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HIV/EBV Flashcards

1
Q

detectable viremia

A

10-15 days after infection

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2
Q

p24 ag with IgM

A

detect before seroconversion

positive in acute infection

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3
Q

early HIV testing

A

4th gen test and RT-PCR at same time

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4
Q

“red flags of HIV”

A

thrush

shingles

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5
Q

Transmission in pregnancy

A

pregnancy
labor and delivery
breastfeeding

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6
Q

Efavirenz in pregnancy

A

causes neural tube defects

if on it and pregnant do not change because she found out too late

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7
Q

drug of choice for HIV+ pregnant woman

A

zidovudine

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8
Q

prophylaxis <200

A

pneumocystis, toxoplasmosis (at 100)

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9
Q

prophylaxis <50

A

MAC/MAI

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10
Q

HLAB5701

A

abacavir

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11
Q

pretreatment CD4 count >250 females/>400 males

A

nevirapine

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12
Q

cobicstat

A

booster without antiviral activity (utilized with elvitegravir)

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13
Q

maraviroc

A

binds CCR5 R to prevent entry

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14
Q

injection site irritation

A

enfuvirtide

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15
Q

MOA enfuvirtide

A

binds pg41

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16
Q

MOA NNRTI

A

bind directly to reverse transcriptase

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17
Q

long half life complications of NNRTI

A

resistance-monotherapy exposure

side effects

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18
Q

NNRTI side effect

A

rash

can progress to Steven Johnson Syndrome (highest in nevirapine)

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19
Q

neuropsychiatric symptoms

A

efavirenz

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20
Q

MOA NRTI

A

block RT after phosphorylation intracellular (building blocks of RNA and DNA)

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21
Q

anemia side effect

A

Zidovudine

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22
Q

peripheral neuropathy

A

didanosine and stavudine

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23
Q

hyperpigmentation of skin

A

emtricitabine

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24
Q

nucleotide NRTI

A

tenofovir

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25
Q

adverse reaction of integrase inhibitor

A

CPK elevation (end in ravir)

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26
Q

MOA protease inhibitors

A

inhibit protease from cleaving large viral polypeptides into smaller functional virons

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27
Q

excretion protease inhibitors

A

hepatic oxidative metabolism-drug drug interactions

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28
Q

booster

A

ritonavir

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29
Q

adverse side effects protease inhibitors

A

endocrine side effects-hyperlipidemia, insulin resistance

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30
Q

hepatitis

A

tipranavir

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31
Q

kidney stones

A

indinavir

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32
Q

prolonged QT

A

atazanavir

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33
Q

PI resistant virus

A

darunavir and tipranivir

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34
Q

post exposure prophylaxis

A

truvada (2 hrs after for 28 days)

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35
Q

pancreatitis

A

didanosine

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36
Q

cross reactivity with sulfa drugs

A

darunavir and tipranivir

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37
Q

jaundice

A

atazanavir and indinavir

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38
Q

paresthesias

A

fosamprenavir and ritonavir

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39
Q

cells infected by HIV

A

T cells-lymphoid tissue are infected
monocytes and macrophages
dendritic cells

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40
Q

loss of T cells

A

direct cytopathic-increased permeability, apoptosis, inflammasome

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41
Q

uninfected killed

A

loss of immature precursors

syncytia formation

42
Q

qualitative defects CD4T

A

reduction in T cell proliferation
decrease in Th1/Th2
loss of memory
decreased B antibody production

43
Q

latent infection

A

CD4 and macrophages (resistant to cytopathic effects)

protected from antiviral therapy

44
Q

abnormal monocyte with HIV

A

CNS infections
decreased phagocytosis
decreased IL1 (no fever)
decreased APC function

45
Q

dendritic cells with HIV

A

transport to LN to transfer to CD4 T cells

46
Q

B lymphocytes in HIV

A

polyclonal activation with germinal center B cell hyperplasia
plasmacytosis
hypergammaglobulinemias
increased immune complexes (TIII HS)

47
Q

HIV in CNS

A

neurons not infected
microglia and macrophages infected
monocytes carry HIV to CNS

48
Q

primary infection

A

mucosal epithelia
memory T cells first to be infected
DC to LN

49
Q

seroconversion

A

mount humoral and cell mediated immune responses

50
Q

acute retroviral syndrome

A

3-6 weeks after infection, resolves in 2-4 weeks

nonspecific symptoms of sore throat, myalgias, fever/sweats, wt loss, fatigue

51
Q

chronic infection

A

LN and spleen as sites of replication

decrease CD4 and increase viral burden

52
Q

AIDS

A

opportunistic infections and cancers

CD4 <200

53
Q

AIDS opportunistic infections

A 
pneumocystis
candidiasis
CMV (mostly eye and GI)
MAI
miliary TB
cryptococcus (meningitis)
toxoplasmosis (encephalitis)
JC virus-PML
HSV
54
Q

Kaposi sarcoma

A

cancer in AIDS patients
vascular neoplasm
caused by HHV8 (STD)

55
Q

high grade B cell lymphoma

A

B cell lymphoma late in AIDS
occur in LN, brain, or body cavities
associated with EBV

56
Q

long term side effects of ART

A

lipoatrophy
excess fat deposition centrally
premature CVD, kidney and liver disease

57
Q

lymph nodes

A

follicular hyperplasia to follicular involution

58
Q

serology

A

antibody response 6 days to 1 month after infection

antigenemia precedes seroconversion

59
Q

CD4 T cell counts

A

indicator of disease progression

60
Q

viral load test

A

monitor effectiveness of antiviral therapy

61
Q

diagnostic algorithm

A

p24 antigen (appears before antibodies), then immunoassay or HIV1 nucleic acid test

62
Q

HIV1

A

widespread

63
Q

HIV2

A

West Africa

64
Q

HIV structure

A

positive polarity RNA

65
Q

M tropic

A

macrophages

66
Q

T tropic

67
Q

GAG

A

capsid and core

68
Q

POL

A

enzymatic complex (RNAse H, protease, integrase)

69
Q

TAT

A

transactivator for viral and cellular (LTR)

contributes to cancer

70
Q

REV

A

transport mRNA out of nucleus and splicing

71
Q

NEF

A

decreases expression of CD4 and MHCI changes T cell signaling

72
Q

VIF

A

virus assembly and inhibits antivrial APOBEC

73
Q

VPU

A

enhances release

74
Q

VPR

A

arrests at G2

75
Q

p24

A

cylindrical core

76
Q

gp120 and 41

A

held together by noncovalent bonds
120 for attachment
41 for fusion

77
Q

errors in HIV

A

RT prone to errors

RT shows copy choice

78
Q

CCR5

79
Q

CXCR4

80
Q

primary HIV screening

81
Q

secondary screening

A

Western blot

82
Q

positive Western Blot

A

positive-serum antibodies bind 120, 41, 31, 24

83
Q

EBV latent infections

A

cells of respiratory system and regional lymph nodes

84
Q

transport of EBV

A

lymphocytes

85
Q

EBV receptor on B cells

86
Q

EBNA

A

DNA binding proteins

87
Q

VCA

88
Q

MA

89
Q

EA

A

early antigen

90
Q

late proteins enable attachment

91
Q

fusion interacts with MHC II

92
Q

latent membrane proteins

A

promote immortalization of B cells

93
Q

cofactor in Burkitts lymphoma

94
Q

Downey Cells

A

atypical lymphocytes in blood in response to EBV infected B cells

95
Q

heterophile antibodies

A

polyclonal antibodies from infected B cells

96
Q

antibody time course

A

VCA (IgM) to VCA (IgG) to EA and EBNA

97
Q

treatment mono

A

valacyclovir

98
Q

vaccine

A

subunit vaccine

99
Q

roseola

A

infects B and T cell and can infect epithelial and endothelial cells and neurons (6 and &

100
Q

HHV8

A

Kaposi sarcoma, GH like product

DT1 (4 decks)

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