Human immunodeficiency virus (HIV)

Question 1

What is the difference between HIV and AIDS?

Answer 1

AIDS occurs as an HIV infection progresses, and the person becomes immunodeficient

Question 2

1) What type of virus is HIV?
2) What does the virus destroy/target?
3) An initial seroconversion flu-like illness occurs within a few weeks of infection - what does this mean?
4) The infection is then asymptomatic until when?
5) What do immunodeficient patients develop (2)?

Answer 2

1) RNA retrovirus
2) CD4 helper T cells
3) Transition from infection with HIV to the detectable presence of HIV antibodies in the blood
4) Condition progresses to immunodeficiency
5) AIDS-defining illnesses and opportunistic infections

Question 3

Name 2 ways HIV can transmit

Answer 3

• Unprotected anal, vaginal or oral sex
• Mother to child at any stage of pregnancy, birth or breastfeeding (vertical transmission)
• Mucous membrane, blood or open wound exposure to infected blood or bodily fluids

Question 4

1) AIDS-defining illnesses are associated with end-stage HIV infection - what causes these?
2) Name 2 AIDS-defining illnesses

Answer 4

1) Low CD4 count
2) Kaposi’s sarcoma, pneumocystis jirovecii pneumonia (PCP), cytomegalovirus infection, candidiasis (oesophageal or bronchial), lymphomas, TB, toxoplasmosis, cryptococcal disease

Question 5

Up to how long can it take to develop antibodies against HIV?

Answer 5

3 months

Question 6

1) What is the typical screening test for HIV?
2) How else can HIV be tested?

Answer 6

1) Antibody test
2) PCR, testing for the p24 antigen

Question 7

A CD4 count of under what cells/mm3 is considered end-stage HIV (AIDS)?

Answer 7

200 cells/mm3

Question 8

What are the 2 aims of treatment in HIV management?

Answer 8

Normal CD4 count and undetectable viral load

Question 9

Name 2 groups of Highly Active Anti-Retrovirus Therapy (HAART) Medications

Answer 9

• Protease inhibitors (PIs)
• Integrase inhibitors (IIs)
• Nucleoside reverse transcriptase inhibitors (NRTIs)
• Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
• Entry inhibitors (EIs)

Question 10

What drugs is given to patients with a CD4 under 200/mm3 to protect against pneumocystis jirovecii pneumonia?

Answer 10

Co-trimoxazole

Question 11

What is the post exposure prophylaxis of HIV?

Answer 11

4 weeks of antiretroviral therapy and arrange HIV testing 12 weeks later

Question 12

Within which time period should post exposure prophylaxis be initiated in HIV?

Answer 12

72 hrs

Question 13

What is the commonest cause of diarrhoea in patients with HIV?

Answer 13

Cryptosporidium

Question 14

How is HIV managed?

Answer 14

2 NRTI and either a protease inhibitor or an integrase inhibitor