HIV: Treatment and Care Flashcards
HIV patients need to have a threshold under __ to be offered treatment
NO THRESHOLD ANYMORE
what preventative measures are taken in a new HIV patient?
vaccines eg hep b
prevention of transmission
partner notification
OI prophylaxis
what HIV subtype is common in subsaharan africa?
c
what HIV subtype is common in the western world?
b
what HIV subtype is common in thailand?
recombinant forms
what serology is done in HIV infection staging?
hep b and c
syphilis
what enzyme is used by viral RNA to replicate itself and turn into DNA?
reverse transcriptase
what enzyme is used by the HIV DNA to enter the host’s DNA?
integrase
what does protease do?
cleaves HIV DNA into smaller virions
what kind of drugs target reverse transcriptase to treat HIV
nucleoside analogues
gold standard anti-retroviral drug?
integrase
name targets for antiretroviral therapy?
reverse transcriptase
integrase
protease
CCR5 receptor
what is HAART?
highly active anti-retroviral therapy
- a combo of 3 drugs from at least 2 classes to which the virus is susceptible
name the 3 drugs that can be put in a single tablet in HAART?
tenofovir
emitricitabine
efavirenz
why can a virus become resistant
its reverse transcriptase enzyme cant proof read so it can come up with sequences that may become resistant
what factors impact on someones adherence to a drug?
lifestyle- night shift work etc
tolerability - sick? diarrhoea?
pharmacokinetics
drug-drug interactions
is it better to just stop a drug or take it sometimes?
stop
what drug is good for minimising resistance?
protease inhibitor
what drugs cause GI side effects?
protease inhibitors
skin side effects of HAART?
rash
hypersensitivity
steven-johnsons
what is seborrhoeic dermatitis
oedematous reaction to a fungal infection
how does HAART affect the renal system?
causes proximal renal tubulopathies
when can protease inhibitors’ side effects be beneficial?
methadone users - constipation
if they have existing constipation
most HIV drugs have what MoA?
potent liver enzyme inhibitors or inducers
what should be used to assess drug-drug interactions?
www.HIV-druginteractions.org
Tx of hep B in someone with HIV?
same as HIV
what vaccines are given to HIV patients?
hep a/b
flu
pneumococcal
HPV
do HIV patients have to tell their partner that they have HIV?
no
how is sexual transmission presented?
condom use
STI screening and treatment
post and pre exposure prophylaxis
risk of transmission of HIV if someone has undetectable HIV?
0
give an example of seroadaptive behaviours to prevent HIV transmission
less likely to transmit HIV if anoreceptive
less likely to transmit if oral sex is performed (BUT TEST FOR STIS)
HIV can be transmitted through casual/household contact T or F
F
what should household items should not be shared in HIV?
toothbrush - bleeding gums
razors
how can you prevent HIV transmission to a foetus?
treatment as prevention (until they are undetectable) + timed condomless sex
if the partner is still uncertain about their child having HIV even though their partner is on preventative therapy, what can you do?
give the partner preventative therapy too
how is mother to child transmission prevented? how is the baby delivered?
HAART during pregnancy
SVD if undetectable, CS if detectable
what preventative treatment is given to babies of an detectable HIV +ve mum?
baby is given 3 drugs as PEP for 4 weeks
what preventative treatment is given to babies of an undetectable HIV +ve mum?
baby is given 1 drug as PEP for 1 week
babies can/cant receive breast milk from an HIV +ve mother
cant; give formula feeding only
what is PrEP?
pre-exposure prophylaxis
eligibility for prep?
- over 16
- HIV -ve
- commits to 3/12 follow up
who is high risk for HIV?
HIV+ partner
MSM or trans woman
UPAI in last year
confirmed bacterial rectal STI in past yr
