HIV/AIDS

Question 1

which strain of HIV is responsible for the global HIV epidemic?

Answer 1

HIV-1

Question 2

methods of HIV transmission

Answer 2

bodily fluid swabbing

• blood transfusion most likely to infect
• unprotected receptive anal sex
• unprotected receptive vaignal intercourse

Question 3

outline the T cell count trajectory when someone gets infected with HIV

Answer 3

T cell CD4+ decreases throughout the natrual history of HIV

Question 4

How does the body usually control opportunistic infections?

Answer 4

with T-cells. OIs are infections and cancers that require T cell immune response to control them. These diseases can occur in HIB negative individuals, but may present differently.

Question 5

name some classic opportunistic illnesses

Answer 5

bacteria; mycobacterium

virus: CMV

Fungi: cryptococcus neoformans (not to be confused with cryptococcus gatti, which can infect healthy people too), PJP

malignancy: burkitts lymphoma, kaposi sarcoma.

Question 6

outline the general stages of HIV progression

Answer 6

1; asymptomatic, CD4+ count is >500

2. minor symptoms , Cd4+ count is 500-350.

III. moderate symptoms. oral candidiase, oral hairy leukiplakia, pulmonary tuberculosis, CD4+ count is 350-200

stage IV: AIDS. Kaposi’s sarcoma, Severe herpes, ulcers, CD4+ <200

Question 7

how is HIV tested for?

Answer 7

rapid test, western blot, 4th gen test.

screening via rapid test, 4th gen test, oraquick.

confiramtion via western blot or nucleic acid pCR.

Question 8

individuals who should receive an HIV test

Answer 8

Question 9

why are multiple anti-retro virals used at once during therapy of HIV

Answer 9

to prevent the development of resistance.

Question 10

overarching classes of ARV drugs

Answer 10

nucleoside reverse transcriptase inhibitor (NRTI)– backbone of HIV therapy

non-nucleotide revese transcriptase inhibitor (NNTRI)

protease inhibotor (PI)

integrase inhibitor

the drugs have so many side effects

Question 11

outline the routine monitoring after HIV diagnosis

Answer 11

1. viral load at 6 months after starting treatment
2. then every 12 months once stable on ARV therapy.
   - if viral load is suppressed, can reduce CD4+ monitoring as risk of opportunistic infections are low. elevated viral load is used to determine treatment failure/anti-viral resistance.