L27+HIV/AIDS

Question 1

Initial HIV infection symptoms

Answer 1

asymptomatic

sore throat, LAD, mimics Mono

Question 2

During which stage of infection is there a high risk of transmission?

Answer 2

Early stages when the patient is unaware

Question 3

Average time from HIV infection to AIDS if left untreated

Answer 3

8 years

Question 4

Main symptoms of Acute HIV infection

Answer 4

Mouth sores
Thrush
Fever
Weight loss
Myalgia
Hepatosplenomegaly
HA, neuropathy
LAD
Rash
N/V

Question 5

When is Stage 3 HIV (AIDS) diagnosed?

Answer 5

severe damage to the immune system= CD4 <200

Question 6

Examples of AIDS defining conditions

Answer 6

Kaposi's sarcoma (HHV-8)
Pneumocystis pneumonia (PJP)
MAC infection, TB
Invasive cervical cancer
CMV retinitis
Chronic intestinal Cryptosporidiosis
Candidiasis
Encephalopathy

Question 7

4 HIV disease course classes

Answer 7

1. Fast: <3 years to AIDS
2. Average: ~10 years
3. Long term non-progressors >10 years, <5% of cases
4. Elite controllers: don’t become infected. RARE AF

Question 8

HIV virus

Answer 8

dsRNA genome
Enveloped
Reverse transcriptase: RNA dependent DNA polymerase inserts DNA copy into human genome, establishes latency

Question 9

HIV-1

Answer 9

Wide spread form, more common

Question 10

HIV-2

Answer 10

Form found in West Africa
less easily transmitted, and has a slower progression
resistant to NNRTI antiretrovirals

Question 11

How did we get AIDs originally?

Answer 11

Zoonotic: Primates: Simian Immunodeficiency Virus

entered into human population in Africa at least 3 times

Question 12

How long has AIDs been around

Answer 12

Found in human sera as early as the 1950s in retrospective studies

Question 13

Which cells does HIV-1 infect?

Answer 13

Infection of cells with CD4 and chemokine co-receptor molecule displayed:
Th, Monocytes, Macrophages

Question 14

Cytopathic effects of HIV

Answer 14

Th cell loss 
immunosuppression
mechanism is uncertain:
1. Direct virus killing
2. Apoptosis of immune cells
Formation of "swarms"

Question 15

Why do you have to use combination therapy for HIV treatment?

Answer 15

Mutates rapidly, prevents swift virus inhibition of antivirals
monitor viral load frequently to ensure virus hasn’t mutated

Question 16

Labs of primary infection:

Answer 16

High CD4 count
High HIV RNA copies
Viremia

Question 17

Labs of clinical latency:

Answer 17

CD4 count declines over time
Viremia sharply declines to 0
HIV RNA copies drop and then level off (don’t get to 0)

Question 18

Labs of reactivation: constitutional symptoms

Answer 18

Lower CD4+ (~300)

Rising HIV RNA and viremia

Question 19

Labs of reactivation: opportunistic diseases and/or death

Answer 19

Few/No CD4+

Very high HIV RNA and viremia

Question 20

Detection of HIV

Answer 20

HIV antibody: 2 steps

1. EIA screen
2. Confirm (+) results with Western blot

Question 21

Direct tests of HIV detect

Answer 21

presence of virus RNA or protein antigens
Nucleic acid test
PCR: antigen p24, RNA genome

Question 22

How is donated blood screened for HIV?

Answer 22

Nucleic acid test, as to avoid antibody response lag

Question 23

Rapid HIV tests

Answer 23

OraQuick Rapid HIV-1/2 Antibody test
takes 20 minutes
identify infected and prevent transmission (doesn’t account for antibody lag though)

Question 24

Classes of antiretroviral agents

Answer 24

***use in combination***//***not curative***
Reverse transcriptase inhibitors:
1. Nucleoside analogs
2. Non-nucleoside inhibitors
Protease inhibitors
-stop maturation of viral assembly
Fusion-penetration inhibitors

Question 25

Viral load tests reveal

Answer 25

amount of HIV in blood as copies per milliliter
limit: minimum 50 copies/ml to be detected
run frequently during early treatment, during effective treatment viral counts are low
watch trends

Question 26

HIV-associated neurocognitive disorder

Answer 26

idk neuro symptoms, brain fog, impacts cognitive function

might not be able to comply with complex drug regimen

Question 27

who ain’t contagious?

Answer 27

viral suppression state

U=U

Question 28

PrEP

Answer 28

pre-exposure prophylaxis for healthy individuals at high risk

Question 29

What’s gonna mess up this HIV situation

Answer 29

Opioid epidemic: neeeedles