Hiv Flashcards
What type of people usually have Kaposi’s Sarcomas?
- Immuno-compromised people
- Associated with elderly
Kaposi’s Sarcomas are the most frequent opportunistic tumours. What percentage of patients with AIDS will have these?
- 20% (mostly homosexuals)
What virus is associated with Kaposi’s sarcomas?
- Human Herpes Virus 8
What is an example of one of the infections that defines that start of AIDS?
Kaposi’s Sarcoma
What are the two types of T-cell?
- T helper and killer cell. (messengers - initiate activity of other immune cells and help to generate your antibodies)
Apart from homosexual men. What other groups were affected by HIV before they know what it was? (3 points)
- Women (associated with injecting drug use or sexual contact with men who had AIDS)
- Haitians residing in the US (all young and denied homosexual activity)
- Heterosexual men with haemophilia - all received factor VIII
What does AIDS stand for?
- Acquired Immunodeficiency Syndrome
Apart from sexual transmission, how else can AIDS be spread?
- Through blood transfusions
- From mother to child
The first test for HIV-1 antibodies was very sensitive but what was one downside to this test?
- It had a high false positive rate which would end up giving the wrong diagnosis to someone but would have no way of knowing you had given them the wrong diagnosis
What is HIV PrEP? (4 points)
- A pill that can stop the person from taking from getting HIV
- PrEP is for HIV negative people who are at high risk of getting HIV
- It is extremely effective at preventing HIV when taken as directed, with few side effects
- Once the drug reaches protective levels it stops HIV from staying in your body
How is HIV Transmitted? (5 points)
- Unprotected sex
- Drug addicts
- Blood transfusions
- Pregnancy
- Non-sterile instruments
How is HIV NOT transmitted? (5 points)
- Touching
- Through food
- With a kiss
- Insect bites
- In a pool
Where is it though that HIV originated?
- In the democratic republic of Congo in the 1920’s
- Via ingestion and/or exposure to blood
- Recon it came from the chimps - associated with humans hunting - either eating or being exposed to chimp blood
How many people globally are living with HIV and what percentage don’t know their status?
- 37.9 million living with HIV
- 21% don’t know their status
What are the 2018 90 90 90 targets?
- Wanted to have 90% of people aware of their HIV status, 90% on HIV treatment and 90% of people virally suppressed
How does HIV spread in the body?
- One in cd4 cell the virus releases RNA - this is converted into DNA with enzymes and this DNA is incorporated into your own DNA
- Your own body then replicates the virus
- Only a small number of cd4 cells are infected but from this you get billions of infected virus cells very quickly (45 mins)
What are the 5 key stages in the HIV cycle?
- HIV releases genetic material into CD4 cell
- Reverse transcriptase copies RNA - DNA
- Viral DNA inserted into DNA cell
- Many copies of the viral RNA and proteins made
- New viral particles assemble and bud from cell
What is the HIV viruses half life?
5.7 hours
How many HIV virus particles can be replicated per day?
- 10 billion
How many HIV virions can be in a ml of blood?
10-100 million
How could you define AIDS? (3 points)
- The presence of one of 25 conditions indicative of severe immunosuppression
- OR HIV infection in an individual with a CD4+ cell count of <200 cells per cubic mm of blood
- AIDS is therefore the end point of an infection that is continuous, progressive and pathogenic
What are 5 clinical features of AIDS?
- Lymphadenopathy and fever
- Opportunistic infections
- Malignancies
- Wasting
- AIDS-related dementia
We don’t just rely on blood tests anymore for testing for HIV, we have other options but the blood tests are the best. What are the other options and what are the positives/negatives of these?
- Rapid tests
- Oral fluid tests - less sensitive
- Dried blood spot - Good for research purposes
Home testing kits for HIV are useful but what needs to be confirmed after taking one?
- All positive tests MUST be confirmed
What are the dental implications for people with HIV?
- HIV infected individuals have poorer oral health and greater dental care needs than the general population BUT
- The experience high levels of HIV-related stigma and discrimination when attending dental services
There are 3 groups of oral lesions associated with HIV. Which one should we be especially aware of?
- Group 1
What are group 1 oral lesions associated with HIV?
- Lesions STRONGLY associated with HIV infection
- e.g. Candidosis, Hairy Leukoplakia, Kaposi’s sarcoma, Non-Hodgkin’s lymphoma and periodontal disease
What are group 2 oral lesions associated with HIV?
Lesions LESS COMMONLY associated with HIV infection
What are group 3 oral lesions associated with HIV?
- Lesions SEEN in HIV infection
What are HIV indicator conditions?
- Conditions that would suggest someone may be infected with HIV
- IF seen then suggest testing
Why would HIV screening in the dental setting be a positive thing? (4 points)
- Key prevention strategy is to improve the availability and access to HIV screening
- Early diagnosis improves health outcomes and provides opportunities to prevent further transmission events
- Several key HIV indicators that are encountered by the dental professional
- Rapid point of care HIV tests could be used to offer chairside HIV screening to patient during dental appointments
What does an undetectable viral load mean for the spread of HIV?
- Means risk of transmission is low
