HIV Flashcards
Name HIV diagnostic and monitoring assays
Viral isolation HIV EIA Western blot p24 antigen detection Proviral HIV-1 DNA detection HIV-1 RNA detection in plasma
Which HIV molecular test is quantitative and which is qualitative?
Proviral DNA = qualitative
HIV-1 RNA = quantitative
What are the 3 HIV tests used to diagnose HIV in children?
HIV rapid
HIV ELISA
HIV PCR
What are the 3 groups of HIV children?
Newborn
<18mo
>18mo
What does HIV viral load detect?
Number of RNA copies?
What does HIV PCR detect?
Total nucleic acid AKA RNA+DNA
What does rapid HIV detect?
Anti-HIV IgM and IgG
What does HIV ELISA detect?
Anti-HIV IgM and IgG
p24 antigen
Name the 2 strategies of PMTCT
- Minimize infant exposure by maternal VL suppression
2. Infant post-exposure prophylaxis
What determines the infant’s HIV risk profile?
Delivery maternal VL
OR
VL in last 12w of ANC (if delivery not available)
When should infant NVP be stopped?
After 12 weeks IF maternal VL <1000c/ml
OR >1w postBF
What is low risk infant HIV prophylaxis?
NVP daily for 6 weeks regardless of feeding choice
What is high risk infant HIV prophylaxis?
Breastfeeding: NVP for 12 weeks \+ AZT for 6 weeks Formula feeding: NVP + AZT for 6 weeks
When does the infant receive cotrimoxazole prophylaxis and when does it stop?
> prophylaxis ends at 6 weeks
Stop when PCR negative after 6weeks postBF and infant clinically HIV -
Which infants are at higher risk for anemia on AZT?
Malnourished
Premature
When should infant be tested for HIV?
Birth 10w 6month (exposed) 18month (all children) 6 weeks postBF Symptomatic Confirmatory viral antigen test <2yo
Name signs of a clinical stage 1 HIV/AIDS child
Asx
PGL
Name signs of a clinical stage 2 HIV/AIDS child
HSM Papular pruritic eruptions Seborrheic dermatitis Extensive HPV infection Extensive molluscum contagiosum Fungal nail infx Recurrent oral ulcerations Lineal gingival erythema Angular cheilitis Parotid enlargement Herpes zoster Chronic RTIs
Name signs of a clinical stage 3 HIV/AIDS child
Moderate unexplained malnutrition Unexplained persistent diarrhoea Unexplained persistent fever Oral candidiasis Oral hair leukoplakia Acute necrotizing ulcerative gingivitis/periodontitis Pulmonary TB Severe recurrent bacterial pneumonia
Name signs of a clinical stage 4 HIV/AIDS child
Unexplained severe wasting/malnutrition PCP Recurrent severe bacterial infections Chronic HSV Extrapulmonary TB Kaposi's sarcoma Oesophageal candidiasis CNS toxoplamosis HIV encephalopathy
How do you treat a child <3 years or older <10kg
ABC + 3TC +LPV/r
How do you treat a child 3-10 years AND >10kg OR older <40kg
ABC + 3TC + EFV
What is kaletra?
LPV/r
How do you treat a child >15yo and >40kg
TDF + 3TC/FTC + EFV
What can be used if EFZ contraindicated?
NVP
When can’t you use TDF and what can you substitute this with?
Cr clearance <80ml/min or proteinuria
Change to ABC
