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NRSG 477 > HIV > Flashcards

HIV Flashcards

1
Q

What type of virus is HIV?

A

Retrovirus in Lenti Virus Genus- Genetic material is carried as RNA

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2
Q

How is Retrovirus in Lenti Virus Genus, genetic material carried?

A

As RNA

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3
Q

General characteristics of Lenti viruses

A
  • Long incubation
  • Ability to transfer a lot of genetic material to host DNA
  • Can replicate in non-dividing cells.
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4
Q

HIV attacks and destroys which types of cells?

A

Immune system cells-
CD4 & T lymphocyte cells and macrophages which allows for replication
(coreceptor CXCR4 and CCR5)

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5
Q

3 primary proteins/enzymes involved with HIV

A

Reverse transcriptase
Integrase
protease

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6
Q

What are the 3 stages of HIV infection?

A

Acute HIV infection
Chronic HIV infection
AIDS

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7
Q

Acute HIV infection

A

Earliest stage of HIV
Generally develops within 2-4wks after infected
Some have flu-like symptoms: fever, sore throat, HA, rash.
Attacks CD4 cells
Level of HIV in blood is VERY HIGH, INCREASING r/f transmission

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8
Q

When does acute HIV infection develop?

A

2-4 weeks after infected

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9
Q

In what HIV stage is the risk for transmission highest?

A

Acute stage; level of HIV in blood is very high

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10
Q

S/Sx of acute HIV infection

A

Flu like Sx: fever, sore throat, HA, rash

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11
Q

Chronic HIV infection

A
  • AKA asymptomatic HIV infection or clinical latency
  • HIV continues to multiply in the body but at very low levels
  • Can still spread HIV to others
  • W/out treatment chronic HIV usually advances to AIDS in 10 years or longer though it may take less time for some.
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12
Q

“Asymptomatic HIV infection” or “clinical latency” is associated with which HIV stage?

A

Chronic stage

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13
Q

T/F those with chronic HIV have symptoms

A

False

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14
Q

T/F without treatment chronic HIV infection will advance to AIDS in 20 years

A

False; w/out treatment HIV can advance to AIDS in 10 years or longer though it may take less time in some people.

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15
Q

Latent HIV reservoir

A
  • A group of immune cells in the body that are infected with HIV but are NOT actively producing new HIV
  • Can be found throughout the body, including the brain, lymph nodes, blood and digestive tract
  • Medicine has not effect on them
  • A major challenge for researchers
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16
Q

A group of immune cells in the body that are infected with HIV but are NOT actively producing HIV.

A

Latent HIV reservoir

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17
Q

Where do latent HIV reservoirs reside?

A

Can be found throughout the body, including the brain, lymph nodes, blood and digestive tract.

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18
Q

Why are latent HIV reservoirs a problem for researchers?

A

Medicines to not effect the reservoirs

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19
Q

What is the final and most severe stage of HIV infection?

A

AIDS

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20
Q

AIDS

A

HIV severely damages the immune system and the body can’t fight off opportunistic infections

  • Aids dx if the CD4 count is <200cells/mm^3 or if they have certain opportunistic infections
  • Without tx people typically survive about 3 years
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21
Q

When is AIDS diagnosed?

A

Aids dx if the CD4 count is <200cells/mm^3 or if they have certain opportunistic infections

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22
Q

Those with AIDS who go without treatment usually live how long?

A

3 years

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23
Q

At what point do most opportunistic infections & complications develop? (CD4)

A

When CD4 count <200

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24
Q

HIV staging (0-3)

A

Stage 0- early HIV infection
Stage 1- >500CD4 and no AIDS defining condition
Stage 2- 200-499CD4 and no AIDS defining condition
Stage 3- <200 CD4 or documentation of AIDS defining condition

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25
What stage is AIDS in HIV staging?
Stage 3
26
Def: Opportunistic infection
Infections that are more frequent or severe due to immunosuppresion
27
AIDS defining illness. Few example
TB Toxoplasmosis Cryptosporidosis
28
Kaposi's sarcoma
Red spots that is highly incidence/ with HIV
29
HIV transmission- fluids
Via contact with certain body fluids from a person infected with HIV. -Blood, semen, pre-seminal fluids, vaginal fluids, rectal fluids, breast milk. Mother to child transmission - Pregnancy, childbirth, breastfeeding
30
T/F HIV can only be spread to a baby via breastfeeding
False; HIV can be spread from mom-to-baby via pregnancy, childbirth and breastfeeding
31
HIV transmission activities
- IV drug use, sharing needles - Sexual contact with an infected partner, including vaginal, anal & oral (least risk) - From infected woman to fetus during pregnancy or the newborn during birth - Breastfeeding by infected mothers to newborns - Transfusion of infected blood or blood products.
32
T/F HIV is NOT transmitted by casual contact such as shaking hands or hugging
True
33
T/F HIV is NOT transmitted by contact with objects such as dishes, toilet seats, doorknobs
True
34
The top 4 highest risks for HIV transmission is
1) Blood transfusion 2) Needle-sharing injection-drug use 3) Receptive anal intercourse 4) Percutaneous needle stick
35
Those undiagnosed an not retained in care account for what percentage of new HIV transmissions?
91.5% of cases; focus is to get these people into care and diagnosed
36
Reproductive cycle of HIV-1 (8)
1) virus entry 2) reverse transcription 3) Integration 4) Transcription 5) Translation 6) Cleavage 7) Assembling 8) Budding & maturation
37
HIV treatment- anti-retroviral agents
Combination of drugs that attack different sites involved with HIV replication -Recommendations come from DPHHS
38
How many classes of drugs stop HIV at different stages in HIV life cycle?
5
39
5 classes of HIV tx drugs
Entry inhibitors Reverse transcriptase inhibitors (non-nucleoside) Reverse transcriptase inhibitors (nucleoside) Integrase inhibitors Protease inhibitors
40
Pharmacokinetic (PK) enhancers (boosters) to improve the PK profiles of some ARV drugs
To allow meds to be more effective
41
How many medications are normally utilized to tx HIV? What changes have we seen more recently?
Utilize three; more recently seeing 2 medications
42
Trends in HIV infection
Increased people living with HIV Decreased new HIV infections Decreased deaths due to AIDS related illnesses (This is due to treatment)
43
Highest population/group of persons living with dx and un-dx HIV in the US HIV transmission categories?
Men who have sex with men
44
What race is HIV most prevalent in?
African Americans
45
What ages do we recommend HIV testing?
Ages 13-64
46
T/F We see high numbers of HIV in rural areas
True
47
T/F We are seeing new HIV diagnoses trending upwards
False; We are seeing HIV dx trending downwards
48
T/F Lifespan for a person with HIV who takes ART is near normal and # of new infections per year is finally decreasing.
True
49
Why has incidence finally decreased some?
-Expanded testing -Efforts at linkage and retention in care -Pre-exposure prophylaxis (PrEP) Treatment for all and "treatment as prevention" (Give to someone who is not infected, but is at a higher risk for infection)
50
T/F If viral load is decreased the risk for transmission is still high
False; If viral load is decreased, the risk for transmission is lower
51
U=U means
Undetectable = Untransmittable
52
What is one issue with those who use PrEP?
People don't think that they need to use prevention. PrEP doesn't protect against STD's.
53
How often should those at high risk receive testing?
Annually (Those having unprotected sex with someone HIV+ or status is unknown, multiple partners, exchanging sex for $$, STD, using drugs with needles and sharing needles, )
54
T/F Having an existing STD is a high risk factor for HIV
True
55
Additional HIV testing should be conducted in those (Excluding high risk)
Women who are pregnant or planning to become pregnant, Those who sought tx for TB or Hepatitis, anyone sexually assaulted).
56
CDC testing guidelines
Consent isn't needed or required as apart of routine care. | - They have the option to decline.
57
Repeat screenings of HIV in pregnant women in high risk areas are performed when?
In the 3rd trimester
58
There are 4 generations of HIV testing. What generation do we use?
4th generation
59
How does the 4th generation of HIV testing work?
Tests the core of the virus and HIV antibodies (but can take a while to show up)
60
Acute (primary) HIV: Eclipse phase
5-10 days that you are infected but rna-transcription hasn't occurred yet.
61
Acute (primary) HIV: Window period
When antibodies will appear | -10-25 days after acquisition, but tell others 3 months
62
Laboratory dx of early HIV infection: In what order will results show?
1) Detect RNA first 2) Detect P24 second 3) Detection of HIV antibodies
63
Positive RNA detection (10-12 days) is indicative of what?
Viral load
64
What is used to confirm HIV cases
"Western blot"
65
Which type of HIV is found in the US? HIV-1 or HIV-2
HIV-1
66
If patient receives an initial + HIV antigen/antibody test and then a negative HIV antibody differentiation test what will we do?
A viral load; maybe in between p24 and when antibodies would show up
67
T/F One positive results confirms diagnosis
False; 2 positive results confirm diagnosis
68
PrEP
A way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill everyday.
69
Truvada
PrEP-combination pill
70
What are two types of PrEP medication?
Truvada and Descovy
71
Those who have receptive vaginal sex cannot take which PrEP medication?
Descovy
72
Recommended indications for PrEP
MSM Heterosexually active men and women IV drug users

NRSG 477 (11 decks)

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