HIV and AIDs

Question 1

List some of the ways HIV can be spread.

Answer 1

Sexual transmission
Injection drug misuse
Blood products
Vertical transmission
Organ transplant

Question 2

Which type of cells does HIV infect?

Answer 2

T-helper cells that are CD4+

Question 3

How is severity of illness reflected in CD4 count?

Answer 3

Severity increases the lower the CD4

Question 4

What is normal CD4?

Answer 4

<500

Question 5

At which CD4 levels do most AIDS diagnosis’ get made?

Answer 5

CD4<200

Question 6

What is the difference between AIDS and HIV?

Answer 6

AIDS is the most advanced form of HIV

Question 7

What is the prognosis for anyone presenting with an AIDS illness?

Answer 7

Very good now, virtually everyone recovers once put on antivirals

Question 8

When should there be testing for HIV carried out?

Answer 8

Any unexplained:

lymphadenopathy
neurology
diarrhoea
weight loss
renal impairment
fever
thrombocytopenia/leukopenia

Question 9

What is the typical presentation of primary HIV?

Answer 9

Abrupt onset 2-4wks after exposure
Symptoms are self-limiting 1-2 wks
Symptoms are usually non-specific so many differential diagnosis’s

->approx half patients w HIV have symptoms initially, half asymptomatic

Question 10

30-60% of patients have a seroconversion illness what happens in this?

Answer 10

HIV antibodies first develop

Question 11

What are the symptoms in seroconversion illness of HIV?

-> remember some are asymptomatic though

Answer 11

Fever
Rash
Swollen glands
Flu-like illness
Malaise and lethargy

Question 12

What is Immune Reconstitution Inflammatory Syndrome?

Answer 12

There is improved immunity with restoration of CD4 cells .
However, the increased CD4 cells detect hidden pathogens that the host immunity previously ignored.
This results in inflammation

Question 13

If you present with HIV at a CD4 of <50, what effect does this have on life expectancy?

Answer 13

Reduced life expectancy to around 58

->basically, quicker it’s spotted and treated, longer the life expectancy

Question 14

How long does HIV treatment last?

Answer 14

Rest of life

Question 15

There are different types of antiviral drugs.
What are some of the potential complications of nucleoside reverse transcriptase inhibitors?

Answer 15

Marrow toxicity
Neuropathy
Lipodystrophy

Question 16

There are different types of antiviral drugs.
What are some of the potential complications of non-nucleoside reverse transcriptase inhibitors?

Answer 16

Skin rashes
Hypersensitivity
Drug interactions
Neuropsychiatric side effects

Question 17

There are different types of antiviral drugs.
What are some of the potential complications of protease inhibitors?

Answer 17

Drug interactions
Diarrhoea
Lipodystrophy
Hyperlipidaemia

Question 18

There are different types of antiviral drugs.
What are some of the potential complications of integrase inhibitors?

Answer 18

Rashes
Headaches
Neuropsychiatric side effects

Question 19

What is one of the biggest challenges when it comes to HIV?

Answer 19

The fact that the body ages quicker than those without HIV

->this can lead to complications like osteoporosis, cognitive impairment, malignancy, renal disease, diabetes, etc