Johns- HIV

Question 1

What is the first step in viral replication and where is the is the of attachment?

Answer 1

HIV attaches to susceptible host cell
Attaches to CD4 antigen found on:
CD4 T cells
macrophages
moncytes
B cells
microglial brain cells
intestinal cells

Question 2

When is viral replication triggered? What may be destroyed in the process?

Answer 2

After period of latency, can last up to 10 years.

Replication occurs at a HIGH rate.

CD4 cells.

Question 3

What causes symptoms of HIV to appear?

Answer 3

destruction of large number of CD4 cells

Question 4

What are the methods of transmission of HIV?

Answer 4

sexual
exposure to infected blood
contaminated clotting factors
sharing needles
transplant
mother to fetus

Question 5

What is primary HIV syndrome?

Answer 5

MONO like, cold or flu-like sxs
can occur 6-12 wks after infection

lymphadenoapathy
fever
rash
HA
fatigue
diarrhea
sore throat
neulogic

or no sxs present

Question 6

When does the HIV Ab test become positive?

Answer 6

Usually 3-6 months after infection (seroconversion)

Question 7

How do you diagnose primary HIV?

Answer 7

viral load titer assay or other test

Question 8

What is the clinical latency period in HIV?

Answer 8

HIV continues to reproduce

CD4 gradually declines from its normal value of 500-1200

Question 9

When is a pt w/ HIV at risk for opportunistic infections?

Answer 9

once cd4 count drops below 500

Question 10

What diseases are predictive of progression to AIDS?

Answer 10

herpes zoster
oral candidiasis
oral hairy lekuoplakia
kaposi’s sarcoma

Question 11

When does a pt have AIDs?

Answer 11

When CD4 ct drops below 200

Question 12

What are AIDS pts at risk for if their blood count is below 200?

Answer 12

PCP (pneumocystis carinii pneumonia)
crptococcal meningitis
toxoplasmosis

Question 13

What are AIDS pts at risk for if their CD4 count drops below 50?

Answer 13

myobacterium avium
CMV
lymphoma
dementia

Question 14

When do most deaths occur?

Answer 14

CD4 counts below 50

Question 15

What are the immunological manifestations of HIV?

Answer 15

Slight depression of CD4, few sxs
Ab detected by 6 months
P24 presents in first 6 weeks along with acute viremia and antigenemia
Abs produced to all major antigens

Question 16

The first antibodies detected are produced against what proteins? Followed by?

Answer 16

gag proteins
p24
p55

Antibody to
p51
p120
gp41

Question 17

What happens as the disease progresses

Answer 17

Ab levels decrease

Question 18

What does ELISA testing do?

Answer 18

screen for HIV

Question 19

What does a western blot do?

Answer 19

confirms HIV

Question 20

What does the CDC require for a positive HIV test?

Answer 20

2 bands of the folllowing:
p24
gp41
gp 120/160

Question 21

What are viral load tests used for?

Answer 21

tells you the quantity of HIV-RNA in the blood

Used to monitor treatment

Question 22

What is the prognosis for HIV?

Answer 22

84% are alive in 10 yrs

Question 23

what are the CDC’s HIV screening guidelines?

Answer 23

routine HIV testing to all persons 13-64 at least one regardless of risk w / repeat testing for person w/ risk factors

Question 24

What is pneumocystis jiroveci?

Answer 24

The most common opportunitistic infection in HIV

yeast like fungus
usually found in healthy lungs but causes sxs in person w/ weak IS

Question 25

What are the classic sxs associated w/ pt w/ pneumocystis jiroveci?

Answer 25

shortness of breath
dry cough
fever

Question 26

The screening test for HIV is…

Answer 26

ELISA

Question 27

What test is used to follow HIV pts?

Answer 27

CD4 count

Question 28

What is the most common opportunistic infection in HIV pts?

Answer 28

Pneumocystis