HIV infection management Flashcards
Transmission of HIV
Vaginal sex (most common) Anal Oral Blood products Mother-to-child
Stages of HIV infection
Acute infection (flu-like symptoms) Chronic infection (asymptomatic) AIDS
Kaposi’s sarcoma
Caused by HSV
What does cryptococcus cause
Meningitis
Progressive multifocal leukoencephalopathy
Myelin sheath covering axons is damaged, causing MS-like symptoms
Timeline of HIV associated diseases
TB -> HSV/thrush -> oesophageal candida -> toxoplasmosis -> PML
How to reduce development of HIV
Diagnosis, monitoring of CD4 and viral load, prophylaxis, acyclovir for herpes
Methods of HIV prevention
- Abstinence, be faithful and use a condom
- Health promotion
- Condom availability
- Circumcision
- Women’s empowerment
- Vaccination
- Treatment for prevention
- PEPSE
- PrEP - pre exposure
Side effects of protease inhibitors and darinovir
Buffalo hump
HIV and reisstance
- Enormous mutation rate of HIV
- <95% but >75% adherence
- Point mutation - M184T to M184V
- Accumulation
- Class resistance - K103 → all NNRTIs
- FDC and AZT cause nail discolouration
- Protease inhibitors and darinovir = buffalo hump
Reasons for treatment failure
- Poor adherence
- Toxicity and side effects
- Wrong combination
- Poor preparation
- Reduced absorption - volume of distribution and GI inflammation
- Drug interactions
- Acquired resistance
Signs of successful HIV treatment
<20 viral load
Increased CD4
Reduced risk of OI
Nucleoside Transcriptase inhibitors
Stop reverse transcriptase enzyme so HIV cant make DNA
Abacavir, tenofvir
Non-nucleoside transcriptase inhibitors
Allosteric inhibition of transcriptase
Boosted protease inhibitors
Boost the effect of antiretrovirals
Lopinavir, atazanvir, darunavir
Fusion inhibitors
Stop HIV from merging with CD4 cell
enfuvirtide (T20)
Integrase inhibitors
Block incorporation of HIV into host genome
Raltegravir, bictegravir
CCR5 inhibitors
stops CCR5 interaction with HIV gp120 so HIV doesn’t enter cell
maraviroc, vicriviroc
