HIV and AIDS Flashcards
What does HIV bind to on WBCs?
CD4
What protein does HIV use to bind to CD4?
GP120
What happens to the infected cell after HIV enters it?
Migrates to lymphoid tissue
Replicates
What does the virus do inside the immune cell?
Uses reverse transcriptase to create DNA from viral RNA (it’s a retrovirus) and then integrates into the cells DNA to be transcribed and translated
What happens once the cell has produced lots of HIV virons?
The virus uses protease to mature
The virus then leaves the cell via budding
What is the first stage of HIV infection?
Primary stage
What symptoms may be present at the primary stage?
Similar to the glandj
- Rash
- Lymphadenopathy
- Pharyngitis
What test can be done in the primary phase?
ACUTE PHASE SERUM
- Test for HIV antigen
What are the findings on early and late acute phase serums?
- Early sample = antigen positive antigen negative
- Late sample = antibody positive
What stage follows the primary stage?
Seroconversion stage
What is the definition of the seroconversion phase?
Time taken for antibodies to be detectable in the blood
When does the seroconversion phase occur?
2-6 weeks post exposure
What symptoms can occur in the seroconversion phase?
- Fever
- Malaise
- Pharyngitis
- MACULOPAPULAR RASH
What does a short non severe seroconversion phase indicate?
Good prognosis
What does a long or severe seroconversion phase mean?
Poor prognosis
What happens to the viral load at the start of the seroconversion phase?
Very very low –> progressively overtakes antibodies over years
What is an AIDS related complex?
Prodromal phase of infection
What are the symptoms of an AIDS related complex?
- Fever
- Night sweats
- Weight loss
- Opportunistic infection
- > oral hairy leukoplakia
- > oral candidiasis
- > Seborrheic dermatitis
First investigation?
ELISA
- Serum anti-HIV antibiotics
What is the conformation test for HIV?
Western blot
What else can confirm?
PCR
What test can be done in developing countries?
Rapid antibody test
What are the limitations of the rapid antibody test?
False pos/neg
Needs confirmation of western blot
What are the 3 drug classes that can be used for treatment of HIV?
NNRTIs (non nucleoside reverse transcriptase inhibitors)
NRTIs (nucleoside revere transcriptase inhibitors)
Protease inhibitors
What are examples of NNRTIs?
Efavirenz
What are examples of NRTIs?
Tenofavir
Zidovudine
What are examples of protease inhibitors?
Saquinavir
Lopanivir
What is the name of the treatment method for HIV?
HAART
- Highly active anti retroviral therapy
What are the regimens of HAART?
1 NNRTI + 2 NRTIs
PI + 2NRTIs
What are the indications for HAART?
CD < 350cells/mm3
Pregnancy
Co infection
Symptoms
What should be given after a risky exposure?
Post exposure prophylaxis
- HAART for 28 days
How do you monitor HIV patients?
CD4 count
Viral load
General bloods
What are the bacterial complications of HIV?
Toxplasmosis
Cryptococcal meningitis
TB
Mycobacterium avium chest infection (VERY LOW CD)
What are the viral complications of HIV?
Cytomegalovirus
JC virus
What does the JC virus cause in HIV?
Progressive multifocal leukoencephalopathy
- Demyelination of CNS
What are the fungal complications of HIV?
Pneumocystis pneumonia (PCP)
Candidiasis
What fungus causes PCP?
Jiroveci fungus
What is used to treat PCP?
Co trimoxazole
What is used to treat mycobacterium avium complex?
Azithromycin
What is used to treat toxoplasmosis?
Co trimoxazole
