HIV - disease processes

Question 1

What are the modes of transmission of HIV?

Question 2

Where does HIV originate from?

Question 3

What genus is HIV from?

Answer 3

Lentivirus

Question 4

Describe the epidemiology of HIV.

Question 5

Describe the structure of HIV

Answer 5

Question 6

How is HIV diagnosed?

Answer 6

HIV infection is usually diagnosed through blood tests detecting the presence or absence of HIV antibodies.

Question 7

Describe HIV-1 infection.

Answer 7

o Entry via the genital mucosal epithelium or intravenous routes
o Entry virus reaches draining lymph nodes and spreads to the GALT.
o GALT has a large number of CD4+ T-cells susceptible to infection.
o At early stage of infection anti-HIV CD8+ T cell responses are a critical determinant of control.

Question 8

Describe the HIV life cycle.

Answer 8

Question 9

Describe the immune response to HIV-1

Answer 9

Question 10

List the three main stages of HIV

Answer 10

Acute phase
Chronic phase
AIDs phase

Question 11

Describe the three main stages of HIV disease.

Answer 11

Question 12

List HIV-1 associated co-morbidities

Answer 12

Opportunistic infection (pneumonia, Salmonella infection, candidiasis, toxoplasmosis)
Co-infection (e.g. M. tuberculosis, Influenza, cryptococcal meningitis).
Cancer
Autoimmune and inflammatory diseases
Cardiovascular disease (CVD)
Liver disease
HIV-associated neurological disease (HAND)
Immune reconstitution inflammatory syndrome (IRIS)

Question 13

List the HIV-1 patient phenotypes

Answer 13

Fast progressor
Slow progressor/long term non progressor (LTNP)
Elite controller
Resistant

Question 14

Describe the state of the immune system for each HIV-1 patient phenotype (exclude resistant)

Answer 14

Question 15

What are the factors influencing disease progression and pathogenicity?

Question 16

How do we measure infection pathogenicity?

Question 17

Which factors influence pathogenicity

Answer 17

immune activation set point and viral load set point

Question 18

What does immune activation help us predict?

Answer 18

disease progression, pathogenicity and morbidity in HIV-1 infection

Question 19

What are the markers of immune activation?

Answer 19

monocyte activation
D-dimer
CRP
Serum LPS

Question 20

What are the possible causes of immune activation?

Answer 20

innate immune activation
pyroptosis during cell-cell infection by HIV-1
LPS translocation across the gut mucosa
co-infection

Question 21

What are the consequences of immune activation?

Question 22

Describe the status of the HIV vaccine.

Question 23

Describe antiretroviral therapy as a treatment for HIV-1

Question 24

Describe the issues with antiretroviral therapy.