Immunity and Immune Deficiency

Question 1

Active Immunity

Answer 1

specific, acquired through immunization or actually having the disease

Question 2

Booster Shot

Answer 2

necessary because plasma cells dissipate eventually and when there aren’t enough memory cells you need a booster

Question 3

Passive Immunity

Answer 3

immunity transferred from another source

can also be artificially provided by the transfer of antibodies produced by other people or animals

e.g. infant from mother

Question 4

HIV Diagnosis

Answer 4

Antigen/Antibody combination enzyme immunoassay (ELISA or EIA) that detects both HIV I and II

If positive, antibody immunoassay to differentiate and confirm (Western Blot)

Polymerase Chain Reaction (PCR) identifies the virus in newborns

Orasure/Oraquick Rapid HIV-1 Antibody test (home)

Question 5

HIV Positive

Answer 5

CD4 count and viral load monitored

HIV is a retrovirus, genetic info in the RNA, reverse transcriptase and incorporates DNA into host cell

HIV targets the CD4 helper T cell, so they cannot work to prevent the virus

Question 6

AIDS

Answer 6

CD4 count below 200 cells/ul and the presence of an AIDS indicator condition (protozoa, fungal, severe viral infection)

Question 7

Stages of HIV

Answer 7

Viral Replication
Seroconversion
Latent Period
Period of More Rapid Virus Production
Overt Aids

Question 8

Viral Replication

Answer 8

0-3 weeks

infection has entered the body, begins to replicate rapidly, undetected

no symptoms, testing based on exposure/antigen may be detected

Question 9

Seroconversion

Answer 9

3 weeks to 6 months after exposure

acute “mono-like” illness

fever, sore throat, aches, night sweats, enlarged lymph nodes, N/V, chills fatigue

antibodies detected

low CD4 but still >400

Question 10

Latent Period

Answer 10

3-12 years

stable serum virus levels

virus continues to reproduce and destroy immune system

persistent lymph node enlargement or mild symptoms

CD4 count still >400

Question 11

Period of More Rapid Virus Production

Answer 11

lasts approx. 18 months

decreased immune activity

symptoms occur

severe viral/fungal infections

herpes, CMV, EBV opportunistic infections

CD4 count <400

can be delayed if access to treatment at this point

Question 12

Overt Aids

Answer 12

CD4 count <200

one or more opportunistic infections

without antiretroviral therapy, death will occur 2-3 years after this point

Question 13

Common Opportunistic Infections with HIV

Answer 13

Opportunistic infections involve common organisms that do not typically produce infection unless there is impaired immune function

Often fungal, protozoal, bacterial and mycobacterial or viral

Bacterial/Mycobacterial: bacterial pneumonia, mycobacterium TB

Fungal: candidiasis, pneumocytosis

Protozoal: toxoplasmosis

Viral: Herpes simplex, zoster virus, HPV and (caused by cytomegalovirus) CMV

Malignancy: karposi sarcoma, skin and any mucosal surface in mouth, non-hodgkins lymphoma

sexually transmitted: HPV and herpes

neurologic: progressive multifocal leukoencephalopathy

Medication related: endocrine, insulin resistance, metabolic, lipodystrophy, increased girth, buffalo hump, wasting of face

Question 14

HIV and AIDS Therapies

Answer 14

antiretroviral medications slow down the disease progression

Question 15

Highly Active Antiretroviral Therapy (HAART)

Answer 15

goal is a sustained suppression of HIV replication resulting in an undetectable viral load and increasing CD4 count

need three or more at once because the virus is always adapting

each class of drugs works to interrupt the HIV life cycle at different stages

Question 16

Classes of HAART drugs

Answer 16

Nucleoside Reverse Transcriptase Inhibitors

Non-nucleoside Reverse Transcriptase Inhibitors

Protease Inhibitors

Fusion Inhibitors

CCR5 Co-receptor antagonists

Integrase Inhibitor