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House Clinical Pathology > HIV IMMUNOLOGY > Flashcards

HIV IMMUNOLOGY Flashcards

1
Q

First Case was reported to the CDC in _____

The etiologic agent of AIDS is a human ______ –

___________

A

1981

retrovirus

Human immunodeficiency virus (HIV).

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2
Q

Retroviruses are (DNA or RNA?) viruses that contain ___________, an enzyme that makes _____ from viral ______.

A

RNA viruses

reverse transcriptase

DNA ; RNA.

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3
Q

Two types of HIV have been identified.

– HIV-1- causes AIDS in ________ and ______

– HIV-2 – causes AIDS in _____

A

America and Europe

Africa

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4
Q

HIV is closely related to a group of (transforming or non transforming?) , ________ retroviruses called _____viruses which cause chronic neurodegerative and wasting disease in animals.

A

non transforming ; cytopathic

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5
Q

HIV is also related to the __________________________ virus type ____ which causes a form of AIDS in _________

A

simian T-cell lymphotrophic virus type III

African green monkeys.

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6
Q

Epidemiology of HIV/AIDS

The global pandemic of HIV/AIDS began in _____, and is an on going world wide public health issue.

A

1981

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7
Q

Epidemiology of HIV/AIDS

According to WHO, as of 2021, HIV/AIDS has killed approx. _______ people, and approx. _______ people are infected with HIV globally

A

40.1 million people

38.4 million people

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8
Q

The HIV virus particles, or virion, is approximately _____nm in diameter.

A

100

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9
Q

The HIV virus particles, or virion

It consists of 3 parts

___________

____________

___________ that contains the viral RNA.

A

The HIV virus particles, or virion

an outer envelop

a core shell of protein

a cone shaped inner core

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10
Q

The HIV virus particles

_____________ combine to give it a spherical shape.

A

Small viral surface proteins

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11
Q

The HIV virus particles, or virion

These proteins are embedded in a lipid bilayer from which the surface glycoproteins protrude as _____ like structures.

A

knob

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12
Q

HIV

The glycoprotein (gp) has two components: gp ___ transverses the membrane and gp _____ extends beyond the surface as a knob.

A

41; 120

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13
Q

The glycoprotein (gp)

gp41 is a ______ D glycoprotein while gp120 is a highly immunogenic protein of m/w ________D.

A

41,000

120,000

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14
Q

The HIV outer envelope also contains _________ antigens.

These antigens are derived from ________ when ____________________ during the process of viral particle formation.

A

human leucocyte antigens

human cell membranes

new HIV virions bud from human cells

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15
Q

HIV

Beneath the outer envelope lies a protein core composed of viral proteins _______ and ______

A

p24 and p17.

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16
Q

HIV

Inside the protein core shell lies a ____-shaped central core containing the ______ and ______

A

cone

viral RNA and reverse transcriptase.

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17
Q

The complete nucleotide sequence of the HIV genome have been determined, making it possible to _______,_________, and ________

A

identify viral genes, viral gene products and the clinical course of AIDS.

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18
Q

The HIV genome has ____ regulatory genes

List them

A

five

tat, art/trs, sor, 3’ orf, and R.

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19
Q

The HIV genome

It also has the usual structural genes – ____ ,________, and ________.

A

gag, pol and env

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20
Q

The HIV genome

The _____ gene codes for the core proteins from which the three core structural proteins, ____,______ ,_____ are formed.

A

gag

P18, P24 and P15

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21
Q

The HIV genome

The gag gene codes for the ______ from which the __________ proteins ____,_____,_____ are formed.

A

core proteins

three core structural

P18, P24 and P15

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22
Q

HIV

The pol (polymerase) gene codes for ___ enzymes:

List them

A

4 enzymes

reverse transcriptase, RNase, protease, and integrase.

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23
Q

Reverse transcriptase transcribes _______________ into _____________

It is an _________ protein designated p__/___.

A

single stranded RNA

double stranded DNA.

immunogenic protein

p66/51.

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24
Q

RNase is an enzyme that ______ the _____ in RNA- DNA hybrids that form an intermediate in the creation of _______.

A

digests the RNA

viral DNA.

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25
Q

Protease (p___) ________ from ______ and cleaves _______ from their _________.

A

31

cleaves itself from an initial polyprotein

other proteins; polyproteins

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26
Q

Integrase is responsible for _______ the ________ into the _______

A

inserting the viral DNA

host DNA.

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27
Q

The env (envelope) gene codes for the glycoprotein gp____, which is found in infected cells.

It is cleaved to form the two envelope glyco proteins gp___, found on the outside of the viral envelope and gp ___, which is embedded in the viral membrane.

A

160

120

41

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28
Q

The sor (_______________) gene is related to viral infectivity.

It produces a protein, p___ which is present in the _____ of virus infected cultures and against which _______ form in the ______ of HIV infected persons.

A

short open reading frame

p23

filtrate ; antibodies; serum

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29
Q

The tat (_________) gene accelerates ____________ and is required for viral replication.

A

trans-activation translation

viral protein production

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30
Q

The tat gene

Without tat ______________ and __________ are formed.

The protien produced by tat is p___

A

only minimal RNA is produced

no viral particles

14.

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31
Q

The art/trs (________________) gene regulates the _____ of the viral genome.

A

anti-repression transactivation

translation

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32
Q

The art/trs

It produces an anti-repression trans activator protein p____, which regulates the expression of viral gene components.

A

20

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33
Q

The B3’ orf (__________) gene is responsible for the _________, and _____________ by ___ fold in CD4 cells.

A

3’ open reading frame

latency of the virus

slowing down viral reproduction

ten

The p27 protein produced by B3’ orf raises antibodies that have been found in infected persons.

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34
Q

The B3’ orf gene

The p___rotein produced by B3’ orf raises antibodies that have been found in infected persons.

A

p27

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35
Q

All the proteins and glycoproteins of HIV may produce an antibody response in an infected person.

T/F

A

T

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36
Q

HIV

Their antibodies are typically seen in only symptomatic seropositive individuals

Do not act as markers of HIV infection.

T/F

A

F

F

Their antibodies are typically seen in both symptomatic and asymptomatic seropositive individuals and act as markers of HIV infection.

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37
Q

In one study of 280 specimens from AIDS patients, 96% of patient had antibodies to ___ and 88% had antibodies to _____.

A

p24

gp41

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38
Q

Declining p24 antibody titres occur in the (early or late?) stages of AIDS when patients clinically ______.

A

Late

deteriorate

39
Q

Antibodies to the envelope gene products (gp____, gp ____, gp ___) can be detected in nearly all HIV positive patients and antibodies to the polymerase gene products (p____, p___ and p___) are also commonly detected.

A

gp 160, gp 120, gp 41

p31, p51 and p66

40
Q

Immunologic Mechanisms of HIV
Infection

The ____ molecule is a high affinity receptor for HIV, this explains the selective tropism of the virus for ____+ T cells and other CD4+ cells especially the ______,__________, and __________

A

CD4; CD4

monocytes and macrophages and dendritic cells.

41
Q

Binding to CD4 is sufficient for infection

T/F

A

F

Binding to CD4 is not sufficient for infection, HIV gp 120 must also bind to other cell surface molecules (co receptors) for entry into the cell.

42
Q

Immunologic Mechanisms of HIV
Infection

HIV gp 120 must also bind to other cell surface molecules (co receptors) for entry into the cell.

Two chemokine receptors, _____ and _____ serve this role.

The initial step in infection is the binding of __________ to ________.

This binding leads to a _________ that results in the formation of a new recognition site on ______ for the ———— ——- or ______

A

CCR5 and CXCR4

the gp 120 envelope glycoprotein to CD4 molecules

conformational change; the gp 120

coreceptors CCR5 or CXCR4.

43
Q

Immunologic Mechanisms of HIV
Infection

After the conformational change in gp 120

The next step involves _________ in ________; these changes results in the insertion of a __________ at the _______ into the cell membrane of the target cell.

After fusion, the ______ containing the HIV genome enters ______________

A

conformational changes

gp41; fusion peptide; tip of gp41

virus core; the cytoplasm of the cell.

44
Q

Immunologic Mechanisms of HIV
Infection

Once internalized, the RNA genome of the virus undergoes ________ leading to formation of _____ (________).

A

reverse transcription

cDNA; proviral DNA

45
Q

Immunologic Mechanisms of HIV
Infection

In quiescent T cells, HIV cDNA may remain in the ____ in a ____ form.

In dividing T cells, the cDNA ______, enters the ______ and is then _______________

A

cytoplasm; linear

circularizes; nucleus

integrated into the host genome.

46
Q

Immunologic Mechanisms of HIV
Infection

After this integration, the provirus may __________________________ and hence the _______ becomes _______

Alternatively, proviral DNA may be ________, with the formation of complete viral particles that bud from the cell membrane. Such productive infection, when associated with __________ leads to ________.

A

remain locked into the chromosome for years or months

infection becomes latent.

transcribed; extensive viral budding

cell death

47
Q

HIV Life Cycle

The HIV _____ carries within it, the genetic information required to reproduce HIV viruses within infected host cells.

A

genome

48
Q

HIV Life Cycle

HIV binds to the host cell through a complexing of the _____ molecules on the viral surface and a receptor molecule – the ______ molecule on host cells.

A

gp 120

CD4

49
Q

CD4 molecules are found on the surface of some immune cells (_______,_______,__________, and __________).

A

helper T lymphocytes, B cells, monocytes and macrophages

50
Q

HIV life cycle

After HIV binds to the CD4 containing cell, it penetrates the host cell and loses its ________ to expose the viral RNA.

The viral RNA is transcribed into DNA and inserted into the host genome during _______ or __________

A

outer layers

cellular division or activation.

51
Q

Host cells can be activated by __________ or by _________ stimulation after exposure to _______,_______, or _________

A

antigenic challenge or by allogeneic

blood, semen or allografts.

52
Q

HIV cycle

Once host cell is activated, ______________ occurs.

Viral RNA and proteins are then ______ at the host cell’s _______ to produce a _______ that escapes the host cell by ____ from the host cell membrane.

A

transcription of viral protein

assembled

cytoplasmic surface

mature virion ; budding

53
Q

HIV life cycle

When HIV replication occurs, the CD4 cell is killed, resulting in ________ of ———— .

It is the ________ that correlates with the progressive severity of ________ and with the increased _______ to _______ seen in the clinical course of AIDS.

A

severe depletion of helper-inducer T lymphocytes

depletion of these cells ; immune deficiency

susceptibility to opportunistic disease and malignancies

54
Q

Effect of HIV on Immune
Response

AIDS is so devastating primarily because of the ___________ of __________ cells and the central role of these cells in mediating immune response.

A

destruction of CD4 containing

55
Q

__________ lymphocytes have a high concentration of CD4 molecules on their surface and are the major targets of the HIV virions.

A

Helper T

56
Q

The depletion of these CD4 cells as a result of HIV infection results in _________________________

A

severe depression of the immune response.

57
Q

The increased viral, protozoal and fungal infections found in AIDS patients are as a direct result of _____________________

A

an impaired cell mediated immune system.

58
Q

Effect of HIV on T Cells

_______ of CD4 lymphocytes.

_________________ suppressor CD8 lymphocytes.

Increased susceptibility to ___________ and _________ due to decreased T-cell function.

A

Depletion

Elevated, normal or depressed

opportunistic infections and neoplasms

59
Q

Effect of HIV on T Cells

_____eased delayed type hypersensitivity.

_____eased production of interleukins 2.

A

Decr

Decr

60
Q

Effect of HIV on B Cells

__________ ————

Elevated circulating _________.

Inability to produce a _________ to a new antigen following _______.

A

Polyclonal hypergammaglobulinaemia.

immune complexes

serologic response

immunization

61
Q

Effect on Other Immune Cells

Decreased _________ activity.

Defective _______ in monocytes and macrophages.

Enhanced _______________________________________ by monocytes.

A

natural killer cell

chemotaxis

release of interleukin 1 and cachecxin

62
Q

Opportunistic Infections and
Neoplasms Seen in AIDS

Bacteria

List 6

A

– Mycobacterium avian – intracellular
– Mycobacterium kansasii
– Mycobacterium tuberculosis
– Streptococcus penumoniae
– Haemophilus influenzae
– Salmonella species

63
Q

Opportunistic Infections and
Neoplasms Seen in AIDS

Viruses

___________
_____________
___________
______________
__________

A

Cytomegalovirus
Herpes simplex
Herpes zoster
Ebstein – Barr virus
Adenovirus

64
Q

Opportunistic Infections and
Neoplasms Seen in AIDS

Protozoa
________
__________
________
___________

A

Pneumocystis carinii
Toxoplasma gondii
Cryptosporidium species
Isospora belli

65
Q

Opportunistic Infections and
Neoplasms Seen in AIDS

Fungi
–___________
–_______________
–_______________
– ____________
–__________ species

A

Candida albicans

Coccidiodes immitis

Histoplasma capsulatum

Cryptococcus neoformans

Aspergillis

66
Q

Opportunistic Infections and
Neoplasms Seen in AIDS

Neoplasms

–_________
-______________
–___________
–________

A

Kaposi’s sarcoma

Hodgkin’s disease

Burkitt-like lymphoma

Undifferentiated Non-hodgkin’s lymphoma

67
Q

Opportunistic Infections and
Neoplasms Seen in AIDS

Neoplasms

–______ lymphoma
– _________ lymphoma
– __________ sarcoma
–__________ preleukaemia

A

C.N.S.

Peripheral organ

Immunoblastic

Lymphocytic

68
Q

Laboratory Diagnosis

The focus of laboratory diagnosis is to ____ HIV, detect ______ and detect ______ in patient’s blood and body fluids.

A

isolate

HIV antibodies

HIV antigen

69
Q

Laboratory Diagnosis

We carry out these procedures in order to detect ——— HIV infection, to monitor ________ of ________ and to detect the progression of ___________ to ________

A

early

effectiveness of antiviral drugs

asymptomatic to symptomatic AIDS.

70
Q

Laboratory Diagnosis

Detection of HIV antigen in patients specimen indicates _________ whereas detection of antibodies to HIV denotes ___________.

A

active HIV infection

prior exposure.

71
Q

Laboratory Diagnosis

Gene probes for HIV viral RNA for use in ______________ techniques have been developed.

A

molecular hybridization

72
Q

Laboratory Methods

________ Methods

__________ Methods

A

Screening

Confirmatory

73
Q

Laboratory Methods

Enzyme-linked Immunosorbent Assay

This is a (screening or confirmatory?) test for HIV antibodies.

It is (simple or difficult ?) to perform, relatively (expensive or inexpensive?) and adapted to screening (small or large?) numbers of specimens in a (short or long?) time (________).

A

screening

Simple

inexpensive

large

short time (<4 hours).

74
Q

ELISA

HIV antigens derived from either ___________ , _______ antigens, or ___________ are immobilized onto microtiter wells.

Patient _________ is then _____ with the fixed antigen and _____.

______ antibody, conjugated to either _______,________, or _______ , is then added and allowed to incubate.

A

disrupted virus particles ; recombinant

chemically synthesized peptides

serum or plasma; incubated; washed

Anti-IgG

horseradish peroxidase, glucose oxidase or alkaline phosphatase

75
Q

HIV antigens derived from either disrupted virus particles ( _____ generation assays), recombinant antigens, or chemically synthesized peptides ( _______ generation assays).

A

first

second

76
Q

ELISA

After a washing step, the appropriate _________________ is added and a ______ occurs that is proportional to the amount of ____ present.

Results are read on a _______ by _______ obtained from ______________ to those from ________

This results in an __________ value above which reaction is identified.

A

chromogenic enzymatic substrate

colour change ; IgG

spectrophotometer; comparing values

positive and negative controls; test specimen.

absorbance cut off

77
Q

Sources of Error in ELISA testing
for HIV Antibodies

_________ errors.

False positive reactions occur in person’s with _______________, ________ and _______

A

Technical

autoimmune diseases, some lymphomas and leukaemias.

78
Q

Sources of Error in ELISA testing
for HIV Antibodies

False negative reactions occur during the ___________ stages of AIDS, in the _____ stages of AIDS, when antibodies typically reduce.

Tests should be run in ________.

A

incubation

late

duplicate

79
Q

Slide Agglutination Tests

Rapid slide agglutination tests are for detecting the presence of ____________________________________

They are widely used in field work in Africa.

A

HIV antibodies or antigens.

80
Q

Slide Agglutination Tests have some advantages over ELISA.

T/F

A

T

81
Q

Slide Agglutination Tests

They are (simple or difficult ?) to perform, takes (lesser or longer?) time (some _________), all the materials are potable.

Results can be read with ________, ___ expensive machinery is needed.

A

simple

Lesser ; 5 minutes

the naked eye; No

82
Q

Slide Agglutination test is a screening test

T/F

A

T

83
Q

Slide Agglutination test and ELISA are both screening tests.

T/F

A

T

84
Q

Western Blot Assay

This is a (screening or confirmatory?) test.

A

confirmatory

85
Q

_________ positive screening test is confirmed using this method.

A

Western Blot Assay

86
Q

Western Blot Assay

In this assay, ________ is _______ and _________ are separated on the basis of ___________ using _________________

The viral proteins are then transferred onto _________ and cut into ______.

Individual strips are incubated overnight with ___________(_________)

A

HIV virus is disrupted

HIV proteins ; molecular weight

polyacrylamide gel electrophoresis.

nitrocellulose sheets; strips

patients’ serum (HIV antibodies).

87
Q

Other Laboratory Methods

___________________ assay.

_______ immunoassay.

_______________ assay.

__________.

A

Indirect immunofluorescence

Radio

Radioimmunoprecipitation

Gene probes

88
Q

Prevention of HIV Infection in
Health Care Workers

Each day, health workers are exposed to the blood and body fluids of patients during patient care or in the laboratory.

The healthcare worker should take precaution to minimize the risk of exposure by appropriate use of protective clothing to minimize direct contact; frequent handwashing,

Proper use of equipment to prevent exposure to aerosols and adoption of a policy of universal precaution for all patients.

A

Okay🚶‍♂️🚶‍♂️🚶‍♂️

89
Q

AIDS is the most serious infectious disease threatening humans today.

T/F

A

T

90
Q

AIDS

To date, there are no effective vaccines and antiretroviral therapies slow progress of the disease.

T/F

A

T

91
Q

AIDS

Extensive research has delineated the structure of the virus, its life cycle, its mode of transmission.

T/F

A

T

92
Q

AIDS results in __________ of host, with ___ cell and ______ defences being affected.

A

severe immunodeficiency

T

humoral

93
Q

Opportunistic infections and cancers are the confounding results of severe immunosuppression of the host.

T/F

A

T

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