complete 28 day course
  • HIV test 2 months after PEP
18
Q

What needs to be done after HBV exposure?

A
  • ? Vaccine history and response
  • HBIG (passive immunisation)
  • Vaccination (active immunisation)
19
Q

What can be done after HCV exposure?

A
  • No PEP or vaccine/immunoglobulin
  • Early treatment decreases risk of chronic infection
  • Important to test after exposure
20
Q

How can exposure to BBV be avoided in the health care setting?

A
  • Hand hygiene
  • Cover existing wounds with waterproof dressings
  • Avoid contamination of person and clothing with blood
  • Protect mucous membranes from blood splashes
  • Prevent puncture wounds, cuts and abrasions in the presence of blood
  • Avoid sharps usage wherever possible
  • Safe procedure for handling and disposal of sharps
  • Clear up spillage of blood or body fluids and disinfect surfaces
  • Follow procedures for the safe disposal of contaminated waste
21
Q

Which groups of the population are at high risk of HIV infection?

A

MSM, sex-workers, IVDAs and partners of HIV positive patients

Infection (15 decks)

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