Infectious diseases

Question 1

What is a prion?

Answer 1

small building block of genetic material- pathogenic- cause things like mad cow disease

Question 2

What is virulence?

Answer 2

Degree of pathogenicity

Question 3

What is the proportion of people who are overweight/obese living with HIV?

Answer 3

2/3

Question 4

What is the most common medical problem of people with HIV and why?

Answer 4

Hyperlipidaemia thought to be due to antiretrovirals

Question 5

What are some common problems in people with advanced HIV/AIDS?

Answer 5

-Oral candida that can go into the oesophagus- can cause taste changes and painful swallow
-villous atrophy attributed to crypt cell hyperplasia
-

Question 6

How do you monitor HIV?

Answer 6

CD4 count, viral load (U=U)

Question 7

What is the estimated adherance to antiretrovirals to prevent viral resistance?

Answer 7

95%

Question 8

What are the long and short term side effects of antiretrovirals?

Answer 8

-short- nausea, vomiting, diarrhoea
-long- metabolic complications eg fat redistribution syndrome, excessive weight gain, increased risk for CVD, diabetes, cognitive decline and osteoporosis

Question 9

What supplements can interact with HIV antiretroviral therapy?

Answer 9

Garlic capsules, st johns wort, some african herbs like leonotis

Question 10

What are the goals for someone newly diagnosed or symptomatic of HIV?

Answer 10

1. slow rate of decline of immune system until initiation of antiretrovirals
2. ensure optimal nutritional status- treat deficiencies
3. maintain/increase lean body mass
4. address factors that affect immune function eg stress, smoking, alcohol

Question 11

What are the risk factors of vertical transmission?

Answer 11

High viral load, STI, breastfeeding but still U=U

Question 12

What is tuberculosis?

Answer 12

bacterial infection mainly affecting the lungs but it can affect any part of the body, including the tummy (abdomen), glands, bones and nervous system. usually only spreads after prolonged exposure to someone with the illness.

Question 13

What is latent tb?

Answer 13

Sometimes the immune system cannot kill the bacteria, but manages to prevent it spreading in the body. Will cause no symptoms but can become active especially if person becomes immunocomprimised

Question 14

Who is at risk of tb?

Answer 14

Close contacts, people with comprimised immune systems, pre existing lung disease

Question 15

What is the treatment of tuberculosis?

Answer 15

Combination antibiotics, for 6 months sometimes longer. Multi drug resistance can occur- IV antibiotics in this case

Question 16

What is open tb?

Answer 16

When live bacteria are present in the sputum. Needs isolation

Question 17

Why is nutrition important for people with tb?

Answer 17

-Pre-existing malnutrition increases likelihood of contracting and developing tb
-Nutritional problems are extremely common in tb- weight loss, poor appetite, drug side effects, isolation, disease stigma

Question 18

Explain vitamin D and tuberculosis

Answer 18

Sun exposure has been central to tb therapy for centuries. Vit D plays a key role in immune system modulation. Maintaining vit D status in tb patients through sun exposure and supplemens might be helpful to control tuberculosis, however evidence is conflicting and more studies are needed.

Question 19

What did the study by Gupta et al published in Nature show in relation to stem cell transplants and HIV?

Answer 19

HIV-positive patient underwent a stem cell transplant from a donor with a rare genetic mutation that confers resistance to HIV infection. The patient remained in remission for over two years in which he didnt take antiretroviral therapy and didnt show signs of infection. The authors concluded that this shows good evidence of a concept of HIV treatment. But they concluded that it may not be a practical or safe treatment for many people with HIV as stem cell transplants have lots of side effects including infection and organ damage. Finding a suitable donor can be very difficult.

Question 20

Discuss the ‘Reducing risk of Type 2 diabetes in HIV: a mixed-methods investigation of the STOP-Diabetes diet and physical activity intervention’ (A Duncan et al)

Answer 20

This was a mixed methods study of the effectiveness and acceptability of an individualized diet and physical activity intervention designed to reduce the risk of Type 2 diabetes experienced by people living with HIV.
Diabetes risk was assessed pre- and post-intervention by measurement of the glucose and insulin response to a 3-h meal tolerance test.
The intervention (n=28) significantly reduced the following: glucose and insulin, both fasting and postprandial
incremental area under the curve, weight, waist circumference and systolic BP
participants expressed concern that deliberate weight loss might lead to disclosure of HIV status or association with AIDS-related illness.