HIV and AIDs

Question 1

HIV glycoprotein =

Answer 1

gp 120

Question 2

what does gp 120 bind to

Answer 2

CD4 and CCR5

Question 3

CD4=

Answer 3

T-helper cell receptor

Question 4

organisation of HIV viron=

Answer 4

in a capsid with glycoproteins on the outside

Question 5

inside HIV viron=

Answer 5

• 2 strands of RNA

- enzymes= Reverse transcriptase, integrase, protease

Question 6

HIV co-receptors=

Answer 6

CCR5

CXCR4

Question 7

when HIV membranes fuse with CD4 cells what happens

Answer 7

RNA and enzymes delivered into cytoplasm

Question 8

what makes DNA copies of the RNA

Answer 8

Reverse transcriptase

Question 9

what combines viral DNA into chromosome

Answer 9

Viral enzyme integrase

Question 10

how long does the virus stay in the cell

Answer 10

life of cell

Question 11

what does protease enzyme do

Answer 11

packages accumulated mRNA into a new virus

Question 12

what is the process of DNA replication by HIV reverse transcriptase prone to

Answer 12

error

Question 13

what can nucleotide changes cause

Answer 13

amino acid changes—->continuous generation of new HIV viral variants

Question 14

what can a HIV infection within an individual be conceived as

Answer 14

a viral swarm (or quasi species)

Question 15

what happens if an mutation error is advantageous

Answer 15

take over as the main type of swarm

Question 16

what happens in primary HIV infection

Answer 16

massive HIV infection of memory CD4 T cells (huge CD4 cell loss in gut lymphoid tissue)

Question 17

what happens in Chronic HIV infection

Answer 17

apoptosis/ bystander killing of uninfected CD4 cells

Question 18

what induces bystander killing

Answer 18

viral proteins (Env, Vpr, Tat, Nef)

Question 19

what pathways activate bystander killing (2)

Answer 19

FasL

PD-1

Question 20

risk of HIV infection >500 CD4 count

Answer 20

minimal or none

Question 21

e.g of 3 opportunistic infections possible <200 CD4

Answer 21

pneumocystis pneumonia
toxoplasmosis
oesophageal candida

Question 22

Kaposi’s sarcoma=

Answer 22

• viral cancer
• caused by HHV8 herpes virus .
• proliferation of blood vessels—>purple red colour on face only

Question 23

most common opportunistic infection

Answer 23

pneumocystis pneumonia

Question 24

CNS toxoplasmosis=

Answer 24

affects plasma in brain —> huge abscesses

Question 25

CMV retinitis=

Answer 25

pizza pie in retina (necrosis and bleeding)

acute onset of blindness 2-3 weeks

Question 26

a pneumonia found in AID/HIV also found in premature infants

Answer 26

pneumocystis jiroveci

Question 27

what is pneumocystis jiroveci caused by

Answer 27

fungi

Question 28

5 classes of Antiviral drugs

Answer 28

NRTIs
NNRTIs
PIs
Boosting agens 
CCR5 inhibitor 
integrase inhibitors

Question 29

NRTIs=

Answer 29

nucleoside reverse transcriptase inhibitors

Question 30

NNRTIs=

Answer 30

non-nucleotide reverse transcriptase inhibitors

Question 31

PIs=

Answer 31

protease inhibitors

Question 32

name 3 NRTIs

Answer 32

abacavir
tenofovir
lamivudine

Question 33

name 4 NNRTIs

Answer 33

nevirapine
Efavirenz
Etravirine
Rilpivirine

Question 34

name 2 protease inhibitors

Answer 34

Atazanavir

darunavir

Question 35

3 integrase inhibitors

Answer 35

Raltegravir
Elvitegravir
Dolutegravir

Question 36

antiviral therapy rule=

Answer 36

always start with 3 agents, 2 NRTIs + either; NNRTI, PI or II

Question 37

after starting Antiviral therapy when should viral load become undetectable

Answer 37

within 6 months

Question 38

what happens if the viral load rises to >500 on Antivirals

Answer 38

ask for sequencing/ anti-retroviral drug resistance and compare with baseline