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HIV/AIDS Flashcards

1
Q

MoA: inhibits HIV integrase -> prevents proviral DNA integration into host cell genome

A

Integrase Strand Transfer Inhibitors (INSTIs)

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2
Q

Lamivudine

A

NRTI

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3
Q

MoA: inhibit action of the viral protease preventing the assembly maturation and release of new virions

A

Protease Inhibitors (PIs)

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4
Q

Biktarvy

A

Bictegravir/TAF/Emtricitabine

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5
Q

Post-Exposure PTx (PEP) recommended when?

A
  • after an accidental exposure to HIV (healthcare setting (needle/blood) or sex/condom break)
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6
Q

When is ART recommended?

A

ALL HIV-infected pts (regardless of CD4 count)… initiate immediately after Dx!

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7
Q

PrEP options

A
  • PO QD: Emtricitabine/TDF (TAF if MSM)
  • PO on-demand: Emtricitabine/TDF (2 tabs after sex, 1 tab next day, 1 tab next day)
  • Injection: Cabotegravir IM (dose, dose month after, then 1dose q2months)
  • PO PrEP Monitoring: SCr, HBV
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8
Q

MoA: elongation termination of growing proviral DNA chain

A

Nucleoside Reverse Transcriptase-i (NRTIs)

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9
Q

What to combo PI with

A
  • Ritonavir or Cobicistat
  • PI Boosting w/ 3A4-i
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10
Q

Neviripine

A

NNRTI
- dose titration over 14 days (to dec frequency of rash)

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11
Q

HIV Surrogate Markers

A
  • CD4 (dec levels = more compromised immune system) - useful before starting Tx
  • HIV RNA (inc baseline levels = faster disease progression) - assess effectiveness of Tx
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12
Q

Temsavir (Fostemsavir is a prodrug of it)

A

Attachment Inhibitors (binds to gp120)

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13
Q

Etravirine

A

NNRTI
- take with food

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14
Q

MoA: Bind to an allosteric site of the reverse transcriptase enzyme reducing functionality

A

Non-Nucleoside Reverse Transcriptase-i (NNRTIs)

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15
Q

When to do Resistance Training

A
  • at entry of care (whether ART is started immediately or not)
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16
Q

Lenacapavir

A

Capsid Inhibitor (binds between capsid protein (p24))
- SQ q6months

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17
Q

NRTIs AE & Pearl

A
  • Mitochondrial Toxicity
  • Lactic Acidosis
  • Renal Adjustment
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18
Q

Pre-Exposure PTx (PrEP) CI’s

A
  • HIV infxn
  • Weight <77lbs
  • CrCl <60 for TDF/Emtricitabine
  • CrCl <30 for TAF/Emtricitabine
  • possible HIV exposure w/in past 72hrs
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19
Q

Efavirenz

A

NNRTI
- take on empty stomach
- AE: CNS

20
Q

Corticosteroid D-I

A

w/ PI (-“navir”) + Cobicistat: Beclomethasone is preferred

21
Q

Elvitegravir

A

INSTI
- needs boosting
- take w/ food

22
Q

INSTI AE

A

Weight gain

23
Q

Genetic Barrier to resistance comparison between boosted PIs and NNRTIs

A

Boosted PIs have a HIGHER genetic barrier to resistance compared to NNRTIs

24
Q

Dolutegravir

A

INSTI
- 50 mg DAILY (INSTI-Naive)
- 50 mg BID (INSTI-experienced)

25
Q

Tenofovir Alafenamide (TAF)

26
Q

Routes of Transmission

A
  • exposure of mucous membrane (sex)
  • Blood stream exposure (IV drug use, needles)
  • Mother-to-child
27
Q

Ibalizumab

A

Post Attachment-i
- IV

28
Q

Acid Reducers & Polyvalent Cation Supplements

A

-w/ INSTI: space apart by 6 hours
- Never give Raltegravir w/ Al or Mg
- Rilpivirine is CI’d with PPI’s

29
Q

PI AE:

A
  • GI (NVD)
  • Insulin Resistance
  • Lipodystrophy
30
Q

PEP Tx

A
  • Emtricitabine/TDF + (Raltegravir or Dolutegravir) x 28 DAYS
  • Use precautions (condom/avoid, breastfeeding) to avoid/prevent transmission, esp. during first 6-12 weeks
31
Q

Abacavir

A

NRTI
- Needs HLA-B*5701 testing before starting – hypersensitivity rxn

32
Q

Rilpivirine

A

NNRTI
- take with a meal (NOT a protein drink)

33
Q

Recommended Initial Regimens for Most People with HIV (no Hx of CAB-LA use for HIV PTx)

A
  • Bictegravir/TAF/Emtricitabine (Biktarvy) (INSTI/ 2 NRTIs)
  • Dolutegravir + TAF/TDF + Emtricitabine/Lamivudine (INSTI/ 2 NRTIs)
  • Dolutegravir/Lamivudine (Dovato) (never if pt also has HBV infxn OR HIV RNA >500,000)
34
Q

At Home HIV Test/results

A
  • OraQuick
  • Reactive Results: go to med profess for confirmatory testing
  • Non-reactive results: repeat test if during Seroconversion window (3months from exposure)
35
Q

AIDS Dx

A
  • Stage 3 HIV
  • CD4<200 or OI diagnosis
36
Q

Is HIV/AIDS curative?

37
Q

Maraviroc

A

Chemokine Coreceptor 5 (CCR5) Antagonist
- test tropism before starting

38
Q

What viral load is needed for best likelihood of yielding a successful standard resistance test result

A

> 500 copies/mL

39
Q

Tenofovir DF (TDF)

A

NRTI
- AE: Renal insufficiency, osteomalacia

40
Q

Emtricitabine

41
Q

Statins D-I

A

w/ PI (-“navir”) + Cobicistat: low doses of Atorva, Rosuva, Pitava, & Prava are preferred (ARPP)
- w/ NNRTIs, dose may need increased

42
Q

What website has federally approved HIV/AIDS guidelines

A

www.aahivm.org

43
Q

Benzodiazepine D-I

A

w/ PI (-“navir”) + Cobicistat: preferred benzos are Lorazepam, Oxazepam, or Temazepam (LOT)

44
Q

Goals of ART Tx

A
  • Suppress HIV RNA to “undetectable”
  • Restore/Preserve immunologic function
  • Reduce morbidity and prolong duration/quality of survival
  • Prevent transmission
45
Q

PDE5-i D-I

A

w/ PI (-“navir”) + Cobicistat: use at very low doses q48-72hr

46
Q

Atazanavir

A

PI
- take with food
- Inc Bilirubin

Infectious Disease (32 decks)

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