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HIV Quizzes Flashcards

1
Q

At year-end 2018, among all persons living with HIV in the United States, approximately what percentage acquired HIV through male-to-male sexual contact?

A

55-60%

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2
Q

What is the main mode of HIV acquisition among women in the United States?

A

Heterosexual Sex

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3
Q

Which one of the following statements is most accurate regarding the rate of new HIV diagnosis in persons who are black/African American versus those who are white?

A

The rate is approximately 8-fold higher in blacks

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4
Q

In the United States, approximately what percentage of people living with HIV are 45 years of age or older?

A

60%

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5
Q

At year-end 2019, what was the estimated total global population of persons living with HIV?

A

38 million

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6
Q

In what year did the CDC issue its first guideline recommending routine HIV screening in all health care settings?

A

2006

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7
Q

According to the CDC 2006 HIV screening guidelines, how often should he undergo HIV screening?

A

At least once a year

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8
Q

Which one of the following has been identified as one of the most important barriers to HIV testing?

A

Low perceived risk of HIV infection

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9
Q

Approximately what percentage of overall HIV transmission in the United States in 2016 was accounted for by the 14% with undiagnosed HIV?

A

38%

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10
Q

The 2019 United States Preventive Services Task Force (USPSTF) recommended screening for HIV infection in adolescents and adults aged 15 to 65 years, as well as in younger adolescents and older adults who are at increased risk of HIV infection.
What grade was assigned to this recommendation?

A

Grade A

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11
Q

What is the appropriate order of test positivity with different types of laboratory tests following infection with HIV?

A

HIV RNA, then HIV p24 antigen, then HIV antibody

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12
Q

What is the initial test in the HIV testing algorithm recommended by the Centers for Disease Control (CDC) and Association of Public Health Laboratories (APHL)?

A

HIV-1/2 antigen-antibody immunoassay

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13
Q

Which is considered the window period (in days) when using laboratory-based HIV-1/2 antigen-antibody immunoassay?

A

45 days

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14
Q

In the Centers for Disease Control (CDC) and Association of Public Health Laboratories (APHL) HIV testing algorithm, a positive initial HIV screening test should be followed by an HIV-1/HIV-2 antibody differentiation assay.

A

To differentiate whether the patient has infection with HIV-1, HIV 2, or both

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15
Q

In relation to HIV testing, what does the sensitivity of the HIV test refer to?

A

Persons with HIV who are correctly identified by a screening test

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16
Q

Which one of the following terms applies to the initial virus that succeeds in catalyzing the initial HIV infection?

A

Founder Virus

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17
Q

Which one of the following best describes the term “early HIV infection”?

A

The initial 6-month time period following HIV acquisition

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18
Q

Which one of the following tests is most likely to identify an individual with acute HIV infection?

A

Laboratory-based HIV-1/2 antigen-antibody immunoassay

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19
Q

According to the Adult and Adolescent ARV Guidelines, what is the recommended antiretroviral treatment approach for persons with acute HIV infection?

A

Begin treatment for all individuals with acute HIV infection

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20
Q

Symptomatic acute HIV infection is most likely to resemble which one of the following illnesses?

A

Mononucleosis

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21
Q

What is the new federal benchmark in the United States for successful linkage to care?

A

Completion of a visit with an HIV medical provider within 1 month (30 days) of HIV diagnosis

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22
Q

For the year 2018, approximately what percentage of persons newly diagnosed with HIV in the United States were linked to care within 1 month after the diagnosis of HIV?

A

80%

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23
Q

In 2018, which one of the following ethnic groups had the lowest rate of linkage to care within 1 month of HIV diagnosis?

A

Black/African American

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24
Q

During 2010 through 2018 in the United States, which one of the following best describes the trend in the percentage of persons linked to medical care after HIV diagnosis?

A

Increased

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25
Q

The 2015 International Association of Physicians in AIDS Care expert panel recommended which one of the following to improve linkage to HIV care?

A

Use of case managers and patient navigators

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26
Q

Which one of the following laboratory test results meets the criteria in the Centers for Disease Control and Prevention (CDC) 2014 HIV case definition?

A

Positive HIV antibody test and a subsequent positive result from a supplemental HIV test different from the initial test

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27
Q

Which one of the following findings is a marker of stage 3 HIV disease?

A

Presence of an AIDS-defining illness

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28
Q

Which of the following is considered an AIDS-defining condition?

A

Invasive cervical cancer

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29
Q

Which one of the following baseline screening tests is recommended for a person with HIV who is being considered for an antiretroviral therapy regimen that includes abacavir?

A

HLA-B*5701 testing

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30
Q

Which one of the following tests is recommended at the initial visit for this man?

A

Interferon-gamma release assay (IGRA)

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31
Q

Which one of the following is the preferred treatment for oral candidiasis in persons with HIV?

A

Fluconazole 100 mg once daily for 10 days

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32
Q

Which infectious pathogen has been strongly associated with oral hairy leukoplakia?

A

Epstein-Barr Virus

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33
Q

Which of the following treatments is most likely to lead to improvement in the aphthous stomatitis?

A

Triamcinolone acetonide 0.1 dental paste applied to ulcer 4 times daily for 7 days

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34
Q

Which of the following tests is the most sensitive for diagnosing oral human simplex virus (HSV)?

A

HSV DNA PCR

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35
Q

Which one of the following pathogens is the causative agent for Kaposi’s sarcoma?

A

Human herpesvirus-8 (HHV-8)

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36
Q

What is the most common mechanism of resistance with acyclovir-resistant HSV?

A

Decreased production of thymidine kinase

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37
Q

What is the approximately relative incidence of herpes zoster in adults with HIV who are not receiving antiretroviral therapy compared with the general population of age-matched immunocompetent adults?

A

The incidence is at least 15-fold higher in persons with HIV

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38
Q

What is the most likely explanation for worsening of eosinophilic folliculitis?

A

Immune reconstitution inflammatory syndrome

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39
Q

What is the most effective therapy for severe molluscum contagiosum in a person newly diagnosed with HIV?

A

Antiretroviral therapy

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40
Q

Which one of the following is TRUE regarding the impact of antiretroviral therapy on the incidence of Kaposi’s sarcoma in persons with HIV?

A

The incidence of Kaposi’s sarcoma has decreased following the widespread use of antiretroviral therapy

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41
Q

What is the primary reason to avoid administering most live virus vaccines to individuals with HIV who have advanced immunosuppression?

A

Disseminated infection with the vaccine viral pathogen

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42
Q

Which one of the following statements provides the appropriate sequence of the pneumococcal vaccines for a 35-year-old woman with HIV who has no prior history of pneumococcal vaccination?

A

PCV13, followed by a dose of PPSV23 (at least 8 weeks later), followed by a second PPSV23 dose (at least 5 years after the first dose of PPSV23), and followed by a dose of PPSV23 after age 65

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43
Q

Which one of the following statements is TRUE regarding meningococcal vaccination in adults with HIV who have not previously received meningococcal vaccine?

A

Conjugate meningococcal vaccine (MenACWY) is recommend in all adults with HIV

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44
Q

Which one of the following influenza vaccines is contraindicated in persons with HIV?

A

Live attenuated influenza vaccine

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45
Q

Which one of the following serologic patterns represents a patient who is immune to hepatitis B through immunization?

A

HBsAg negative, anti-HBc negative, anti-HBs positive

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46
Q

Which one of the following is considered a cardiovascular risk factor in persons with HIV?

A

Low CD4 Count

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47
Q

Which one of the following statin medications should be avoided in persons taking a protease inhibitor boosted with ritonavir?

A

Simvastatin

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48
Q

According to HIVMA Primary Care Guidelines what should be recommended for osteoporosis screening in this woman with HIV?

A

Order a dual-energy x-ray absorptiometry (DXA) of the hip and lumbar spine

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49
Q

What is the recommended for cervical cancer screening for this woman?

A

Screen at initial entry to HIV care and, if normal, screen again in 6 to 12 months

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50
Q

Based on the current GFR, what category of chronic kidney disease does he have?

A

G3b: Moderately to severely decreased GFR

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51
Q

Which one of the following statements best describes the relationship between the presence of mental health conditions and HIV risk?

A

Mental health conditions increase both HIV acquisition and transmission risk

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52
Q

Which one of the following mental health conditions has been most consistently associated with poor adherence to antiretroviral therapy?

A

Depression

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53
Q

Which one of the following cluster of symptoms is evaluated by the Primary Care PTSD (PC-PTSD) screening test?

A

Re-experiencing, numbness, avoidance, and hyperarousal

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54
Q

Which of the following statements best describes the prevalence of HIV-associated neurocognitive disorders (HAND) following the widespread use of effective antiretroviral therapy?

A

Prevalence of HIV dementia has declined

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55
Q

Based on his score, would you recommend at this point?

A

The score indicates possible dementia and he should have further evaluation for possible dementia

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56
Q

Which one of the following statements is TRUE regarding tobacco use disorder in persons with HIV?

A

Persons with HIV smoke at approximately twice the rate of persons without HIV

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57
Q

Which one of the following antiretroviral medications should not be used with disulfiram?

A

Lopinavir-ritonavir oral solution

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58
Q

Which one of the following is considered a potential cardiac adverse effect with methadone?

A

Prolongation of QT interval

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59
Q

The DSM-5 category of stimulant use disorder includes problems associated with the use of one or more of the following three substances:

A

Methamphetamine, amphetamines, and cocaine

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60
Q

Community leaders gather to discuss harm reduction strategies after a cluster of HIV infections in their city. Which one of the following practices is considered a harm reduction strategy?

A

Providing access to sterile needles and syringes to persons who inject drugs

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61
Q

Which one of the following statements identifies a reason why early models underestimated the number of persons with HIV who are retained in HIV medical care?

A

Earlier surveillance data did not account for persons with HIV who moved or transferred care

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62
Q

Approximately what percentage of new HIV infections in 2016 were transmitted by persons who were diagnosed with HIV but not retained in care?

A

43%

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63
Q

Which one of the following factors has been associated with decreased retention in care?

A

Active substance use disorder

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64
Q

Which one of the following is the criteria used in the CDC Surveillance data reports to define retention in HIV medical care for persons with diagnosed HIV?

A

At least 2 CD4 cell counts or viral load tests performed at least 3 months apart during the year of evaluation

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65
Q

What is the impact of missed clinic visits on HIV outcomes?

A

Missed clinic visits are associated with an increase in all-cause mortality

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66
Q

What result is required for maraviroc to be considered appropriate for use?

A

R5-tropic HIV

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67
Q

Which one of the following medications requires phosphorylation to become active as an inhibitor of HIV?

A

Lamivudine

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68
Q

According to the Adult and Adolescent ARV Guidelines, at what CD4 threshold should antiretroviral therapy by recommended for persons with HIV?

A

Antiretroviral therapy is recommended for all, regardless of CD4 cell count

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69
Q

According to the Adult and Adolescent ARV Guidelines, which one of the following is classified as a recommended initial regimen for most people with HIV?

A

Dolutegravir plus tenofovir alafenamide-emtricitabine

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70
Q

A 23-year-old trans man (he/him/his) newly diagnosed with HIV and a baseline HIV RNA level of 112,240 copies/mL is started on an antiretroviral therapy regimen of bictegravir-tenofovir alafenamide-emtricitabine.

A

After 2 to 4 weeks

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71
Q

Which one of the following antiretroviral therapy regimens has been most clearly associated with weight gain?

A

Dolutegravir plus tenofovir alafenamide-emtricitabine

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72
Q

Which one of the following medications requires baseline HLA-B*5701 testing to identify persons at increased risk of developing a medication-related hypersensitivity reaction?

A

Abacavir

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73
Q

Which organs are most likely to be adversely impacted by long-term tenofovir DF therapy?

A

Kidneys and bone

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74
Q

A 29-year-old trans woman (she/her/hers) with HIV starts on antiretroviral therapy with the single tablet regimen bictegravir-tenofovir alafenamide-emtricitabine. She tolerates the regimen well, but at a follow-up visit 4 weeks later the baseline serum creatinine of 0.9 mg/dL has increased to 1.1 mg/dL. A urinalysis showed no proteinuria. Over the next 9 months, the serum creatinine remains stable at a level of 1.0 to 1.3 mg/dL.

A

Inhibition of tubular secretion of creatinine by bictegravir

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75
Q

Atazanavir causes hyperbilirubinemia by inhibiting what enzyme?

A

Uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1)

76
Q

Which superfamily of enzymes is responsible for the metabolism of more than half of all antiretroviral medications?

A

P450

77
Q

Which one of the following antiretroviral medications is most likely to have levels decreased if taken with a proton-pump inhibitor?

A

Rilpivirine

78
Q

What impact will this antiretroviral therapy switch likely have on methadone levels during the next 6 weeks?

A

Methadone levels are likely to increase

79
Q

Which one of the following can be a serious complication of coadministration of ritonavir and inhaled fluticasone?

A

Cushing’s Syndrome

80
Q

Which one of the following antiretroviral medications should be avoided in a patient taking rifampin?

A

Tenofovir alafenamide

81
Q

Which one of the following statements is most accurate when describing the virologic outcomes in this study?

A

Rates of virologic suppression are about the same (not statistically different) in the two groups

82
Q

Which one of the following antiretroviral switches involving non-nucleoside reverse transcriptase inhibitors (NNRTIs) has been shown in clinical trials to improve lipid profiles?

A

Efavirenz to rilpivirine

83
Q

Which of the following statements provides accurate advice for what to do when switching from efavirenz to maraviroc?

A

Prescribe a higher dose of maraviroc for 2 weeks

84
Q

Which one of the following changes was seen in GS-112 participants who were switched from a regimen containing tenofovir DF to a regimen containing tenofovir alafenamide (elvitegravir-cobicistat-tenofovir alafenamide-emtricitabine)?

A

Significant decrease in proteinuria

85
Q

When considering a simplification of a 3-drug antiretroviral regimen to a 2-drug regimen of dolutegravir-rilpivirine, which one of the following is considered a requirement?

A

Virologic suppression for at least 6 months prior to the switch

86
Q

Approximately what percentage of persons with new HIV infection acquire drug-resistant HIV?

A

10-17%

87
Q

What is the signature mutation associated with resistance to emtricitabine and lamivudine?

A

M184V

88
Q

Which one of the following is most accurate regarding medications in the non-nucleoside reverse transcriptase inhibitors (NNRTIs) class that retain good activity against HIV in the presence of the K103N drug resistance mutation?

A

Doravirine, etravirine, and rilpivirine

89
Q

What are the most common two pathways of resistance with raltegravir?

A

Q148 and N155

90
Q

Which one of the following best describes resistance related to darunavir?

A

Darunavir boosted with ritonavir has a very high genetic barrier to resistance

91
Q

In the United States during the last 10 years, what has been the trend in the number of cases of tuberculosis in persons with HIV?

A

Decreased

92
Q

A 41-year-old man with HIV has a positive tuberculin skin test. He has no history of receiving treatment for tuberculosis and he is currently asymptomatic.

A

5-10% risk per year

93
Q

When testing for latent tuberculosis infection, which one of the following is an advantage for IGRA testing versus TST?

A

IGRA tests do not produce false-positive result from prior immunization with Bacillus Calmette-Guerin (BCG)

94
Q

24-year-old homeless woman presents for a follow-up visit after a new diagnosis of HIV. Initial laboratory results show a positive interferon gamma release assay (IGRA). She is asymptomatic and a follow-up chest radiograph is normal. She has a CD4 count of 240 cells/mm3 and recently started taking bictegravir-tenofovir alafenamide-emtricitabine.

A

Isoniazid plus pyridoxine for 9 months

95
Q

Which one of the following combinations of antiretroviral and anti-tuberculosis medications is contraindicated due to drug interactions?

A

Rifampin and bictegravir-tenofovir alafenamide-emtricitabine

96
Q

Which one of the following medications provides sufficient prophylaxis for both Pneumocystis pneumonia and Toxoplasma encephalitis?

A

Trimethoprim-sulfamethoxazole

97
Q

Which one of the following is an indication for discontinuing primary Pneumocystis pneumonia prophylaxis?

A

CD4 count has increased from less than 200 cells/mm3 to 200 cells/mm3 or greater for at least 3 months in response to antiretroviral therapy

98
Q

What is recommended regarding prophylaxis for cryptococcal meningitis?

A

Routine prophylaxis for cryptococcal meningitis is not recommended

99
Q

A 27-year-old man from Ethiopia is newly diagnosed with HIV and initial laboratory studies show a CD4 count of 32 cells/mm3. He is immediately started on an antiretroviral regimen of dolutegravir plus tenofovir alafenamide-emtricitabine and trimethoprim-sulfamethoxazole.
Which one of the following best describes the recommendation for primary prophylaxis against disseminated Mycobacterium avium complex (MAC) infection?

A

Primary prophylaxis for MAC is not recommended since antiretroviral therapy was immediately started

100
Q

Which one of the following statements is most accurate regarding prophylaxis for cytomegalovirus retintitis?

A

Routine prophylaxis for cytomegalovirus retinitis is not recommended for persons with HIV, regardless of CD4 cell count

101
Q

In the setting of newly diagnosed Pneumocystis pneumonia and HIV, when should antiretroviral therapy be started?

A

Within 2 weeks of starting Pneumocystis therapy

102
Q

What is the preferred initial treatment for the Toxoplasma encephalitis?

A

Pyrimethamine plus leucovorin plus sulfadiazine

103
Q

Which one of the following is a preferred treatment for disseminated MAC?

A

Azithromycin plus ethambutol

104
Q

Which one of the following is a preferred antifungal treatment for acute cryptococcal meningitis?

A

Intravenous liposomal amphotericin B plus oral flucytosine

105
Q

Which one of the following is the preferred treatment for esophageal candidiasis in persons with HIV?

A

Fluconazole for 14 to 21 days

106
Q

Which one of the following is an appropriate first-line treatment regimen for this woman’s chlamydia infection?

A

Azithromycin 1 gram orally in a single dose

107
Q

Which one of the following is recommended to treat gonorrhea in this man with HIV?

A

Ceftriaxone 250 mg by intramuscular injection plus azithromycin 1 gram orally

108
Q

What is the recommended treatment for secondary syphilis in this man who also has HIV?

A

Benzathine penicillin G 2.4 million units intramuscularly in a single dose

109
Q

As part of his evaluation and management, what should be recommended regarding HPV immunization?

A

Administer 3 doses of the 9-valent HPV vaccine

110
Q

Which one of the following best describes a characteristic of herpes simplex lesions in persons with HIV who have a CD4 count less than 100 cells/mm3?

A

Deep, extensive and non-healing ulcers

111
Q

Which one of the following serologic patterns is most consistent with chronic hepatitis B infection?

A

HBsAg positive, HBcAb positive, HBsAb negative

112
Q

Which one of the following would be a major concern with using dolutegravir-abacavir-lamivudine in this man with HIV-HBV coinfection?

A

Inadequate treatment of HBV and development of HBV drug-resistance to lamivudine

113
Q

Assuming that he has been acquired HIV at least 3 months ago, what potential negative impact related to HIV may have occurred from the entecavir treatment?

A

Entecavir monotherapy can lead to the development of HIV drug resistance (M184V mutation)

114
Q

What is the recommendation for hepatocellular carcinoma surveillance in this woman?

A

Abdominal ultrasound, with or without serum alpha-fetoprotein (AFP) every 6 months

115
Q

Which one of the following statements is most accurate regarding the tenofovir alafenamide-emtricitabine component of this regimen with regard to treatment of HBV?

A

Tenofovir alafenamide-emtricitabine is effective and safe therapy for HBV in persons with HIV coinfection

116
Q

Approximately what percentage of persons with HIV have coinfection with hepatitis C virus (HCV)?

A

25%

117
Q

Which one of the following statements most accurately describes the progression of liver fibrosis in persons with HIV and HCV coinfection compared with those who have HCV monoinfection?

A

Persons with HIV-HCV coinfection have accelerated progression of liver fibrosis compared with those who have HCV monoinfection

118
Q

Which one of the following is recommended regarding treatment of HCV in persons with HIV who are already taking antiretroviral therapy?

A

HCV treatment is recommended for all persons with HIV

119
Q

Which one of the following is the Centers for Disease Control (CDC) recommended initial screening test for diagnosing chronic HCV infection?

A

HCV enzyme immunoassay antibody test

120
Q

What is the likelihood of achieving a 12-week sustained virologic response (SVR) with initial treatment of genotype 1a chronic hepatitis C virus (HCV) in a person who has HIV coinfection?

A

Greater than 90%

121
Q

For a pregnant woman with HIV, what is the estimated risk of perinatal (mother-to-child) HIV transmission in the absence of any antiretroviral intervention for the mother or the child? Assume the birth is an uncomplicated vaginal delivery.

A

25%

122
Q

Which one of the following antiretroviral regimens is recommended as a preferred regimen in the Perinatal Guidelines for use during pregnancy in a treatment-naïve woman with HIV?

A

Raltegravir plus tenofovir DF-emtricitabine

123
Q

A 31-year-old woman presents late to prenatal care and is diagnosed with HIV and initial laboratory studies show an HIV RNA level of 126,000 copies/mL. She begins antiretroviral therapy without delay, but is counseled that she may require cesarean section delivery if her viral load does not decrease below the designated threshold by 38 weeks of gestation.

A

HIV RNA greater than 1000 copies/mL

124
Q

A 28-year-old woman with HIV is taking elvitegravir-cobicistat-tenofovir alafenamide-emtricitabine and has an undetectable HIV RNA level. She has very recently found out she is pregnant and is now being seen for her first visit while pregnant. She is between 10 and 12 weeks into the pregnancy.

A

Change the regimen now to raltegravir plus tenofovir DF-emtricitabine

125
Q

Based on recommendations in the Perinatal Guidelines, what is the indication for use of intravenous zidovudine during labor in pregnant women with HIV?

A

The woman’s HIV RNA level is greater than 1,000 copies/mL near the time of delivery or she has an unknown HIV RNA level near the time of delivery

126
Q

According to the 2016 Center for Disease Control and Prevention (CDC) Progression and Transmission of HIV (PATH 2.0) model, approximately what percentage of new HIV transmissions in 2016 were attributed to this 14.5% of persons unaware of their HIV diagnosis?

A

37.5%

127
Q

Assuming he continues to consistently maintain undetectable HIV RNA levels, what is the likelihood that he will transmit HIV to his female partner if they regularly have condomless vaginal sex?

A

<0.1%

128
Q

According to the African circumcision studies, which situation is most likely to show benefit from male circumcision in terms of preventing HIV transmission?

A

Circumcision of HIV-uninfected males who have sex with HIV-infected females

129
Q

Which one of the following statements most accurately summarizes the correlation of sexually transmitted infections (STIs) and HIV infection?

A

STIs facilitate transmission and acquisition of new HIV infection

130
Q

Which one of the following statements most accurately summarizes the trend in HIV incidence among persons who inject drugs during the time period 1988 through 1990 compared with 2003 through 2006?

A

HIV incidence declined by approximately 80%

131
Q

If the health care worker does not take any postexposure prophylaxis, what is the approximate risk of acquiring HIV?

A

0.2%

132
Q

Which one of the following regimens is a recommended regimen for occupational postexposure prophylaxis?

A

Tenofovir DF-emtricitabine plus raltegravir

133
Q

A trauma surgeon sustains a laceration during an emergency laparotomy following a motor vehicle accident involving a 26-year-old man with HIV infection. The surgeon starts postexposure prophylaxis with three antiretroviral medications, the next day laboratory results from the source patient show an undetectable HIV RNA.

A

Continue the postexposure prophylaxis regimen for the standard 28 days

134
Q

A medical student is seen after an HIV exposure in the emergency department and is placed on a 28-day course of postexposure prophylaxis. The student is trying to plan for when follow-up HIV testing will be needed. The laboratory is using an HIV-1/2 antigen-antibody immunoassay. The source patient tested negative for hepatitis C virus.
What is the recommended schedule for follow-up HIV testing for the medical student?

A

6 and 16 weeks

135
Q

A physician in a rural community suffers a needlestick injury when placing a central line for a 37-year-old man with HIV and sepsis. The hospital has tenofovir DF-emtricitabine, but they do not have raltegravir in stock. They have some older medication that they are considering choosing from to serve as a replacement for raltegravir.

A

Nevirapine

136
Q

When evaluating the risk of a condomless sex exposure with a person with HIV, which one of the following is associated with the highest risk of HIV acquisition?

A

Receptive anal sex

137
Q

According to the 2016 Nonoccupational PEP Guidelines, what is the recommended time cut-off for when postexposure prophylaxis is generally not recommended following a sexual exposure to HIV?

A

After 72 hours

138
Q

Which one of the following regimens is considered a preferred antiretroviral regimen for nonoccupational PEP?

A

Raltegravir plus tenofovir DF-emtricitabine

139
Q

What is the recommended duration for nonoccupational postexposure prophylaxis antiretroviral therapy?

A

28 days

140
Q

A person receiving postexposure prophylaxis for prevention of HIV infection should have their follow-up HIV testing extended out to 6 months if they develop which one of the following infections (related to the exposure)?

A

Hepatitis C Virus

141
Q

In persons taking preexposure prophylaxis for HIV prevention, how often should HIV testing be performed?

A

Every 3 months

142
Q

What has been identified as the main reason for the low efficacy seen in the FEM-PrEP and VOICE trials?

A

Poor adherence among women in the trial

143
Q

What is the recommended PrEP regimen for this woman?

A

Tenofovir DF-emtricitabine one pill daily

144
Q

For a person starting on preexposure prophylaxis, why is it so important to perform baseline testing for hepatitis B virus infection?

A

Patients with chronic hepatitis B infection may develop a significant hepatitis flare after discontinuation of preexposure prophylaxis

145
Q

Which one of the following is considered a contraindication for initiating PrEP with tenofovir alafenamide-emtricitabine?

A

An estimated creatinine clearance less than 30 mL/min

146
Q

In the United States, approximately what percentage of persons living with HIV are younger than 13 years of age?

A

Less than 1%

147
Q

A 32-year-old mother with HIV gives birth at week 38 via vaginal delivery. The mother received antiretroviral therapy throughout her pregnancy and had undetectable HIV RNA levels consistently during her pregnancy, including an undetectable level at 2 weeks prior to delivery.
What is the preferred method for diagnosing HIV in a newborn?

A

HIV RNA test at weeks 2, 4, and 20 after birth

148
Q

A 6-month-old boy was diagnosed with HIV and he has been receiving antiretroviral therapy for 2 weeks. He has no HIV-related clinical symptoms and a CD4 count is 658 cells/mm3 and CD4 percentage of 23.
What is his HIV stage?

A

Stage 3

149
Q

A 5-month-old girl has just been diagnosed with HIV. A CD4 cell count and CD4 percentage are ordered and pending.
Which one of the following strategies is recommended for Pneumocystis pneumonia prophylaxis for this 5-month-old girl?

A

Initiate Pneumocystis pneumonia prophylaxis regardless of CD4 cell count or CD4 percentage

150
Q

Which one of the following would be considered a preferred antiretroviral regimen for initial therapy in a 14-month-old girl with HIV?

A

Zidovudine plus lamivudine plus raltegravir

151
Q

Among all persons living with diagnosed HIV in the United States, approximately what percentage are adolescents and young adults (ages 13-24)?

A

3%

152
Q

Among persons 13-24 years of age living with HIV in the United States, approximately what percentage have undiagnosed HIV?

A

45%

153
Q

A 15-year-old girl is newly diagnosed with HIV. Her sexual maturity rating is Tanner stage V. Initial laboratory studies show a CD4 count of 784 cells/mm3 and a plasma HIV RNA level of 47,860 copies/mL.
Which one of the following best describes antiretroviral therapy recommendations for her?

A

Antiretroviral therapy should be started now

154
Q

A 13-year-old girl living with HIV is seen for routine follow-up. Her most recent CD4 count was 824 cells/mm3. She has never received any doses of any human papillomavirus (HPV) vaccine.
Which one of the following options is recommended regarding administering HPV vaccine in this 13-year-old girl?

A

Administer 3 doses of the 9-valent HPV vaccine (9vHPV) and give the first dose in the series at this visit

155
Q

Which one of the following statements is TRUE regarding the option to use tenofovir DF-emtricitabine as preexposure prophylaxis for this 17-year-old adolescent male?

A

Tenofovir DF-emtricitabine is FDA-approved for preexposure prophylaxis in adolescents who weigh at least 35 kg (77 pounds)

156
Q

In the United States, among all persons living with HIV, approximately what percentage are women?

A

22%

157
Q

For women newly diagnosed with HIV in the United States, which one of the following is TRUE regarding reported HIV transmission category?

A

Approximately 85% have heterosexual contact as the reported HIV transmission category

158
Q

What is the concern regarding using dolutegravir in a woman of childbearing age?

A

Neural tube defects in babies born to mothers who initiated a dolutegravir-based regimen prior to pregnancy

159
Q

Which one of the following is TRUE regarding hormonal contraceptive interactions with antiretroviral medications?

A

Efavirenz typically decreases blood levels of hormonal contraceptives and this may result in decreased contraceptive efficacy

160
Q

A 27-year-old woman living with chronic HIV presents with vaginal discharge. She is diagnosed with trichomoniasis.

A

Metronidazole 500 mg twice daily for 7 days

161
Q

Among all persons with HIV who live in the United States, approximately what percentage are 50 years of age or older?

A

50%

162
Q

Among all persons newly diagnosed with HIV in the United States in 2018, approximately what percentage were 50 years of age or older?

A

17%

163
Q

For all persons 55 years of age and older living with HIV in the United States in 2015, approximately what percentage have undiagnosed HIV?

A

7%

164
Q

Which one of the following best represents the recommendation for initiating antiretroviral therapy in persons 50 years of age and older?

A

Antiretroviral therapy should be initiated in all persons 50 years of age and older, regardless of CD4 cell count

165
Q

Which one of the following statements is TRUE regarding response to antiretroviral therapy in persons 50 years of age and older when compared with younger persons with HIV treated with antiretroviral therapy?

A

Persons 50 years of age and older typically have blunted CD4 cell count responses

166
Q

In the United States in 2015, approximately what percentage of inmates in correctional facilities had HIV infection?

A

1.3%

167
Q

Which one of the following statements is TRUE regarding the number of prisoners with HIV in state prisons versus federal prisons?

A

The number of persons with HIV is substantially higher in state than in federal prisons

168
Q

Which one of the following statements is TRUE regarding the relative number of men with HIV versus women with HIV in state and federal prison systems in the United States?

A

The number of men with HIV is approximately 10 times the number of women with HIV

169
Q

For persons with HIV who become incarcerated, approximately what percentage have undiagnosed HIV at the time of entry into jail or prison?

A

22%

170
Q

What does the Centers for Disease Control and Prevention recommend for HIV testing practices in correctional facilities?

A

Opt-out testing (the HIV test is offered and performed unless prisoner declines testing)

171
Q

In the United States, approximately what percentage of persons with HIV are black/African American?

A

41%

172
Q

Among Hispanic/Latina women living with HIV in the United States, approximately what percentage have heterosexual sex as their transmission category?

A

75-80%

173
Q

Which racial/ethnic group has the lowest percentage of persons living with HIV who are undiagnosed?

A

White

174
Q

Which racial/ethnic group has the lowest percentage of persons living with HIV who have viral suppression (HIV RNA less than 200 copies/mL)?

A

Black/African Americans

175
Q

For black/African American men who have sex with men, what is the projected lifetime risk of being diagnosed with HIV?

A

1 in 2

176
Q

Among all persons living with HIV in the United States, approximately what percentage have male-to-male sex as their reported transmission category?

A

55-60%

177
Q

Among persons living with HIV in the United States, approximately what percentage are cisgender women who acquired HIV through sex with other cisgender women?

A

Less than 1%

178
Q

Which one of the following is a potential toxicity that occurs with significant frequency when using testosterone for masculinizing therapy?

A

Polycythemia

179
Q

Which one of the following is a potential adverse effect that occurs with significant frequency when using spironolactone as an antiandrogen feminizing treatment?

A

Hyperkalemia

180
Q

Among transgender women living with diagnosed HIV in the United States, which racial/ethnic group had the most number of persons diagnosed?

A

Black/African American

181
Q

Which one of the following statements is TRUE regarding the global epidemiology of HIV-2?

A

Most persons with HIV-2 reside in West Africa

182
Q

Approximately what percentage of HIV infections in the United States are caused by HIV-2?

A

1%

183
Q

Which one of the following is TRUE when describing the pathogenesis and natural history of persons with untreated HIV-2 in comparison with persons who have untreated HIV-1?

A

Persons with HIV-2 typically have lower mortality rates than persons with HIV-1

184
Q

Which one of the following statements is TRUE regarding testing for HIV-2 infection?

A

Use of the Centers for Disease Control and Prevention and Association of Public Health Laboratories HIV diagnostic algorithm reliably detects chronic HIV-2 infection

185
Q

Which one of the following medications should be avoided when treating HIV-2 due to intrinsic resistance?

A

Efavirenz

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