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Microbiology > HIV epidemiology and confidentiality > Flashcards

HIV epidemiology and confidentiality Flashcards

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Biology 101 flashcards
1
Q

What were the UNAIDS goals?

A

90% of people living with HIV being diagnosed
90% diagnosed on ART
90% viral suppression for those on ART by 2020

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2
Q

What do the two blood tests done for HIV measure?

A

CD4 count

viral load

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3
Q

Do more males or females have HIV in the UK?

A

males

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4
Q

Why do older people in the UK have more HIV?

A

didn’t have sex ed at school
may not use condoms as infertile anyway
divorce rate high

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5
Q

In the UK, which group of people has highest rates of HIV?

A

homosexual men

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6
Q

Why is there low HIV from drugs in the UK?

A

needle exchange programme

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7
Q

What needs to be improved in the UK in terms of HIV?

A

timely diagnosis - need to increase the number of people being diagnosed and people being diagnosed earlier rather than later

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8
Q

What CD4 count is classed as a late diagnosis?

A

CD4 < 350

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9
Q

What CD 4 count is termed AIDS?

A

CD4< 200

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10
Q

What age group + gender + sexuality are likely to be diagnosed late?

A

over 60s
females
heterosexuals

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11
Q

What is the chance that a mother who isn’t on ART will transmit HIV to their child?

A

35%

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12
Q

What is the chance that a mother who is on ART will transmit HIV to her child?

A

0.5%

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13
Q

What does PEP stand for?

A

post-exposure prophylaxis

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14
Q

Which part of the world has the highest number of people with HIV?

A

Africa

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15
Q

Which part of England has the highest rate of HIV?

A

London

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16
Q

Has diagnosis of HIV increased or decreased in the uk?

A

decreased

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17
Q

What are the routes of transmission of HIV?

A

blood
sexual
vertical (mother to child)

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18
Q

List the methods to prevent HIV transmission

A 
circumcision
PEP
PreP
STI control
[vaccines (not available)]
microbicides
HIV diagnosis and partner notification
HAART
behavioural
screen blood products
needle exchange
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19
Q

By what percentage does circumcision protect against HIV?

A

60%

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20
Q

if you have a needle stick injury what do you need to take and for how log for and in what space of time do you need to take it?

A

PEP
within 72 hours
take for 1 month

21
Q

What does PEPSE stand for?

A

post-exposure prophylaxis after sexual exposure (to HIV)

22
Q

What is the risk of getting HIV from a needle stick injury?

A

0.3%

23
Q

What is the risk of getting HIV from mucocutaneous exposure?

A

0.09%

24
Q

Why is there not much evidence for PEPSE (PEP in general)?

A

unethical to conduct trial to expose people to HIV and then test half the group with the drug

25
Q

What are the two ways to take PreP?

A

everyday

before sex and a couple of days after

26
Q

How effective is PreP?

A

HIGHLY effective

27
Q

List behavioural changes that can be made to reduce spread of HIV

A

sex ed
reduce frequency of partner change
reduce number of partners at the same time
reduce high risk sexual practices eg traumatic anal sex
use condoms

28
Q

What does TASP means?

A

Treatment as prevention - ie use of HAART to get the viral load so low that transmission to sexual partners is negligible

29
Q

By what percentage does HAART reduce transmission from serodifferent couples?

A

96%

30
Q

What are the advantages of knowing HIV status?

A 
access to appropriate treatment and care
reduction in morbidity and mortality
reduction in MTCT
reduction of sexual transmission
public health
cost-effective
31
Q

How are HIV drugs cost effective?

A 
Savings on:
lost work days
social care 
infecting other people
AIDS related diseases 
benefits claimed
32
Q

Should a positive HIV result be disclosed to insurers?

A

yes

33
Q

Should having an HIV test be disclosed to insurers?

A

no

34
Q

Give reasons why someone might get an HIV test

A

clinician initiated - as pt comes with AIDS defining illness
screening in pregnancy to reduce MTCT
screening in high risk groups
pt initiated

35
Q

What are the AIDS defining conditions?

A 
TB
pneumocystis 
cerebral toxoplasmosis
primary cerebral lymphoma
cryptococcal meningitis
progressive multifocal leucoencephalopathy
Kaposi's sarcoma
Persistent cryptosporidiosis 
Non-hodgkin's lymphoma
36
Q

Why do doctors not test for HIV?

A

underestimate risk
misconception that pre-counselling is needed
misunderstanding of insurance implications
anxiety about false positive

37
Q

What are the risk factors for HIV?

A 
sexual contact with people from high prevalence groups
multiple sexual partners
rape
sharing needles
iatrogenic 
MTCT
38
Q

what are the symptoms of seroconversion illness?

A

occurs in most individuals 2-4 weeks after infection
fever
maculopapular rash
myalgia
headache
aseptic meningitis
usually lasts 3 weeks and have complete recovery

39
Q

Where in particular should you look for the rash of seroconversion illness?

A

palms

40
Q

What should the differential diagnosis of rash on the palms be?

A

secondary syphilis

41
Q

What types of conditions should you have a high index of suspicion for?

A 
gereralised lymphadenopathy
acute generalised rash
glandular fever
prolonged episodes of herpes simplex
perisistent and recurrent oral candidiasis
new skin conditions/ worsening - psoriasis and moluscum
mouth lesions - oral hairy leukoplakia 
uneplained weight loss or night sweats
persistent diarrhoea 
gradually increasing SOB and dry cough 
recurrent bacterial infections 
recurrent/multidermatomal shingles
lymphoma
PUO
flu-like illness
meningitis
unexplained blood dyscrasias
42
Q

What differentiates oral candida from oral hairy leukoplakia?

A

can’t move the hairy leukoplakia with a brush, but can move oral candida

43
Q

Which virus causes oral hairy leukoplakia?

A

EBV

44
Q

What fungus causes pneumocystis pneumonia?

A

Pneumocystis jirovecii/carinii

45
Q

What blood picture is seen in HIV?

A

raised protein
lymphopenia
low platelets
low WBCs

46
Q

Which healthcare professionals can offer a HIV test?

A

ANY

47
Q

Which antigen does the fourth generation HIV test look for?

A

p24

48
Q

What are the advantages of POCT?

A 
outreach
increases pt choice
increased access to testing
earlier diagnosis 
reduce complications 
reduce transmission

Microbiology (12 decks)

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