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Immunology-Week 3 & 4 > HIV > Flashcards

HIV Flashcards

1
Q

What kind of virus is HIV?

A

Lentivirus

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2
Q

Describe Lentiviruses

A

Retroviruses that can infect NON-dividing cells. HIV 1 and HIV 2 are human lentiviruses.

  • HIV 1 is more pathogenic than HIV 2.
  • 4 HIV groups (M, O, N, P)
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3
Q

What is the predominant form of HIV in the US?

A

HIV 1 M subtype B

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4
Q

What three enzymes must be brought by the HIV into the host cell?

A
  1. reverse transcriptase
  2. integrase
  3. protease
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5
Q

What are the 6 steps of the viral replication cycle?

A
  1. Attachment
  2. Entry/Fusion
  3. Uncoating
  4. DNA and protein synthesis
  5. Assembly
  6. Release
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6
Q

What are the subunits of glycoprotein on HIV envelope associated with attachment and entry/fusion?

A

gp120 & gp41

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7
Q

Describe HIV Attachment & Entry/Fusion Process

A
  1. gp120 subunit binds to CD4 receptor on helper T cell. This induces a conformation change to expose co-receptor binding site of gp120.
  2. CCR5 on helper T cell binds to the co-receptor binding site of gp120. This induces a second conformational change in the gp41 subunit.
  3. N-terminal fusion peptide gets inserted into the host cell’s membrane.
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8
Q

What are the co-receptors on T cells and what viruses uses them?

A
  1. CCR5: used by M Tropic R5 Virus
  2. CXCR4: used by T Tropic X4 Virus
  3. Both CCR5 & CXCR4: Dual/Mixed (D/M) Tropic Virus

*CCR5 is used by most virus strains, but viruses can evolve to use CXCR4 later time in infeciton.

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9
Q

True or False: In addition to CD4, a coreceptor is needed for HIV to enter the host cell.

A

True

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10
Q

What 3 processes are carried out by reverse transcriptase?

A
  1. Reverse transcription of ssRNA –> viral ssDNA
    * RNA-dependent DNA polymerase
  2. RNase H degrades ssRNA
    * RNase H
  3. Production of viral dsDNA
    * DNA-dependent DNA polymerase

** all three enzymatic activities are on the HIV RT enzyme.

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11
Q

HIV replication is a highly error-prone process due to

A

frequent mutations during reverse transcription

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12
Q

What is the function of an integrase?

A

It helps identify integration site on host DNA and executes the viral strand transfer (irreversible) in the host DNA.

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13
Q

What are the most commonly used agents against HIV?

A

reverse transcriptase inhibitors (NRTIs)

*competitive inhibitor of RT

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14
Q

What is the protein of HIV associated with the capsid?

A

p24

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15
Q

What is the protein of HIV associated with the matrix?

A

p17

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16
Q

What are the three major classes of structural genes of HIV?

A
  1. env (gp120, gp41)
  2. gag (p24, p17)
  3. pol (reverse transcriptase, integrase, protease)
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17
Q

What NRTIs do we have to know?

A
  1. Zidovudine
  2. Abacavir
  3. Lamivudine
  4. Emtricitabine
  5. TDF & TAF
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18
Q

What NRTI is the first ARV drug developed?

A

Zidovudine

- thymidine analog

19
Q

What NRTI has the potential risk for the severe hypersensitivity and cardiac disease?

A

Abacavir

20
Q

What NRTI is also effective for Hep B?

A

Lamivudine & Emtricitabine

21
Q

What NRTI is commonly used in combination pills?

A

TDF & TAF

22
Q

What antiretroviral agents are protease inhibitors (PI)?

A
  1. Lopinavir
  2. Rotnavir

*-navir

23
Q

What antiretroviral agent is an integrase inhibitor?

A

Raltegra

24
Q

What antiretroviral agent is a co-receptor (CCR5) inhibitor?

A

Maraviroc

25
Q

What antiretroviral agent is a fusion (gp41) inhibitor?

A

Enfuvirtide

26
Q

Describe Acute Retroviral Syndrome

A

Primary HIV infection stage that mimics mono-like illness (fever, sore throat, lymph nodes).

27
Q

What is the specific target for HIV?

A

CD4+ T Cell

28
Q

What cell is present in high numbers early and is involved in initial control of viremia?

A

CD8+ T Cell

29
Q

What is the main reason that HIV can escape from the host immune control?

A

Error-prone RT causing mutations

30
Q

What is the HIV gene that is associated with low viral load and slow loss of CD4 T cells when it gets deleted?

A

nef gene

31
Q

What protein does HIV diagnostic testing detect for?

A

p24 antigen

32
Q

What is the diagnostic testing to test HIV in infants?

A

HIV DNA/RNA (nucleic acid) PCR

33
Q

What diagnostic testings are used to detect HIV antibody?

A

ELISA/Western Blot

34
Q

Describe Immune Reconstitution Inflammatory Syndrome (IRIS)

A

An exaggerated inflammatory reaction to pathogens that occurs when the immune system begins to recover following antiretroviral therapy (ART).

35
Q

What is Perinatal Transmission?

A

aka. Horizontal Transmission

The transmission of disease from mom to child.

36
Q

What is the infection caused by pathogen that doesn’t normally cause infection in individual with normal immune system?

A

Opportunistic Infection

37
Q

Symptoms of thrush, Kaposi sarcoma, leukoplakia, angular cheilitis, seborrheic dermatitis, Herpes zoster (shingles), and herpes simplex are red flags to be considered for what?

A

HIV

38
Q

What are the common infections in HIV+ individuals with CD4 cell count > 200?

A
  1. Tuberculosis

2. Strep. pneumonia

39
Q

What are the common infections in HIV+ individuals with CD4 cell count < 200 (AIDS)?

A

Fungi

  1. Pneumocystis jiroveci
  2. Candida
  3. cryptococcus (enveloped)
40
Q

What is the most common opportunistic pathogen of AIDS?

A

Pneumocystis jiroveci pneumonia

*shortness of breath, hypoxemia

41
Q

What viral infections are most common in AIDS?

A
  1. CMV –> retinitis (blindness)

2. Human Herpes Virus (HHV 8) –> kaposi’s sarcoma

42
Q

Describe common characteristics of Herpesvirus family

A
  1. ds DNA

2. enveloped

43
Q

What protozoan infections are most common in AIDS?

A
  1. Toxoplasma gondii –> reactivation in CNS

2. cryptosporidia –> watery diarrhea

44
Q

What bacteria causes the most common bacterial infection in AIDS?

A

Mycobacterium avium complex –> affects multiple organs

  • related to tuberculosis

Immunology-Week 3 & 4 (11 decks)

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