HIV & Fwens

Question 1

Gimme the regimen combi
HBV coinfected regimen
\+
PrEP
PEP timelines

Answer 1

2 NRTI + NNRTI / II / PI + PK
- EI is not here

NRTI w HBV
- will have Emtri/Lami + TAF/TDF,

PrEP 
- Emtricitabine + Tenfovir
- take for 1 week; then after contact 4 weeks
PEP
- standard RVT
- take within 3 days, for 4 weeks

Question 2

NRTI
MOA [3] - gimme enzyme
HBV which ones can and whats the problem

Answer 2

They are ribosides analogs wO 3’OH group

• enter cell, viral phosphorylase
• chain termination
• • HSV: Viral thymidine kinase
• • CMV: viral phosphotransferase

Tenofavir
Emitricitabine
Lamivudine all can
- problem is exacerbation of hepatitise in coinfected Px when remove drugs

Question 3

NRTI
- ROA, ROE

• whats the deal w guanosine and adenosine analogs

Answer 3

Oral, Renal

• Guanosine: Abacavir (A) - HLA-B 5701 NEGATIVE
• Adenosine: Tenofovir - 2: TDF, TAF
• • TAF better on renal markers, bone markers

Question 4

Integrase Inhibitors

• names
• ROA, ROE
• whats the problem

Answer 4

Raltegravir; Dolutegravir

• Oral, Hepatic
• Cation problem

Question 5

Protease inhibitor

• names
• ROA, ROE
• whats the problem

AE
Contra-I drug

Answer 5

navir

• Lopinavir, Darunavir
• Plus Ritonavir PK enhancer

Oral Hepatic
- CYP450 INHIBITOR

AE - HHH

• hyperglycaemia, hyperlipidaemia
• hepatotoxic
• lipodystrophy

Contra-I
- statins cos of CYP and hyperlipid

Question 6

NNRTI

Answer 6

Efavirenz

• non-competitive inhibitor
• allosteric

ORAL, RENAL

• induce CYP

Question 7

Entry inhibitor

- biochemistry

Answer 7

HIV

• GP120 binds to CD4 and CCR5
• then GP41 binds CD4 for entry

Enfuvirtide - subcutanous injection
- binds GP41 to block GP41-CD4

Maraviroc - oral

• binds CCR5 to block GP120-CCR5
• check CCR5 vs CXCR4 tropism’

Question 8

Acyclovir
MOA
2 names
ROA, ROE

Answer 8

Guanosine analog

• enter cells, viral thymidine kinase phoshorylat
• chain termination

Acyclovir and Val-acyclovir
- val better oral bioabvailability cos ester

Oral, Renal
can IV also

Question 9

Gancyclovir

MOA
2 names
ROA, ROE

Answer 9

Also guanosine analog

CMV: viral phosphotransferase; HSV also can
Val and normal

Oral, Renal

Question 10

What does Efavirenz bind to

Answer 10

GP41

Question 11

What does Maraviroc bind to

Answer 11

CCR5

Question 12

What are side effects of Protease inhibitor

Answer 12

CYP Inhibition

• GI
• Hepatotoxicity
• Hyperlipidemia, Hyperglycemia