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
