HIV and hepatitis! Flashcards
how many cases worldwide of HIV r there?
37 million
what is an opportunistic infection?
name three opportunistic infections linked to AIDS
**(alaa they said this could be a good exam qs)
TB, PCP, Cryptococcal disease.
opportunistic infection is an infection caused by pathogens that take advantage of an opportunity not normally available, such as a host with a “weakened immune system”, an altered microbiota (such as a disrupted gut flora), or breached integumentary barriers.
is there a cure for HIV? what happens if u diagnose it late?
nopes
they die
simple as that ;)
how much HIV is present in theUK?
Men= 67% Women= 33%
in which group of ppl is HIV rising increase
MSM> men who have sex with men (gays)
which group of ppl r being diagnosed at a late stage?
Heterosexuals.
average age of diagnosing=40
What is HIV? classify it? what time of cells do they infect
Human Immunodeficiency Virus
-Retrovirus “backwards” (injects its material as RNA which is then converted to DNA.
-they infect cells with CD4 surface receptor
- monocytes/ macrophages
- t helper lymphocytes
-the virus carries enzymes with it! (RIP) 7aywan shayil shalayla wiyah!
Viral Structure
Genome - RNA or DNA
• Single-stranded (ss)
• Double-stranded (ds)
Capsid – protein shell, protects the genome
• Helical (rod-shaped or coiled)
• Icosahedral (spherical or symmetric)
*****Lipid envelope – present or absent
• Derived from host cell membranes
• Contains virus-specific proteins (antigens)
****THIS IS WHAT GIVES THE VIRUS ABILITY TO BECOME INFECTIOUS!
describe HIV replication, where does it replicate? in which step is the process irreversible?
details in ur notes lally
-in the cell
-once the viruse’s DNA is injected into our DNA via the INTEGRASE ENZYME»Irreversible
how is HIV transmitted?
1) sexual
2) transfusion
3) contaminated needles
How can u confirm that a patient has been infected with HIV?
The presence of HIV antibody!
what does the presence of HIV antibody in the patient mean?
The presence of HIV antibody means the patient has been exposed to HIV, but has mounted an immune response and is clearing the infection
how can HIV transmitted vertically?
when mum gives birth
in placenta during pregnancy
or
during birth where there is mixing of baby and mamas blood!
what is an opportunistic infection?
pathogen “takes the opportunity”
it takes advantage of immunocompromised patients and cause serious damage
OR
they appear in a location other than their homes
why r lymph nodes activated in HIV? what symtom can that cause?
Lymphadenopathy
thrombocytopenia
as ur CD4 count starts to decrease.. number of symptoms start arising.
got it
Factors Affecting HIV Transmission? preventing and causing
-type of exposure
How u decide to have sex..ANAL» bigger transmission
- condom use
- breaks in skin and mucosa
how can breaks in the skin cause HIV?
u get inflammation of the genital tract (maybe ulcers will break down and pass the virus much easily)
what is the life expectancy and quality of life with those who have HIV?
HIV +ve: 77yrs as long as they: detected early (before their CD4 count falls!) Treatment Adherence Healthy living • Smoking, alcohol, metabolic problems
what r u looking for when give a serology blood test?
- detects Antigen-viral protein
- detect antibodies-immue response to antigen
- result can be given same day
- u can get a false negative sometimes if u do it so early
what does serology mean?
blood tests that look for antibodies in your blood.
how to u test for HIV?
Blood test serology
Blood test PCR
Rapid tests
what is ur goal to check for in a PCR test?
- HIV nucleic acids
- u can detect very small early of DNA» u can detect HIV early!
what r some rapid tests u can perform for HIV testing? what r they checking for?
ANTIBODIES
blood test (finger prick) Oral (saliva) Postal testing sugar test home-testing
who should be tested?
EVERYONE
Resp: bacterial pneumonia / TB
• Neuro: meningitis/dementia
• Derm: Severe psoriasis
Recurrent/multi-dermal shingles
• Gastro: Chronic diarrhoea/weight loss ?cause
• Haem: any unexplained blood abnormality
• Onc: lymphoma, anal cancer
• Gynae: Cervical intrapithelial neoplasia (CIN) • Any STI/ Hep B/ HepC
what r u trying to achieve when treating HIV?
-reduce the viral load
-allow CD4 to recover
reduce inflammation
-reduce transmission risk
-give good quality of life
is their a vaccine available for HIV?
NO
bs il7aywan keeps changing its envelope structure!
(extra: due do mutation and alteration in the GP120 gene)
when giving treatment, what areas do u want to target on the HIV virus?
-its enzymes (RIP)
-stop virus from binding
-
which drugs is commonly given to those with HIV? how much of give and why?
3!
to make it harder for the virus to develop resistance!
what strategies would you use to treat and reduce the prevalence of HIV?
- increase condom usage
- prevention mother to child transmission
- post and pre exposure prophylaxis.
what r the Ethical dilemmas that may rise in HIV?
-Worried about stigma in community
-Patient confidentiality vs:
– Health of mother
– Health of unborn child
– Health of sexual contact (husband) – Health of older child
– Risk to patients / staff at workplace
Globally, the majority of new cases with HIV are diagnosed in?________
In the UK, the majority of new cases with HIV are diagnosed in_______
Heterosexual men/women
MSM
what is the average life expectancy of people with HIV in the UK?
77 yrs
The risk of acquiring HIV from a needlestick injury from a positive person is:
a) 1:3
b) 1:30
c) 1:300
C
what is a latent infection?
A latent infection is an infection that is hidden, inactive, or dormant.
As opposed to active infections, where a virus or bacterium is actively replicating and potentially causing symptoms, latent infections are essentially static
when do ppl start to notice that they r unwell?
hint: CD4
when CD4 cell count drop so much (to about 350 cells).
if Hep B is untreated, what consequence can it lead to?
Liver cirhossis
Hepatocellular carcinoma
what is hepatitis?
hepa-titis
Liver-inflammation
SOOOO
Inflammation of the liver!
M|IND BLOWN
which classes of hepatitis r spread via fecal-oral route?💩
A & E
u can’t get hepatitis____with having hepatitis______
D
B
What is jaundince
A term used to describe the yellowing of the skin and the white of the eyes😶
Explain excretion of bile
Ur notes alaa
Types of jaundice
Preheptic
Cholestatic
~intrahepatic
~extrahepatic
What is cholestasis?
Bile is is not moving, its stuck🤢
What r some types of liver function tests? (4)
Liver transaminases
- ALT
- AST
Alkaline phosphotase
(checks for bilary tract cell damage)
Albumin
Coagulation tests
What is transamination?
Removal of NH2 from aa via amino transaminase
It transfers NH2 from aa to keto acid
whatever of jaundice do u see with those who have hepatitis? or any other sort of infection?
intra-hepatic jaundice!
how is Hep B mostly transmitted? (5)
Vertical trasmission mostly
- sexual contact
- ppl who inject drugs!
- houshold contact (ex sharing raizers, shavers) some blood can be transmitted.
- needle stick injury (healthcare workers!)
Symptoms of Hep B? (7)
- jaundice
- Fatigue
- abdominal pain
- Anorexia
- nausea
- vomitting
- arthralgia (pain in joints)
SOMETIMES NO SYMPTOMS AT ALL!
discuss the hep B serology and what does the presence of each one indicate?
Hb S ag> means virus is currently preSent
Hb E ag> HIGHLY INFECTIOUS
Hb C ag> Core antigen
HB C Ab»IgM & IgG
which antibody comes first during early infection?
igM
MAMA always number 1
During diagnosis? the presence of which antigen is a very important marker during pregant women and why?
HbE! if the mother has this while giving birth, this means that the virus is ACTIVELY replicating, which means mum has a high risk of transmitting this to the baby!
which antigen first appears during a Hep B infection? what does it indicate?
Hbs> surface antigen
indicates that virus is present
how can u tell if a person has Chronic Hep B infection?
if they still have the HbS antigen 6 months later!
ACUTE HBV, either immune system helps us out and we r resolved or….
it can become chronis> liver cirrhosis>Hepatocellular carcinoma
sorry, but ur in deeeeep shit.
Treatment of HBV?
No cure
- u can give life long antivirals! to suppress viral replication
- though some ppl can have the virus but the immune system is rocking its job and their liver doesn’t have to shit up, but these ppl still have to be managed!
Is there a vaccination for HBV?
YASSSS
Give SURFACE antigen vaccine
ur body will produce a SURFACE antibody response!
3 doses bitchesss.
a booster may be needed later
in hep C who is at risk?
ppl who inject drugs (Iv drug users)
- heroin
- crack
- metamphetamines
Hep C=Crack
- sexual
- blood transfusion.
unlike Hep B where most ppl do NOT get chronically infected, those with Hep C 80% become chronically infected!
ok
those with Hep C go on to develop chronic liver disease, this will result in:
- Hepactocellular carcinoma
- Transplant
- death
Hep C symptoms
the CAT is evil! its hiding the symptoms!
80% have NO symptoms! 20% have a vague symptoms -fatigue -anorexia -nausea -adominal pain
Blood test for Hep C?
ya 7alat il Cat, rayi7 balna wa ga3ad,
Serolgy= anti-Hep C antibody only
having Hep C antibody doesn’t mean u “currently” have the infection.
it can still remain there even after clearance.
Soooo
we do Viral PCR,
& if its positive= confirms its ongoing action.
how do u treat Hep C? is there a vaccine?
8-12 weeks of anti-viral drugs
no
who is at more risk of transmission from a needle stick injury?
HIV
hep B
hep C
Hep B 1/3
what is the Risk of transmission from needlestick injury for Hep B, Hep C, HIV?
- HIV - 1/300
- HepC- 1/30
- HepB- 1/3
Why does HBcAg (Hepatitis B core Antigen) NOT appear in the blood?
ONLY present in liver tissue
Define Chronic Hepatitis B
Persistence of Hepatitis B Surface Antigen (HBsAg) after 6 months from infection
which hepatitis is mostly in IV drug users
Hep C
bad ass cat
which hepatitis is 80% Asymptomatic?
Hep C
which Hep has no vaccine?
Hep C
which type of bodily fluid exposure from hiv infected person carries greatest risk of HIV transmission?
Anal sex
