HIV II testing and clinical management - infectious disease

Question 1

how to look for HIV

Answer 1

look for indicator illnesses

those with HIV more likely to get opportunistic infections

Question 2

examples of opportunitstic infections in head and neck

Answer 2

kaposis sarcoa
oral candidasis
oral hairy leukoplakia
hodgkins lymphoma

Question 3

risk factors for oral candidasis

Answer 3

Antibiotics

immunocompromised

Question 4

shingles

Answer 4

reactivation of viricella zoster virus
dermatomal distrubition (ie following nerves)
blishering rash
malaise

Question 5

how to test for HIV

Answer 5

send clotted blood to lab
(blood is allowed to separate
need serum to look for Ab and Ag)
Ag detection earlier than Ab

other test
- point of care test
HIV RNA PCR

Question 6

kaposis sarcaom

Answer 6

purple lesions on skin or musoca
HHV 8 linked
spindle cells on biopsy

Question 7

orla hairy leukoplakia

Answer 7

EPV
white patches cannot be scrped
linked with HIV smoking and ummunosuprpesson

Question 8

management of HIV

Answer 8

HAART

3+ antiretroviral drugs

Question 9

how can HIV be prevented in CD4 cell

Answer 9

• can prevent virus fusing with viral cell by blocking receptors/co receptors
• can prevent transcription of viral RNA into viral DNA (only viral DNA can be integrated into nucleus of host cell) – via reverse transcription, some drugs can act on these proteins (nucleotide reverse transcriptase inhibitors, or non nucleotide)
• Integrase inhibitor can be used to prevent viral DNA to be integrated into host DNA
• protease inhibitors prevent budding and packaging of virus

Question 10

why does HIV become resistant to drug

Answer 10

1 mutation in every 2 new virus produced

drug pressure can lead to survival dominance and species changes

Question 11

drug levels to keep HIV suppressed

Answer 11

non adherence can be a problem, can cause resistance
drug drug interactions
- many drugs can interact with antireterovirals
can cause therapeutic levels