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Infection > HIV > Flashcards

HIV Flashcards

1
Q

Globally , more people living with HIV are men or women ?

A

Women

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2
Q

Is there a cure for HIV ?

A

No

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3
Q

What fungal proble,s are people with HIV more likely to get ?

A

Yeast infections

Mould

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4
Q

What viral infections are people with HIV more likely to get ?

A

Reactivation of viral infections such as chickenpox and shingles

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5
Q

Is the overal rate of HIV increasing or decreasing ?

A

Decreasing

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6
Q

Describe the structure of the HIV virus

A
  • has a RNA genome
  • has a capsid : a protein shell that protects the genome. This. Can be helical or icosahedral.
  • lipid envelope can be present or absent, this is derived from the host cell membrane. This contains virus specific proteins ( antigens)
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7
Q

Outline the replication strategy of HIV

A
  1. The virus binds to CD4+ ( these are T helper cells , so,e macrophages and monocytes ) molecule and one of two coreceptors ( either CCR5 or CXCR4). The virus then fuses with the cell.
  2. The virus penetrates into the cell. Contents of the virus is emptied into the cytoplasm of the Host cell. These contents include HIV RNA and reverse transcriptase enzyme.
  3. Reverse transcriptase in the CD4+ cell converts single stranded viral RNA into double stranded DNA , which then enters the host nucleus.
  4. Viral DNA is combined with the cells own DNA by the integrase enzyme.
  5. When the infected host cell divides , the Viral DNA is read and protein synthesis using viral DNA occurs.
  6. Set of viral protein chains come together.
  7. The immature virus pushes out of the cell taking some cell membrane with it .
  8. Immature virus breaks free of the infected cell
  9. Immature long Protein chains in the new viral particle are cut out by protease enzyme into smaller mature proteins that combine to make a working virus
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8
Q

How is HIVvirus transmitted ?

A
  1. Sexual contact
  2. Blood transfusion
  3. Contaminated needles
  4. Perinatal transmission ( breastfeeding, transplacental)
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9
Q

Factors affecting HIV transmission

A
  1. Type of sexual act , eg oral sex puts you at a lower risk.
  2. Viral load of infected person - if their viral load is low then you are unlikely to get it.
  3. Whether you used condom or not.
  4. Other STI
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10
Q

What is the general life expectancy of HIV ?

A

78 years of age , when the general population is 80 years

But this depends on whether they drink , smoke , good treatment and early detection

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11
Q

What class of virus is HIV ?

A

Retro virus -it belongs to. The retroviridae family

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12
Q

How to test for HIV ?

A
  1. A blood test called serology.
  2. Blood test : PCR
  3. Rapid tests
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13
Q

What is a serology blood test ?

A

This involves a full blood sample sent to labs with much slower results (7-10 days) . This test looks for HIV antigen and HIV antibody ( immune response to antigen).

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14
Q

What is a PCRblood test ?

A

This detects HIV nucleic acid . It is highly sensitive test which can detect very early infection , but it is expensive. Results can take a week.

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15
Q

What is a rapid test ?

A

Low cost , rapid test that can be done at home as a discrete postal test and involves blood testing through a finger prick or saliva swab.

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16
Q

What strategies would you use to reduce the prevalence of HIV ? X

A
  1. Anti-retroviral drugs as prevention
  2. Increase condom usage
  3. Increasing testing ( every pregnant woman gets tested )
  4. Post exposure prophylaxis ( worried you had sex with someone wit HIV , you give person this )
  5. Male circumcision - prevent a man from getting HIV
17
Q

Which anti-retro viral drugs do we use for HIV patients ?

A
  1. Nuceleoside reverse transcriptase inhibitor ( TWO OF THESE)

ALONGSIDE

  1. Non-nucleoside reverse transcriptase inhibitors

Or

  1. Protease inhibitor

Or

  1. Integrase inhibitor

Or

CC5 inhibitor

18
Q

Why do we give three anti-retro virus drugs a day ?

A
  1. There are millions of rounds of viral replicatio. Each day
  2. Virus mutates every 2-3 rounds
  3. Resistance to drugs develops in days - giving one drug means resistance would develop quicker. BUT giving three drugs would make it much harder to develop resistance to the drugs
19
Q

What are the 4 stages HIV progression can be divided into with regards to CD4 count ?

A

STAGE 1 : corresponds to a normal CD4 count which is above 500 cells / uL ( usually between 500-2000) and the patient is usually asymptomatic

  1. STAGE 11 : is when the count drops below 500 cells /uL. And the patient shows mild symptoms.

STAGE 111: described as CD4 count dropping below 350 cells /uL. Symptoms become more advanced

STAGE 1V : when the CD4 count drops below 200 cells /uL. The presentation is more severe and defined as ‘ AIDS’

20
Q

What are the 3 clinical stages of HIV ?

A
  1. Seroconversion stage
  2. Latent stage
  3. AIDS
21
Q

What is the seroconversion stage of HIV ?

A
  • this is where the CD4 count initially drops on initial infection and copies of the HIV virus spike in number.
  • the patient presents with acute HIV symptoms such as fever , malaise , weight loss and a generalised rash.
  • CD4 levels start to go back to normal
  • HIV virus decreases in number after
22
Q

What is the latent stage of HIV ?

A

CD4 numbers slowly drop

And the viral load slowly increases

23
Q

What is the AIDS stage ?

A

When the CD4 count drops below 200 cells / uL. And opportunist infections being to develop.

This includes candidiasis , Protozoa infections , pnemocytosis pneumonia , kaposi’s sarcoma

24
Q

What are the main acute HIV infection symptoms ? ( first 5-10 years)

A

Systemic : fever , weight loss

Mouth : sores , Thrush

Lymph nodes : lymphadenopathy

Skin : rashes

Gastric : nausea , vomiting

Liver and spleen enlargement

Esophagus : sores

25
Q

Conditions associated with severe HIV ( AIDS)

A
  1. Meningitis
  2. Pneumocystis pneumonia ( fungal infections which indicate white patches in lungs on X ray)
  3. TB
  4. Tumours
  5. Chronic diorreah
  6. CANDIDA ( in mouth and vagina )
  7. Kaposi’s sarcoma : raised nodules on skin
26
Q

What diseases are more likely to be acquired with HIV ?

A
  1. TB ( A bacterial infection caused by mycobacterium , symptoms often present with a persistent cough that lasts more than three weeks , phlegm that may be bloody , weight loss , high temp , tiredness and fatigue)
  2. Toxoplasmosis - caused by toxoplasma Gondii parasite. This is where you catch the infection from poo of infected cats or meat. Often present with flu like symptoms.
  3. Pneumocystis pneumonia which is yeast like fungal infection.This is often presented with
    dry cough , shortness of breath , chills , weight loss.
  4. Crytococcal disease ( fungal ) . Similar symptoms to pneumonia and meningitis.
  5. CMV : viral infection. Similar to herpes such as cold sores. Usually doesn’t cause symptoms.
  6. Cryptosporidiosis : caused by parasites
  7. Other sexually transmitted diseases. Eg chlymidia

Infection (24 decks)

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