HIV Flashcards
what type of organism is HIV
retrovirus
which strain of HIV is more virulent, type 1 or 2
HIV 1
which immune cells are targeted by HIV
CD4 cells
what effects on CD4 does HIV have
reduced circulating CD4 cells
reduced proliferation of CD4 cells
reduced CD8 cells
chronic immune activation
what is the normal range of CD4 cells
500-1600 cells/mm3
a CD4 cell count of what puts individuals at risk of opportunistic infection
<200
how is HIV transmitted
through sexual contact - anal, vaginal, oral
transplacentally
via breast milk
outline some of the clinical features of primary HIV infection
fever maculopapular rash pharyngitis mucosal ulceration myalgia lymphadenopathy headache/aseptic meningitis
what opportunistic infections are HIV patients at risk of
pneumocystis jirovecii TB toxoplasma gondii CMV EBV Kaposii's sarcoma Lymphoma
how does pneumocystis jirovecii present
shortness of breath
malaise
dry cough
CXR shows perihilar infiltrates
how does toxoplama gondii present
toxoplasma abscess - commonly in brain
focal neuro signs, seizures, features of raised ICP
ring enhancing lesions on MRI
EBV increases risk of what conditions
non-hodgkins lymphoma
oral hairy leukoplakia, white patch on side of tongue
describe Kaposii’s sarcoma
AIDS defining condition, due to human herpes virus 8
either cutaneous or mucosal lesion, patch, plaque or nodular
which specific lymphomas are HIV patients at increased risk of
non-hodgkin lymphoma - Burkitt lymphoma
primary CNS lymphoma
outline some groups at increased risk of developing HIV
men who have sex with men
women who have sex with MSM
people who inject drugs
children and adults from endemic countries such as South Africa, Thailand and Caribbean
what are the 3 preventative measures to prevent HIV spread
barrier methods
pre-exposure prophylaxis
post-exposure prophylaxis
how does PEP work
short term use of ART after potential exposure
can be given up to 72 hours after exposure
how does PrEP work
similar to COCP, at risk groups can take regularly before exposure to prevent infection
what is the main treatment for HIV and what is the aim of it
anti retroviral therapy
aim is to achieve an undetectable viral load and preserve immune function
when is ART commenced in HIV patients
anyone with diagnosis of HIV irrespective of CD4+ count
outline some of the drug classifications that are used as ART drugs
nucleoside reverse transcriptase inhibitors (NRTIs)
non-nucleoside reverse transcriptase inhibitors (NNRTIs)
protease inhibitors
what is the first line treatment for HIV
HAART - highly active antiretroviral therapy
what drugs are involves in HAART
2 nucleoside reverse transcriptase inhibitors as backbone combined with either 1 NNRTI or 1 PI
(3 drugs in total)
give examples of NRTIs
tenofovir
zidovudine
abacavir
give examples of NNRTIs
nevirapine
etravirine
rilpivirine
give examples of protease inhibitors
darunavir
atazanavir
what are some of the toxicity problems associated with HAART
GI effects skin rash and steven johnston syndrome proximal renal tubulopathies osteomalacia - tenofovir increased risk of MI anaemia - zidovudine
