HIV Diagnosis and Tx Flashcards
What are attributes of the HIV-1 Virus?
Infects and deplets CD4+ T cells High Mutation rate Evades Ab and Cellular Immunity Defies Traditional vaccines Hides in resting memory CD4+ T cells
What defines diagnosis of AIDS?
CD4+ T cells
What diseases can you catch as your CD4 count drops?
>750 normal 400 Kaposi's sarcoma and TB Dementia 200 Pneumocystis Wasting 100 Toxoplasmosis, cryptococcis 50 CMV, Myco Avium
What are diseases that can appear in healthy people but worse in AIDS
Bacterial Pneumonia Zoster Thrush Oral Hairy Leukoplakia HPV-related dis Anemia Immune thrombocytopenia Neutrosyphilis Lymphadenopathy
What has happened to incidence and prevalence of HIV as Tx has improved?
Prevalence still increasing (people are living longer with the disease)
Incidence going down (new cases)
WHat Tx has changed the death rate from HIV the most?
Era of combination Antiretroviral Treatment (cART)
WHat demographic has the highest percent of new HIV diagnoses?
Male to Male sex
Need pre-exposure prophylaxis!
What race represents the highest new HIV Diagnoses?
African/African American
Caucasians 2nd
What are the signs of acute Retroviral Syndrome?
Flu or Mono syndrome 75%
Pharyngitis, rash, headache 50%
What is the time frame of Blood markers in an HIV infection?
HIV RNA rises first, drops then levels off
HIV p24 Antigen rises second, drops to zero
HIV Antibody rises last, drops then rises steadily
What are the Chosen Screening tests for HIV ab?
ELISA- Gold Standard
Rapid Tests
What are the confirmatory tests for HIV?
Western Blot HIV-1
Multispot HIV-1/2 test
What is the 2 step testing protocol process
- Reactive HIV Ag/Ab screening test
- Multispot HIV-1/2 Discriminatory Assay
- HIV1 nucleic acid testing
What is the age range that has the Grade A recommendation for HIV screening?
15-65 yo
What is the difference between HIV-1 and HIV-2?
Less transmissable and Pathogenic
Dual Infection possible
What are the Traits of the CCR5 tropic HIV Strain?
Major viral species
Essential for Transmission
What are the Traits of the CXCR4 tropic HIV Strain?
80% incidence in AIDS
Associated with more rapid disease progression
What are the benefits of the Delta 32 CCR5 mutation?
Homozygous: Much lower risk of infection by HIV
Heterozygous: Delayed progression to AIDS
How can risk of transmitting HIV from mom to baby be minimized?
Treat Mom’s HIV
Post exposure prophylaxis for baby
Do NOT Breast feed
What are the skin symptoms of secondary Syphilis?
Macular - Papular Rash
Palmar-Plantar rash
Mucous Patches
Condyloma Lata
What is the prevalence, Tx and DDx of Pneumocystis Pneumonia?
Most common AIDS defining illness
CD4
WHich Opportunistic infections require Primary Prophylaxis (Prevention)?
Pneumocystis
Toxoplasma
MAC
WHich Opportunistic infections require Secondary Prophylaxis (Maintenence)?
Pneumocystis Toxoplasma MAC CMV Cryptococcus Histoplasma
What are the ARV Drug Classes?
CCR5 co-receptor antagonist Fusion Inhibitor Reverse transcriptase Inh Integrase strand transfer inhibitor Protease inhibitor
Which HIV drugs have the highest risk for Drug-Drug interaction?
PI- HIGH: Decreases effectiveness of BC pills
NNRTI- Mod: Efavirenz is teratogenic
What needs to be dome before putting a patient on Abacavir?
HLA- B5701 test prior to abacavir use
What are the components of Metabolic Syndrome?
Central Obesity Hypertension High TRGs Low LDL Insulin Resistance
What are the common causes of death in AIDS patients?
AIDS-related Liver CVD Non-AIDS Cancer Other (substance abuse)
