HIV/HAART Flashcards
1
Q
HIV Origins
A
- originated in chimps (SIV)
- transfered to humans during eating/hunting
- mutated to HIV, spread through world
2
Q
HIV Spread
A
- sexually transmitted (receptive anal sex)
- blood borne (sharing needles, blood transfusions)
- vertical transmission (pregnancy, birth, breastfeeding)
3
Q
HIV Structure
A
- ssRNA genome
- integrase, protease, integrase, RT present in virion
- gp120 and gp41 found on envelope
4
Q
HIV Life Cycle
A
- Attachment - virus binds CD4 and CCR5/CXCR4 on cell surface
- Fusion and Penetration - viral envelope fuses with cellular membrane, RNA genome is inserted into cell
- Reverse Transcription - RT turns ssRNA into dsDNA
- Integration - integrase integrates viral genome into cellular genome
- Transcription - when cell divides, viral genome is read and viral proteins are synthesized
- Assembly - viral proteins assemble into visions
- Budding - immature virion buds out and gets envelope, protease produces mature vision
- Maturation - maturation completes once virion is out of the cell
5
Q
HIV Effect on Immune System
A
- infects CD4 T cells
- eventually kills CD4 cells, impairing immune system
6
Q
HIV Stages
A
- Acute infection
- Seroconversion (production of antibodies)
- Asymptomatic stage
- Symptomatic stage
- AIDS
7
Q
HIV/AIDS Natural History
A
- initial spike in viral load, reduced to low levels after seroconversion
- initial drop in CD4 T cells, reduced to normal levels for years, begin to drop as viral load increases later
8
Q
Normal CD4 count
A
<400
9
Q
HIV Viral Load
A
- done by PCR
- measures number of copies of HIV RNA in blood
- copies/mL
10
Q
Devo of AIDS as train analogy
A
Viral Load = speed of train
CD4 count = length of track left
11
Q
HIV -> AIDS
A
- usually below 200 CD4 count
- opportunistic ix’s
- opportunistic cancers
12
Q
Opportunistic ix’s <200
A
- Pneumocystic jirovecii pneumonia
- Progressive multifocal leukoencephalopathy
- Oral thrush
13
Q
Opportunistic ix’s <100
A
- CMV retinitis
- Toxoplasmosis
- Cryptococcal meningitis
14
Q
Opportunistic ix’s < 50
A
-MAC
15
Q
Opportunistic ix’s at any CD4 count
A
-TB
16
Q
HIV related cancers
A
- lymphoma
- cervical cancer (HPV)
- Kaposi’s sarcoma
17
Q
Antiretrovirals
A
- drugs to treat HIV
- used in combo therapy
- monitored by CD4 counts and viral load
- goal: undetectable viral load, normal CD4 counts
18
Q
Types of Antiretrovirals (6)
A
NRTI's NNRTI's Integrase Inhibitors Protease Inhibitors Fusion Inhibitors CCR5 Antagonist
19
Q
Common ART Regimens1
A
2 NRTI’s + 1 NNRTI
2 NRTI’s + 1 Protease Inhibitors
2 NRTI’s + 1 Integrase Inhibitor
20
Q
Primary Prophylaxis
A
-preventing a disease from occurring
21
Q
Secondary Prophylaxis
A
-preventing a disease from re occurring
22
Q
HIV Prophylaxis
A
- lifestyle changes
- medications (abx for various infectious diseases)
- vaccinations (pneumococcus, Hep A and B, HPV, influenza)
23
Q
HIV Management
A
- TB skin test
- eye exam if s
- pap test
