HIV/AIDS

Question 1

What are risk factors for HIV/AIDS?

Answer 1

Needle sharing, unprotected sex, needle stick injury

Question 2

How does HIV enter cells?

Answer 2

It binds to CD4 receptors via GP120 envelope glycoproteins

Question 3

How does primary HIV infection present?

Answer 3

Flu-like symptoms and a rash 2-4 weeks after infection, Can have persistent generalised lymphadenopathy

Question 4

What test is gold standard?

Answer 4

ELISA for HIV antibody and antigen

Question 5

What tests are used to monitor progression?

Answer 5

Viral load, CD4 count

Question 6

What test is used to test for vertical transmission?

Answer 6

Nucleic acid testing/viral PCR

Question 7

What are some differential diagnoses?

Answer 7

Infectious mononucleosis, influenza, cytomegalovirus infection

Question 8

What do CCR5 antagonists do?

Answer 8

Inhibit entry of virus into cells

Question 9

What types of reverse transcriptase inhibitors are there?

Answer 9

Nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors

Question 10

What other enzyme inhibitors can be used?

Answer 10

Integrase strand transfer inhibitors, protease inhibitors

Question 11

What can lower the dose needed?

Answer 11

Pharmacokinetic enhancers

Question 12

What are the steps done before starting drugs?

Answer 12

Counselling, screen for infections and malignancy, baseline tests, review usual medications for potential drug interactions

Question 13

What are the first line drugs in the UK?

Answer 13

NRTI, protease inhibitors, NNRTI, integrase inhibitor

Question 14

What should you monitor?

Answer 14

Adherence, adverse effects, CD4 count

Question 15

What is the commonest systemic fungal infection in HIV?

Answer 15

Cryptococcus neoformans

Question 16

What is the commonest cause of intracranial mass lesions in AIDS?

Answer 16

Toxoplasma gondii

Question 17

What is a common cause of non-bloody, watery diarrhoea in HIV pre-ART?

Answer 17

Cryptosporidium

Question 18

What is the most common tumour in HIV and AIDS?

Answer 18

Kaposi’s sarcoma

Question 19

The risk of developing what type of lymphoma is increased in HIV?

Answer 19

Non-Hodgkin’s

Question 20

What complicating comorbidities can develop?

Answer 20

CVD, bone disease, TB, hepatitis B and C

Question 21

What prevention options are there?

Answer 21

Condoms, PEP, PrEP

Question 22

What prevention options are there specifically for vertical transmission?

Answer 22

Caesarean if viral load >50 per mL, neonatal PEP, ART for mother

Question 23

Which cause of pneumonia is most typically associated with AIDS?

Answer 23

Pneumocystis jirovecii