HIV

Question 1

what type of virus is HIV

Answer 1

RNA retrovirus

Question 2

how is HIV spread

Answer 2

unprotected sex (vaginal,anal,oral)
IV drug use
mother to child (vertical transmission)
blood transfusions

Question 3

what cells does HIV attack

Answer 3

CD4 T cells

Question 4

time course of HIV infection and symptoms

Answer 4

3-12 weeks post infection seroconversion illness occurs

• 60-80% of people are asymptomatic
• presents similarly to infectious mononucleosis – fever, sore throat, lymphadenopathy, malaise

latent phase – CD4 count continues to drop, 30% of patients develop persistent lymphadenopathy

after around 10 years, infections and cancers develop

Question 5

what is AIDS

Answer 5

acquired immunodeficiency syndrome

• late stage HIV
• CD4 count <200

Question 6

what causes pneumonia in HIV patients

Answer 6

pneumocystis jiroveci

Question 7

presentation of pneumocystis pneumonia

Answer 7

dry cough
SOB on exertion
sweats
no chest signs on examination

Question 8

what other respiratory infections are HIV patients more at risk of

Answer 8

fungal - aspergillus, cryptococcal
TB
CMV

Question 9

most common neurological complication in HIV

Answer 9

toxoplasmosis

Question 10

what is seen on CT in toxoplasmosis

Answer 10

multiple ring enhancing lesions

Question 11

symptoms of toxoplasmosis

Answer 11

headache
confusion
drowsiness
focal neurological signs

Question 12

treatment of toxoplasmosis

Answer 12

sulfadiazine + pyrimethamine

Question 13

what virus are primary CNS lymphomas linked to

Answer 13

EBV

Question 14

what causes meningitis in HIV patients

Answer 14

cryptococcus

Question 15

what virus is causes progressive multifocal leukoencephalopahty

Answer 15

JC virus

Question 16

most common cause of diarrhoea in HIV patients

Answer 16

cryptosporidium

Question 17

what virus causes Kaposi’s sarcoma

Answer 17

HHV-8

Question 18

presentation of Kaposi’s sarcoma

Answer 18

purple papules/plaques on skin/mucous membranes

Question 19

what virus causes hairy leukoplakia

Answer 19

EBV

Question 20

what problem can occur when CD4 count is <50

Answer 20

CMV retinitis

Question 21

how is HIV tested for

Answer 21

antibody blood test – test done in hospital to screen
PCR for p24 antigen
PCR for HIV RNA – gives viral load

Question 22

treatment of HIV

Answer 22

high-active antiretroviral therapy (HAART)

Question 23

what should be given to prevent pneumocystis pneumonia in patients with CD4 count <200

Answer 23

co-trimoxazole

Question 24

how long should babies born to HIV +ve mothers receive antiretrovirals for

Answer 24

4 weeks of zidovudine

Question 25

safest way for babies to be born if mother is HIV +Ve

Answer 25

C-section - only consider vaginal delivery if viral load is undetectable - give zidovudine infusion 4 hours before start of C section

Question 26

is it safe to breast feed if mother has HIV

Answer 26

no

Question 27

what is given for post-exposure prophylaxis in HIV

Answer 27

Truvada + raltegravir for 28 days

Question 28

what does tenofovir increase risk of

Answer 28

osteoporosis