HIV/AIDs

Question 1

What are the ways HIV can be spread?

Answer 1

Sexual transmission
Injection drug misuse
Blood products
Vertical transmission
Organ transplant

Question 2

Can an unconscious patient be tested for HIV?

Answer 2

Yes, if it is in the patients best interests

Question 3

How can HIV be tested?

Answer 3

POC testing (blood)

Question 4

What cells does HIV infect & destroy in the immune system?

Answer 4

CD4 cells

Question 5

Over the course of the infection, what can be observed?

Answer 5

Decrease in CD4 count

Increase viral load

Question 6

As HIV infection progresses, what are you more susceptible to?

Answer 6

Oppurtunistic infection

Tumours

Question 7

When do most AIDs infections occur?

Answer 7

At CD4 count <200

Question 8

How many different stages of disease are there?

Answer 8

4

Question 9

What are some of the most common opportunistic infections observed in HIV patients?

Answer 9

Thrush
PJP
TB
Lymphoma
Cryptococcal meningitis

Question 10

What is the difference between HIV & AIDs?

Answer 10

Asymptomatic - HIV

AIDs = severe infection

Question 11

What is the timeline of infection observed?

Answer 11

Acute infection (seroconversion)
Asymptomatic 
HIV related illnesses
AIDs defining illnesses
Death

Question 12

What is a seroconversion illness?

Answer 12

This is when the HIV antibodies develop (similar to flu-like symptoms)
Typical of acute HIV infection

Question 13

What are some of the symptoms of seroconversion?

Answer 13

Flu-like illness
Fever
Malaise & lethargy
Pharyngitis
Lymphadenopathy
Toxic exanthema

Question 14

What infection is associated with late stage AIDS infection?

Answer 14

PJP (Pneumocystis pneumonia)

Question 15

What investigations would you do in suspected PJP?

Answer 15

CXR

Sputum or bronchoscopy (PCR)

Question 16

What is the treatment for PJP?

Answer 16

Cotrimoxazole

Pentamidine

Question 17

What are the classes of antiviral drugs available?

Answer 17

AZT, DDI, DDC, 3TC, D4T

Question 18

What is antiretroviral therapy?

Answer 18

Combination antiretorviral therapy (cART) means at least 3 drugs from 2 groups

Acts at different stages of lifecycle

Question 19

Where do antiviral treatments work?

Answer 19

Reverse transcriptase inhibitors
Integrase inhibitor
Protease inhibitor

Question 20

When do patients start treatment?

Answer 20

At point of diagnosis

Question 21

In pregnancy, when should antivirals be taken?

Answer 21

Before 3rd trimester

Question 22

What can be done to assess the sensitivity of drugs to HIV infection?

Answer 22

Resistance testing

Question 23

What are some of the causes of incomplete suppression of viral load?

Answer 23

Inadequate potency
Inadequate drug levels
Inadequate adherence
Pre-exisiting resistance

Question 24

What are some of the side effects of nucleoside reverse transcriptase inhibitors?

Answer 24

Neuropathy

Lipodystrophy

Question 25

What are some of the side effects of protease inhibitors?

Answer 25

diarrhoea
lipodystrophy
hyperlipidaemia

Question 26

What are some of the side effects of integrase inhibitors?

Answer 26

Rashes

Disrupted sleep

Question 27

What are some of the mechanisms of HIV prevention?

Answer 27

Behaviour change/ condoms
Treatment as prevention (low VL = untransmissable)
PrEP
PEPSE