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Repro > HIV Treatment and Management > Flashcards

HIV Treatment and Management Flashcards

1
Q

What are the targets of anti-retroviral drugs?

A 
Reverse transcriptase
Integrase
Protease
Entry - fusion, CCR5 receptor
Maturation
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2
Q

What drugs have vitro activity against HIV?

A

Nucleoside analoguesreverse transcriptase inhibitors (NRTI)

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3
Q

Give an example of a Nucleoside analoguesreverse transcriptase inhibitor?

A

Zidovudine

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4
Q

When did zidovudine not work?

A

When used as monotherapy against asymptomatic individuals

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5
Q

What is the definition of highly active anti-retroviral therapy?

A

A combination of 3 drugs from at least 2 drug classes to which the virus is susceptible

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6
Q

What is the purpose of anti-retroviral therapy?

A

Reduce viral load to undetectable
Restore immunocimpetence
Reduce morbidity and mortality
Minimise toxicity (maximise tolerability)

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7
Q

Give an example of an effective anti-retroviral therapy

A

Tenofovir
Emtricitabine
Efavirenz

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8
Q

What is the wish-list for anti-retroviral therapy?

A 
Tolerability
Low toxicity
Low pill burden
Low dosing frequency
Minimal drug-interactions
High barrier to resistence
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9
Q

What are the side effects of HAART therapy?

A

GI - protease inhibitors, transaminitis, fulmient hepatitis (nevirapine + most others)
Skin - rash, hypersensitivity, Stevens-Johnsons (abacavir, nevirapine)
CNS - mood, psychosis (efavirenz)
renal - proximal renal tubulopathies (tenofovir, atazanavir)
Bone - Osteomalacia (tenofovir)
CVS - Increased MI risk (Abacavir, lopinavir, maraviroc)
Haem - anaemia (Zidovudine)

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10
Q

What are co-infections of HIV?

A

Hep B
Hep C
TB

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11
Q

What are the 3 types of partner notification?

A

Partner referral
Provider referral
Conditional referral

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12
Q

How can you prevent HIV transmission?

A 
Condom use
HIV treatment
STI screening and treatment
Sero-adaptive sex behaviours
Disclosure
Post-exposure prophylaxis
Pre-exposure prophylaxis
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13
Q

Can you transmit HIV by casual/household contact?

A

No

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14
Q

How do you prevent transmission from mother to child?

A 
HAART during pregnancy
Vaginal delivery if undetected viral load
Caesarean section if viral load detected
4/52 PEP for neonate
Exclusive formula feeding
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15
Q

What is sero-discordance?

A

When a couple has one person who is HIV -ve and the other is HIV +ve

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16
Q

What ways can sero-discordant couples conceive?

A

HIV +ve male: - Timed unprotected sex with HAART
HIV +ve female: self insemination
Timed unprotected sex with HAART
Treatment as prevention

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