I'm HIV+ Flashcards
env
is gp160, cleaved into gp120 (CD4 attachment) and gp41 (fusion and entry)
gag
capsid (aka p24)
pol
reverse transcriptase, aspartate protease, integrase
what cells does HIV infect?
CD4 and marcrophages
what does HIV bind to?
Helper T (CD4): CCR5 (early) and CXCR4 (late) Macrophage: CD4 + CCR5
HIV immunity gene
homozygous CCR5 mutation is immune. heterozygous is slower course
how to test for HIV?
1st: ELISA (sensitive)
2nd: Western (specific)
3rd: PCR (test viral load)
how many months may a baby test HIV + after birth from a HIV mother?
two months till the antibodies clear
AIDS definition
Cd4 less than 200 or hiv and defining illness or hiv and ratio 4:8 is less than 1.5
immunocompromised vs AIDS
Ic is cd4 less than 400
Aids is 200
stages of HIV
Four Fs. Flu-like (acute), Feeling good (replication in lymph nodes), Falling count, Final crisis
HIV: low grade fever, cough, hepatosplenomegaly, tongue ulcer. oval yeast cells within macrophages
Histoplasma capsulatum (not just in lungs unlike reg people)
HIV: fluffy white cottage-cheese lesions in mouth or even esophagous if bad. pseudohyphae.
Candida albicans (thrush)
HIV: superficial vascular proliferation, neutrophilic inflammation on skin.
bartonella henselae (angiomas)
HIV: chronic watery diarrhea. acid fast cysts in stool
Cryptosporidium spp.
HIV: encephalopathy. demyelination.
JC virus causing PML
HIV: brain abscess. “ring-enhancing lesions”
Toxoplasma gondii
HIV: meningitis. India ink shows yeast with narrow-based budding large capsule
cryptococcus neoformans
HIV: retinitis, cotton-wool spots on funduscopic exam. esophagitis too
CMV
HIV: dementia
HIV can do that all by itself
HIV: superficial neoplasic proliferation of vasculature. lymphocytic inflammation
HHV-8 (kaposi sarcoma)
HIV: hairy leukoplakia
EBV
HIV: Non-Hodgkins lymphoma (large cell) in Waleyer’s ring
EBV
HIV: Squamous cell carcinoma of anus or cervix
HPV
HIV: primary CNS lymphoma
EBV but must distinguish from toxoplasma
HIV: interstitial pneumonia with intranuclear inclusion bodies. “owl eyes”
CMV
HIV: pleuritic pain, hemoptysis, infiltrates on imaging
invasive aspergillosis
HIV: general pneumonia (most common)
Pneuocystis jirovecii
HIV: tuberculosis-like disease with CD4
mycobacterium avium
prophylaxis for HIV
TMP-SMX for anything >50. add azithromycin for
Four classes of drugs used in HAART?
Protease inhibitors, Nucleoside Reverse Transcriptase Inhibitors, Non-Nucleoside Reverse Transcriptase Inhibitor, Integrase Inhibitors
What combo of drugs are needed in HIV?
2 NRTIs + 1 of the others (pick one)
name of the protease inhibitors
-navir (Navir tease a protease)
mech of protease inhibs
inhibs the protease function of pol to make functional components of HIV
Ritonavir toxicity
inhibits p-450
general toxicity of protease inhibitors
hyperglycermia, GI intolerance, lipodystrophy
toxicity of indinavir
nephropathy, hematuria
NRTI names (7)
(-vudine) Lamivudine, Zidovudine, Stavudine
(and others) Tenofovir, Abacavir, Emtricitabine, Didanosine
NRTI work how?
lack 3’ OH so they are chain terminators. they are nucleosides so they require phosphorylation
which NRTI doesn’t require phosphorylation?
Tenofovir (it is a nucleotide)
which NRTI is used in pregnancy to prevent fetal transmission?
ZDV (zidovudine)
NRTI tox
bone marrow suppresion, peripheral nueopathy, lactic acidosis, rash
NNRTI mechanism
bind RT at non active site and thus don’t need phospho (they aren’t nucleosides)
NNRTIs names
nevirapine, Efavirenz, Delavirdine
Integrase inhibitors name and mech
Raltegravir. inhibs HIV integrase
Raltegravir tox
hypercholesterolemia
copies of genome in HIV
diploid RNA
