Infection: Hepatitis/HIV

Question 1

How is HIV infection managed in pregnancy and breastfeeding?

Answer 1

Treatment of HIV infection in pregnancy aims to reduce the risk of toxicity to the fetus (although information on the teratogenic potential of most antiretroviral drugs is limited), to minimise the viral load and disease progression in the mother, and to prevent transmission of infection to the neonate.

Breast-feeding by HIV-positive mothers may cause HIV infection in the infant and should be avoided.

Question 2

What is the drug combination in PrEP?

Answer 2

Emtrictabine with tenofovir disoproxil

Question 3

What drug used in HIV treatment is used for its ability to ‘boost’ the activity of the other drugs?

Answer 3

Ritonavir in low doses.

Question 4

Protease inhibitors in general are associated with what side effects?

Answer 4

1. Lipodystrophy

2. Metabolic effects

Question 5

Which subtype of HIV is most prevalent in the UK? (and conversely which is rare?)

Answer 5

The non-nucleoside reverse transcriptase inhibitors efavirenz, etravirine, nevirapine, and rilpivirine are used in the treatment of HIV-1 infection, but not against the subtype HIV-2, a subtype that is rare in the UK.

Question 6

The antiHIV drug Nevirapine is associated with what?

Answer 6

Nevirapine is associated with a high incidence of rash (including Stevens-Johnson syndrome) and occasionally fatal hepatitis.

Question 7

Psychiatric or CNS disturbances are common with what antiHIV drug?

Answer 7

Efavirenz; often self-limiting and can be reduced by taking the dose at bedtime.

Question 8

What bone condition has been reported in patients with advanced HIV disease or following long-term exposure to combination antiretroviral therapy?

Answer 8

Osteonecrosis

Question 9

Autoimmune disorders (such as what?) have been reported many months after the initiation of treatment with anti-HIV meds.

Answer 9

Graves

Question 10

The reactivation of what form of hep can occur when treating hep c?

Answer 10

Hep b