HIV MODULE

Question 1

What is the most common stage 1 symptom of HIV infection during seroconversion?

Answer 1

A flu-like illness with symptoms such as fever, swollen glands, muscle aches, and tiredness.

Question 2

What is the prevalence of HIV in South Africa as of 2019?

Answer 2

Approximately 7.7 million people, with a 20.4% prevalence among the general population.

Question 3

Which phase of HIV infection is characterized by asymptomatic progression, and how long can it last?

Answer 3

Phase 2, the asymptomatic phase, which can last for several years.

Question 4

What symptoms characterize WHO Stage 2 of HIV?

Answer 4

Mild symptoms such as unexplained weight loss (under 10% of total body weight), recurrent respiratory infections, and skin conditions like angular cheilitis and seborrheic dermatitis.

Question 5

In the WHO staging of HIV, what distinguishes Stage 3 from earlier stages?

Answer 5

Symptoms include unexplained weight loss (more than 10% of body weight), chronic diarrhea, pulmonary tuberculosis, and oral candidiasis.

Question 6

What are common infections associated with WHO Stage 4 (AIDS)?

Answer 6

Infections such as Pneumocystis pneumonia, CMV retinitis, and chronic orolabial herpes, as well as cancers like Kaposi’s sarcoma and cervical cancer.

Question 7

What is the primary purpose of WHO staging in HIV management?

Answer 7

To guide prognosis and treatment decisions based on the severity of symptoms and immune function.

Question 7

What baseline test is essential before initiating ART in HIV patients?

Answer 7

CD4 count, which helps assess immune status and need for additional tests like Cryptococcal Latex Antigen Test if CD4 <100.

Question 8

What is the UNAIDS 90-90-90 target?

Answer 8

A goal that aims for 90% of people with HIV to know their status, 90% of diagnosed individuals to be on ART, and 90% of those on ART to achieve viral suppression.

Question 9

When should ART be initiated in an HIV patient co-infected with TB?

Answer 9

After treating TB for 2 weeks to ensure a positive response before starting ART, unless the TB involves the central nervous system.

Question 10

A patient with HIV presents with prolonged diarrhea and weight loss over 10% of body weight. Which WHO stage does this align with, and what is the implication?

Answer 10

WHO Stage 3, indicating an advanced HIV infection that requires prompt medical intervention.

Question 11

In South Africa, what are the first-line medications in the Fixed Dose Combination (FDC) for HIV treatment?

Answer 11

Tenofovir, Emtricitabine, and Efavirenz, which simplify adherence by reducing the pill burden.

Question 12

What is Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV management, and when is it most likely to occur?

Answer 12

IRIS is an inflammatory response to opportunistic infections triggered by immune recovery after starting ART, often occurring in patients with low CD4 counts.

Question 13

How does WHO Stage 4 (AIDS) differ from WHO Stage 3 in terms of symptoms and prognosis?

Answer 13

Stage 4 involves more severe, life-threatening conditions such as specific cancers and severe opportunistic infections, indicating a severely compromised immune system.

Question 13

Why is counseling crucial for ART adherence in HIV patients, and what are potential consequences of poor counseling?

Answer 13

Counseling improves adherence, reduces the risk of treatment default, and prevents resistance; poor counseling may lead to drug resistance and treatment failure.

Question 14

Which co-infections require additional screening in HIV patients with a low CD4 count before starting ART?

Answer 14

Cryptococcal infection (via Cryptococcal Latex Antigen Test) and tuberculosis, especially if the CD4 count is below 100.

Question 15

An HIV-positive patient on ART reports intense itching and mild jaundice. What condition might this suggest, and why is it important?

Answer 15

Drug-Induced Liver Injury (DILI), which requires careful monitoring as it can lead to severe liver dysfunction and affect ART adherence.

Question 16

What skin and oral conditions are commonly seen in WHO Stage 2 of HIV?

Answer 16

Conditions such as recurrent oral ulcers, seborrheic dermatitis, and fungal nail infections, which are indicators of mild immunosuppression.

Question 17

What is the significance of monitoring viral load in patients on ART, and how often should it be tested?

Answer 17

Viral load helps track the effectiveness of ART, aiming for viral suppression; it is typically checked at baseline and periodically during treatment.

Question 18

Why must TB treatment be initiated before ART in co-infected HIV patients, and what is the exception?

Answer 18

Starting TB treatment first reduces the risk of IRIS; however, in cases of TB meningitis, ART is delayed 4-6 weeks to prevent severe inflammation.

Question 19

What is angular cheilitis, and why is it significant in WHO Stage 2 of HIV?

Answer 19

Angular cheilitis is an inflammatory condition causing red, swollen patches in the corners of the mouth, often due to immune suppression, making it a sign of mild HIV-related immunosuppression.

Question 20

How do recurrent oral ulcerations present in WHO Stage 2 of HIV?

Answer 20

These ulcers appear as painful sores in the mouth that recur frequently, indicating mild immunosuppression.

Question 21

What is linear gingival erythema, and how is it associated with HIV?

Answer 21

Linear gingival erythema is a distinctive red line along the gum margins, linked to immune suppression in HIV, and seen in Stage 2 as an early sign of disease progression.

Question 22

Why is herpes zoster (shingles) considered a Stage 2 HIV condition?

Answer 22

Herpes zoster, or shingles, occurs due to reactivation of the varicella-zoster virus, which can flare up due to weakened immunity in HIV patients, indicating moderate immune compromise.

Question 23

What is extensive Human Papillomavirus (HPV) infection, and how does it present in Stage 2?

Answer 23

Extensive HPV infection can cause widespread warts or lesions, often more severe in HIV patients with weakened immunity, and is a sign of moderate immunosuppression.

Question 24

What are papular pruritic eruptions, and what do they indicate in HIV?

Answer 24

Papular pruritic eruptions are itchy, small bumps on the skin that can indicate moderate immune system suppression, commonly appearing in WHO Stage 2 of HIV.

Question 25

How does seborrheic dermatitis manifest in HIV-positive individuals at Stage 2?

Answer 25

Seborrheic dermatitis appears as flaky, scaly patches, often on the scalp or face, and becomes more severe with HIV-related immunosuppression.

Question 26

Why are fungal nail infections categorized under WHO Stage 2 in HIV?

Answer 26

Fungal nail infections, like onychomycosis, are common in immunosuppressed patients, and their prevalence in HIV indicates moderate immune decline.

Question 27

In HIV, what is the significance of recurrent dermatological infections or conditions in WHO Stage 2?

Answer 27

Recurrent infections suggest a decline in immune function and act as markers of early disease progression, as seen in conditions like herpes zoster and oral ulcerations.

Question 28

How can WHO Stage 2 dermatological conditions impact quality of life in HIV patients?

Answer 28

Conditions like chronic itching, painful oral sores, and skin lesions can lead to discomfort, social isolation, and may affect nutritional intake if oral lesions are severe.

Question 29

What level of weight loss characterizes WHO Stage 3 in HIV?

Answer 29

Unexplained weight loss exceeding 10% of total body weight, often a result of chronic illness and malnutrition associated with advancing HIV.

Question 30

Why is prolonged diarrhea (lasting over a month) a Stage 3 symptom of HIV?

Answer 30

Chronic diarrhea, often due to infections, indicates significant immune suppression and can lead to severe dehydration and nutrient loss.

Question 31

What respiratory condition is a hallmark of WHO Stage 3 in HIV?

Answer 31

Pulmonary tuberculosis is common, as the weakened immune system allows latent infections like TB to become active and symptomatic.

Question 32

What is lymphocytic interstitial pneumonia (LIP), and how does it relate to HIV?

Answer 32

LIP is a rare chronic lung disease, presenting with cough and breathing difficulties, associated with HIV-related immune suppression in Stage 3.

Question 33

How does severe recurrent pneumonia present in WHO Stage 3 of HIV?

Answer 33

Patients experience multiple episodes of bacterial pneumonia, which is an indicator of weakened immunity and a defining feature of Stage 3.

Question 34

What type of bacterial infections are commonly seen in WHO Stage 3?

Answer 34

Severe systemic infections like pyelonephritis, empyema, and meningitis, which are hard to control due to immunosuppression.

Question 35

What is pyomyositis, and why is it significant in HIV?

Answer 35

Pyomyositis is a bacterial infection of skeletal muscles, leading to abscess formation and often requiring drainage, more common in HIV due to immune deficits.

Question 36

Why is oral candidiasis significant in WHO Stage 3?

Answer 36

Oral candidiasis (thrush) suggests moderate immune suppression, as it occurs due to overgrowth of fungi in the oral cavity, commonly found in advancing HIV.

Question 37

How does oral hairy leukoplakia manifest in WHO Stage 3, and what causes it?

Answer 37

It appears as white, hairy patches on the sides of the tongue, caused by Epstein-Barr virus reactivation due to weakened immunity in HIV.

Question 38

What is acute necrotising ulcerative gingivitis/periodontitis in HIV?

Answer 38

It’s a severe gum infection that leads to painful ulcers and tissue death, indicative of advanced immune system suppression.

Question 38

What differentiates oral hairy leukoplakia from oral candidiasis?

Answer 38

Oral hairy leukoplakia is often painless and cannot be scraped off, whereas candidiasis is often painful and can be removed with scraping.

Question 39

Why are bone and joint infections more frequent in WHO Stage 3 of HIV?

Answer 39

Weakened immune responses in Stage 3 allow bacteria to infect bones and joints, leading to conditions like osteomyelitis and septic arthritis.

Question 40

How do bacterial blood infections present in WHO Stage 3?

Answer 40

Bacteremia, or the presence of bacteria in the bloodstream, can lead to sepsis and is more common as the immune system weakens in advanced HIV.

Question 41

What lung conditions beyond TB are common in WHO Stage 3?

Answer 41

Chronic HIV-associated lung diseases, including chronic bronchitis and lymphocytic interstitial pneumonia (LIP), reflect pulmonary immune damage.

Question 42

How do WHO Stage 3 conditions affect HIV treatment considerations?

Answer 42

Severe infections and chronic conditions may necessitate adjustments in ART and supportive care to manage complex symptoms and improve patient outcomes.