HIV (Clinical Correlation) Flashcards
What are the goals of HIV screening?
Who should be screened?
Identify infected individuals to start early treatment and decrease transmission.
Anyone who hasn’t been screened before, pregnant mothers, IV drug users, sex workers, and those with new sexual partners.
What symptoms are observed in acute retroviral syndrome? When?
2-6 weeks after infection: fever, myalgia, fatigue, rash, pharygnitis, lymphadenopathy.
When are western blots used in HIV monitoring?
As a confirmatory test to ELISA (presumably Ab).
What does pooled HIV RNA testing entail?
Sample 90 patient’s worth of blood. If the batch is negative, they’re all clean. If not, retest them in smaller batches. Apparently this is more efficient.
What are the goals of HIV treatment?
When should treatment be started?
To eliminate viral load, restore CD4 counts, and eliminate direct symptoms.
Start treatment if CD4 < 500/uL, but offer to anyone.
In HAART, two of the three drugs belong to a particular class of drug. Which is it?
2 are nucleoside RT inhibitors. The remaining drug may be a protease inhibitor, integrase inhibitor, or even another RT inhibitor.
What is the risk of infection for a fetus of an untreated, HIV+ mother?
What would this risk be if the mother underwent HAART?
25%.
0-1%.
What routes of transmission of HIV are highest risk? Lowest risk?
Blood inoculation (via IV) poses greatest risk. Receptive anal sex is next highest risk, followed by percutaneous needle stick and receptive vaginal sex.
Oral sex is low risk.
What is the rule of 3’s?
Describes the risk of infection of someone stuck with a tainted needle.
- For hepatitis B, the risk is approximately 30%.
- For hepatitis C, the risk is approximately 3%.
- For HIV, the risk is approximately 0.3%.
By what means can a healthcare worker contract HIV from a patient?
By what means do they generally NOT contract it?
How often does this happen?
Purcutaneous injury, mucous membrane contact, and exposure to blood, tissue, CSF, synovium, pleural/pericardial/peritoneal/amniotic fluids, and seminal/vaginal fluids.
Feces, urine, vomit, saliva, sweat, tears, sputum, nasal secretions.
It hasn’t happened since 2001.
Distinguish between PEP and PrEP.
PEP is prophylactic treatment for people exposed to HIV (usually in a healthcare setting). It must be initiated within 72hrs of exposure for efficacy.
PrEP is prophylactic treatment for people expected to be exposed to HIV. It appears to reduce risk by around 40%.
