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Path - Microbiology > HIV in African children > Flashcards

HIV in African children Flashcards

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Biology 101 flashcards
1
Q

rank these regions in order of number of Children (<15 years) living with HIV 2012 from highest to lowest

Caribbean
S+SE Asia
SS Africa
Middle East + N africa
Latin America
A

SS Africa
S+ SE Asia

Latin America
Middle East + N africa

Caribbean

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2
Q

HIV accounts for __% of deaths in children < 5 yrs in S. Africa

A

35

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3
Q

HIV in children: > 90% due to ____ transmission?

A

mother-to-child

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4
Q

clinical features of HIV in kids?

mmemonic?

A

FAST:

Failure to thrive
Anaemia
Severe pneumonia
TB

Enlarged lymph nodes
Enlarged liver/spleen

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5
Q

A 3 y/o child presents with severe nappy rash, recurrent diarrhoea and easy bruising.

O/E he has Chronic bilateral parotid swelling, and molluscum on his face.

Possible ddx?

A

HIV - these are all symptoms

A very common feature of HIV in African children - chronic bilateral parotid swelling, and molluscum

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6
Q

a 1y/0 presents with in pain on swallowing, poor feeding, weight loss.

his mother has hiv .

possible ddx?

A

Oral candidiasis

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7
Q

name one benign lymphoproliferative disorder characterised by lymphocyte predominant infiltration of the lungs, that is common in kids with HIV?

A

Lymphocytic interstitial pneumonitis - LIP

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8
Q

Lymphocytic interstitial pneumonitisis hard to distinguish from?

A

TB

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9
Q

how does vxv commonly present in kids with hiv?

A

chicken pox complicated with pneumonitis

shingles - Multidermatomal!

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10
Q

the following are present in which complication of HIV?

Basal ganglia calcification
White matter changes
Atrophy
Vasculopathy / Strokes

A

HIV Encephalopathy

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11
Q

Kaposi sarcoma is associated with co-infection with which virus?

A

HHV8

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12
Q

Coinfection with which virus (which is transmitted perinatally) usually causes no consequences but can cause sight-threatening retinitis?

A

CMV

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13
Q

What is the major risk factor for Mother To Child Transmission?

A

Maternal plasma viral load

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14
Q

what is the pattern of viraemia in HIV infected adult?

A

Initial peak - millions of copies
Set point - 10^3 - 10^5 /ml
Late disease - peak similar to first stage

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15
Q

can a foetus contract HIV intrapartum?

A

No

A healthy placenta is an effective barrier to transmission of HIV from mother to baby

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16
Q

Risk of MTCT increases by 2% for every hour post ?

A

rupture of membranes

17
Q

Breast Feeding increases risk of transmission by how much compared to formula feeding?

A

16%

18
Q

Breast Feeding increases risk of transmission compared to formula feeding. But what are the caveats with formula feeding?

A

increased mortality risk 20%

19
Q

WHO recommends that if infant mortality rate > 40/1000 live births, recommend what in terms of feeding the baby?

A

§ Exclusive breastfeeding
§ ARVs for mother OR baby

sounds crazy but: only 4% transmission of HIV-1 for ever y6 months

20
Q

Why can some people be infected with HIV but not affected?

A

There is a small subset known as HIV elite controllers.

They are able to spontaneously control viral replication to almost undetectable levels for many years without cART

21
Q

zidovudine is what drug class?

A

nucleoSide reverse transcriptase inhibitors - NRTIs

22
Q

Tenofovir is what drug class?

A

nucleoTide reverse transcriptase inhibitor - NRTI

23
Q

List measures adopted to reduce Vertical transmission of HIV?

A

in order of mortality:

None 25 - 40%
Avoid BreastFeed 12 - 25%
Zidovudine mono Rx 6 - 8%
elite controllers + AZT mono < 2%

24
Q

WHO recommended measures adopted to reduce Vertical transmission of HIV?

A

All pregnant and BF women should initiate triple ARVs:

Fixed dose combination Tenofovir+ Lamivudine+efavirenz

BF infants should receive daily nevirapine for 6 weeks

25
Q

according to WHO, what are the recommendations for HIV in MTCT?

A

Maintain ARVs for duration of MTCT risk

Maintain ARVs lifelong with those meeting Rx eligibility (CD4< 500)

Path - Microbiology (27 decks)

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