HIV/AIDS - Sandkovsky Flashcards

1
Q

What type of virus is HIV

A

A retrovirus: RNA virus, infects cell, forms DNA, makes more RNA

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2
Q

T/F: HIV is able to replicate continuously in their host cells despite a competent host immune response

A

True

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3
Q

Major cellular targets for HIV-1

A

Lymphocytes

mononuclear phagocytes

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4
Q

HIV transmission factors

A
AIDS
Active STD
presence of genital lesions
frequency and type of unprotected sex
circumcision
viral load
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5
Q

How is HIV transmitted

A

Bodily fluids: blood, semen, breast milk

Needles

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6
Q

HIV pathogenesis and progression to AIDS

A

CD4 depletion in GALT in the acute phase of HIV. Selective loss of Th17, polyclonal B cell activation, increased CD4 and CD8 turnover with decreased half lives

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7
Q

T/F: Shingles is suggestive of HIV infection

A

True- also several other indications

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8
Q

AIDS indicators

A

CD4 count <14% of total lymphocytes

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9
Q

Diagnostic testing for HIV

A

Oral fluid testing, urine testing, home test kit, rapid HIV testing

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10
Q

Screening highest sensitivity for HIV

A

ELISA- detecting antibodies to HIV-1 and HIV-2

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11
Q

Confirmation- highest specificity for HIV

A

Western Blot

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12
Q

Acute HIV infection you should perform

A

HIV RNA by PCR

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13
Q

Specific tests used in HIV infection

A

Quantitative HIV RNA, CD4 cell count/percentage, Total lymphocyte count, HLA B5701 (always before abacavir), Resistance testing

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14
Q

Definition of success for HIV

A

HIV RNA <50 copies/mL

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15
Q

A 55 y.o. women has HIV with CD4 count of 344 cells.mm and viral load of 34000 copies/mL. What is treatment

A

2 nucleoside reverse transcriptase inhibitors and 1 non-nucleoside reverse transcriptase inhibitor
OR
2 nucleoside reverse transcriptase inhibitors and 1 protease inhibitor OR
2 nucleoside reverse transcriptase inhibitors and an integrase inhibitor

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16
Q

What drug is used with all PIs to exploit CYP3A4 inhibition to allow for smaller doses

A

Ritonavir

17
Q

Preferred initial treatments

A

1) Tenofovir (TDF)/ Emtricitabine (FTC) + Efavirenz

2) Abacavir/lamivudine + dolutegravir

18
Q

Why is anti retrovirus treatment (ART) necessary?

A

Prevent transmission by lowering viral load

19
Q

HIV in pregnancy- recommended regimen: All infected should be treated regardless of CD4 count with…

A

ZDV/#TC/lopinavir/ritonavir or TDF/FTC+Atazanavir/ritonavir

20
Q

Protease inhibitors are associated with

A

Metabolic syndrome

21
Q

Side effects of HIV medication:

A

Lipodystrophy, Bone disorders, etc…

22
Q

HIV RNA in plasma: HIV RNA should be greater than

A

10,000 copies

23
Q

Oral complications of HIV

A
Apthous ulcer
oral hairy leukoplakia
candidiasis
Kaposi's sarcoma
HSV
24
Q

Frequent Dermatologic complications in HIV patients

A
Herpes zoster (More than 1 dermatome suggests HIV infection)
Eosinophilic folliculitis
MRSA related
Seborrheic dermatitis
purigo nodularis
herpes simplex
bacillary angiomatosis
molluscum contagiosum
cryptococcus
scabies
25
Q

Cardiovascular complications of HIV

A

Dilated cardiomyopathy
pulmonary HTN
Tricuspid valve endocarditis

26
Q

Chronic diarrhea in HIV patients is associated with a CD4<____

A

100

27
Q

Two big neurologic complications in HIV patients

A

Cryptococcus and Bacterial Meningitis

28
Q

T/F: CMV retinitis the CD4 count is usually less than 50 and fundoscopic exam looks like cottage cheese and ketchup

A

True

29
Q

What type of pneumonia is associated with HIV patients

A

Pneumocystitis jirovecci pneumonia

30
Q

What fungal infection is associated with HIV

A

Coccidioides immitis and Histoplasmosa Capsulatum (<150 CD4)

31
Q

Pneumocytitis pneumonia prophylaxis should be started at CD4+ t cell count less than

A

200 cell/mm

32
Q

Prophylaxis for toxoplasmosis in HIV patients. What drug and CD4 count?

A

Bactrim at CD4 <100

33
Q

Definition of virologic management failure

A

HIV RNA> 200 copies/mL

34
Q

Patients who cannot get HIV have what type of mutation

A

CCR5 mutation