HIV Symposium

Question 1

Where did HIV come from?

Answer 1

HIV 1 from Chimpanzees and HIV2 from sooty managebeys

Question 2

When did the start calling it AIDS?

Answer 2

1982

Question 3

HIV was discovered in?

Answer 3

1983- Pasteur

Gallo- 1984

Question 4

Which drug was primarily given to HIV patients?

Answer 4

Zidovudine

Question 5

Prophylaxis in 1989 was?

Answer 5

Nebulised pentamidine

Question 6

AZT could reduce transmission by?

Answer 6

25 to 8%

Question 7

Lazarus syndrome?

Answer 7

Blood circulation return spontaneously after your heart stops beating and fails to restart despite CPR.

Question 8

What is highly active anti-retro viral therapy, HAART?

Answer 8

Combination therapy- usually at least 3 anti retro viral drugs

Question 9

Side effects of HAART?

Answer 9

Wasting of face
Lipodystrophy (gain fat some places and lose in other)
Gain of weight

Question 10

HIV life cycle?

Answer 10

Attaches to CD4, require cofactors CCR5
Fuses with membrane and releases 3 enzymes
Uses reverse transcriptase to turn rna strand to dna
DNA integrated to host nucleus , integrase
Produces proteins
Protease to snip proteins and buds off

Question 11

Anti- retro viral classes?

Answer 11

Fusion inhibitors
Coreceptor inhibitors
Nucleoside reverse transcriptase inhibitors
Non nucleoside reverse transcriptase inhibitors
Integrate inhibitors
Protease inhibitors

Question 12

How many viruses produced per person per day?

Answer 12

10 billion

Question 13

Mutations in HIV happen every?

Answer 13

10,000 bases

Question 14

Normal values of CD4?

Answer 14

> 500

Question 15

If diagnosed for CD4 was less than 350 then increased risk of death is by?

Answer 15

10 fold

Question 16

Combination prevention?

Answer 16

Treatment as prevention TasP
Pre-exposure prophylaxis- PrEP
Expansion of HIV testing

Question 17

U=U?

Answer 17

Undetectable is untransmittable

Question 18

PrEP?

Answer 18

Truvada (tenofovir)

Question 19

When was PrEP allowed to be given?

Answer 19

Oct 2020

Question 20

How many people living with HIV globally?

Answer 20

37.7 million

Question 21

How much reduction in infections since 1997?

Answer 21

52%

Question 22

What happens initially in HIV?

Answer 22

Mucosal infection keeps developing, HIV specific CD8 T cells rise sharply and reduce viral load, gradual loss of CD4 t lymphocytes

Question 23

Where does the virus undergo lyric replication?

Answer 23

CD4 t helper cells

Question 24

Examples of opportunities diseases?

Answer 24

Tuberculosis
PCP, pneumonia
Kaposi sarcoma

Question 25

What is the main receptor for HIV?

Answer 25

CD4 via gp120

Question 26

What are the stages of HIV?

Answer 26

``` Fusion Viral genome is released Reverse transcription Integration Replication and protein synthesis Budding New mature vision ```

Question 27

What co receptors are present when HIV tries to invade a cell?

Answer 27

CXCR4 or CCR5

Question 28

What is CCR5?

Answer 28

Receptor for RANTES, MIP 1 alpha

Question 29

What are rantes and MIP 1 alpha and SDF 1?

Answer 29

Molecules involved in lymphocyte chemotaxis and HIV suppression

Question 30

Where are high levels of HIV entry co-receptor CCR5 expressed?

Answer 30

Lamina propria and intraepithelial CD4 T cells

Question 31

What happens to the co-receptors during HIV infection and and why is their role important?

Answer 31

Depleted Prevention of invasive infection Killing infected epithelial cells Immune regulation

Question 32

The viruses using CCR5 co receptors are called?

Answer 32

R5 viruses

Question 33

Which strains are most commonly transmitted sexually?

Answer 33

R5

Question 34

When are viruses able to use CXCR4?

Answer 34

5 years into infection

Question 35

When they are able to use CXCR4 what are the viruses called?

Answer 35

X4, if use both then called R5X4

Question 36

How are CD4 T cell destroyed after HIV infection?

Answer 36

Death by cytoplasmic effects Activation induced cell death apoptosis Killing of infected cells by cytotoxic t lymphocytes

Question 37

What are the mucosal HIV transmission routes?

Answer 37

Genitourinary, rectal and oral mucosa

Question 38

What percent of CD4 cells are in gut?

Answer 38

60%

Question 39

Lamina propria CD4 T cells express high levels of?

Answer 39

CCR5

Question 40

Depletion of CD 4 t cells in the gut leads to?

Answer 40

Increased translocation of gram negative lipopolysaccharide positive bacteria

Question 41

Rise of LPS systemically causes?

Answer 41

Immune activation and TNF production, which drive HIV replication and upregulation of CCR5

Question 42

Whe did antibody test for HIV come out?

Answer 42

1985

Question 43

In 1989 what was the treatment for HIV?

Answer 43

Nebuliser pentamidine

Question 44

What was the mono therapy for HIV?

Answer 44

AZT- zidovudine

Question 45

What is current practice?

Answer 45

Combination therapy 3 drugs Normal vaginal delivery f viral load less than 40 Transmission rates less that 1

Question 46

In early replication what are the levels of virus?

Answer 46

More than 10 million copies/ml

Question 47

Aim for viral load to be?

Answer 47

Less than 40

Question 48

Significant risk of morbidity and mortality if CD4 count is less than?

Answer 48

350cells/mm

Question 49

Over 200 CD4 you are prone to?

Answer 49

TB, Kaposi’s Sarcoma, shingles, oral thrush, seborrhoeic dermatitis

Question 50

Between 50 and 200 you are prone to?

Answer 50

Pneumocystis pneumonia, | toxoplasmosis, lymphoma

Question 51

Under 50 CD4 you are prone to?

Answer 51

MAC, CMV, PML, CNS lymphoma

Question 52

What is treatment as prevention?

Answer 52

Taking ART to prevent

Question 53

What are the aims?

Answer 53

All new diagnosis on ARVs by 30 days 98-100% to be taking effective treatment 100% have undetectable viral loads

Question 54

Event based PrEP?

Answer 54

2 tablets 2-24 hours before sex 1 tablet 24 hours later 1 tablet 48 hours later

Question 55

AIDS related death reduced by?

Answer 55

64%