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3rd Year Infection > HIV Disease > Flashcards

HIV Disease Flashcards

1
Q

How is HIV transmitted?

A 
Sexual transmission
Injection drug misuse
Blood products
Vertical transmission
Organ transplant
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2
Q

What is the most common route of HIV transmission?

A

MSM

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3
Q

What is the pathophysiology of HIV?

A

HIV attacks T-helper cells that are CD4+

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4
Q

CD4 receptors are present where?

A

Macrophages
Monocytes
Cells in brain
Skin

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5
Q

Worsening HIV is described as what?

A

↑viral load

↓CD4

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6
Q

When does AIDS occur?

A

CD4 <200

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7
Q

What is stage 1 HIV?

A

Asymptomatic

Persistent generalised lymphadenopathy

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8
Q

What is stage 2 HIV?

A

Weight loss (<10%)
Minor mucocutaneous manifestations
Herpes zoster
Recurrent URTI

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9
Q

What Minor mucocutaneous manifestations are associated with HIV?

A 
Seborrheic dermatitis
Prurigo
Fungal nail infections
Recurrent oral ulcerations
Angular chelitis
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10
Q

What is stage 3 HIV?

A 
Weight loss >10%
Unexplained chronic diarrhoea
Prolonged fever
Tuberculosis
Oral candidiasis
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11
Q

What are the earliest opportunistic infections associated with HIV?

A

Thrush
Skin changes
PJP

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12
Q

What are the respiratory conditions suggestive of HIV?

A

TB
Pneumocystis
Bacterial pneumonia
Aspergillosis

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13
Q

What are the neurological conditions suggestive of HIV?

A 
Toxoplasmosis
Cryptococcal meningitis
PML 
Aseptic meningitis
Cerebral abscess
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14
Q

What are the dermatological conditions suggestive of HIV?

A

Kaposi’s sarcoma
Severe dermatitis/psoriasis
Recurrent herpes zoster

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15
Q

What are the GI conditions suggestive of HIV?

A

Persistent cryptosporidiosis

Oral candidiasis

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16
Q

What are the oncological conditions suggestive of HIV?

A

Non-hodgkin’s lymphoma

lung, seminoma, anal, head and neck

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17
Q

What are the cervical conditions suggestive of HIV?

A

Cervical cancer

Vaginal/cervical neoplasia

18
Q

What are the haematological conditions suggestive of HIV?

A

Unexplained:
Thrombocytopenia
Neutropenia
Lymphopenia

19
Q

What are the ophthalmological conditions suggestive of HIV?

A

Cytomegalovirus retinitis

Toxoplasma

20
Q

What is the natural history of HIV?

A 
Acute infection - seroconversion
Asymptomatic
HIV related illness
AIDS defining illness
Death
21
Q

What proportion of HIV patients have seroconversion illness?

A

30-60%

22
Q

What are the symptoms of HIV seroconversion?

A 
Non-specific:
Flu-like illness 
Fever
Malaise and lethargy 
Pharyngitis
Lymphadenopathy 
Toxic exanthema
23
Q

What is the most common AIDS infection?

A

Pneumocystis jiroveci pneumonia

24
Q

At what CD4 level does PJP commonly present?

A

<200

25
Q

How does PJP present?

A

Dry cough

Increasing breathlessness over weeks

26
Q

How should PJP be investigated?

A

CXR

Sputum broncoscopy - PCR

27
Q

How should PJP be treated?

A

Co-trimoxazole
Pentamidine
Prophylaxis until CD4>200

28
Q

What adherence is necessary for Combination antiretroviral therapy?

A

> 90%

29
Q

What is Combination antiretroviral therapy?

A

At least 3 drugs from at least 2 different drugs

30
Q

Where do Combination antiretroviral therapy drugs act?

A

Reverse transcription inhibitors
Integrase inhibitor
Protease inhibitor

31
Q

What risk is associated with CD4<350?

A

Risk of symptoms without treatment

32
Q

When should pregnant women be started on Combination antiretroviral therapy?

A

Start before third trimester

33
Q

What is the life expectancy of HIV?

A

Depends on CD4 before starting therapy
<100 - 52
100-200 - 62
>200 - 70+

34
Q

What are the typical causes of failed HIV treatment?

A

Inadequate potency
Inadequate drug levels
Inadequate adherence
Pre-existing resistance

35
Q

What antiviral drugs are used in HIV?

A

Nucleoside reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
Protease inhibitors
Integrase inhibitors

36
Q

What side effects are associated with Nucleoside reverse transcriptase inhibitors?

A

LIPODYSTROPHY
Marrow toxicity
Neuropathy

37
Q

What side effects are associated with Non-nucleoside reverse transcriptase inhibitors

A

Skin rashes
Hypersensitivity
Drug interactions
Neuropsychiatric effects

38
Q

What side effects are associated with Protease inhibitors?

A

LIPODYSTROPHY
Drug interactions
Diarrhoea
Hyperlipidaemia

39
Q

What side effects are associated with Integrase inhibitors?

A

Rashes

Disturbed sleep

40
Q

How does Lipodystrophy present?

A

Additional visceral fat
Sunken cheeks
Less fat on limbs

41
Q

Lipodystophy is associated with what in HIV?

A

Older antivirals:
Protease inhibitors
Nucleoside RT inhibitors

42
Q

How is HIV prevented?

A 
Behaviour/Condoms
Circumcision
Treatment as prevention
Pre-exposure prophylaxis
Post-exposure prophylaxis (for sex)

3rd Year Infection (16 decks)

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