HIV

Question 1

Name HIV diagnostic and monitoring assays

Answer 1

Viral isolation
HIV EIA
Western blot
p24 antigen detection
Proviral HIV-1 DNA detection
HIV-1 RNA detection in plasma

Question 2

Which HIV molecular test is quantitative and which is qualitative?

Answer 2

Proviral DNA = qualitative

HIV-1 RNA = quantitative

Question 3

What are the 3 HIV tests used to diagnose HIV in children?

Answer 3

HIV rapid
HIV ELISA
HIV PCR

Question 4

What are the 3 groups of HIV children?

Answer 4

Newborn
<18mo
>18mo

Question 5

What does HIV viral load detect?

Answer 5

Number of RNA copies?

Question 6

What does HIV PCR detect?

Answer 6

Total nucleic acid AKA RNA+DNA

Question 7

What does rapid HIV detect?

Answer 7

Anti-HIV IgM and IgG

Question 8

What does HIV ELISA detect?

Answer 8

Anti-HIV IgM and IgG

p24 antigen

Question 9

Name the 2 strategies of PMTCT

Answer 9

1. Minimize infant exposure by maternal VL suppression

2. Infant post-exposure prophylaxis

Question 10

What determines the infant’s HIV risk profile?

Answer 10

Delivery maternal VL
OR
VL in last 12w of ANC (if delivery not available)

Question 11

When should infant NVP be stopped?

Answer 11

After 12 weeks IF maternal VL <1000c/ml

OR >1w postBF

Question 12

What is low risk infant HIV prophylaxis?

Answer 12

NVP daily for 6 weeks regardless of feeding choice

Question 13

What is high risk infant HIV prophylaxis?

Answer 13

Breastfeeding:
NVP for 12 weeks 
\+
AZT for 6 weeks
Formula feeding:
NVP + AZT for 6 weeks

Question 14

When does the infant receive cotrimoxazole prophylaxis and when does it stop?

Answer 14

> prophylaxis ends at 6 weeks

Stop when PCR negative after 6weeks postBF and infant clinically HIV -

Question 15

Which infants are at higher risk for anemia on AZT?

Answer 15

Malnourished

Premature

Question 16

When should infant be tested for HIV?

Answer 16

Birth 
10w
6month (exposed)
18month (all children)
6 weeks postBF
Symptomatic
Confirmatory viral antigen test <2yo

Question 17

Name signs of a clinical stage 1 HIV/AIDS child

Answer 17

Asx

PGL

Question 18

Name signs of a clinical stage 2 HIV/AIDS child

Answer 18

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

Question 19

Name signs of a clinical stage 3 HIV/AIDS child

Answer 19

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

Question 20

Name signs of a clinical stage 4 HIV/AIDS child

Answer 20

Unexplained severe wasting/malnutrition
PCP
Recurrent severe bacterial infections
Chronic HSV
Extrapulmonary TB
Kaposi's sarcoma
Oesophageal candidiasis
CNS toxoplamosis
HIV encephalopathy

Question 21

How do you treat a child <3 years or older <10kg

Answer 21

ABC + 3TC +LPV/r

Question 22

How do you treat a child 3-10 years AND >10kg OR older <40kg

Answer 22

ABC + 3TC + EFV

Question 23

What is kaletra?

Answer 23

LPV/r

Question 24

How do you treat a child >15yo and >40kg

Answer 24

TDF + 3TC/FTC + EFV

Question 25

What can be used if EFZ contraindicated?

Answer 25

NVP

Question 26

When can’t you use TDF and what can you substitute this with?

Answer 26

Cr clearance <80ml/min or proteinuria

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