Lesson 4.1 - HIV/AIDS Flashcards

1
Q

What Baltimore classification is HIV?

A

Group 6; 2 (+) ssRNA; retrovirus

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2
Q

What enzymes are involved in HIV?

A
  • Integrase - allows provirus to be part of host
  • Protease - involved in building HIV at cell membrane; cuts polypeptides
  • Reverse transcriptase
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3
Q

What glycoprotein spikes are involved with HIV?

A

gp120 and gp41

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4
Q

What is the viral capsid made of?

A

p24

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5
Q

What is tRNA used for in HIV?

A
  • used as a primer for DNA synthesis
    • short segment of ds nucleic acid; provides a 3’ OH
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6
Q

HIV is a descendant of _______.

A
  • Simian immunodeficiency virus (SIV)
    • Same capsid, different envelope as HIV
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7
Q

What are the predominant strains of HIV?

A
  • HIV-1
  • HIV-2
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8
Q

What is HIV-1?

A
  • Derived from SIVcpz
  • Chimps in Central Africa
  • 95% of human infections
    • Mutation 1 million times faster
    • Serogroups w/ 50-60% difference in envelope proteins
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9
Q

What is HIV-2?

A
  • Derived from SIVsm
  • Sooty mangabeys in West Africa
    • Less virulent (not less deadly, just slower)
    • 5-10x lower transmission than HIV-1
    • 50% DNA sequence homology
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10
Q

How is HIV transmitted by?

A
  • Anal, vaginal, and oral sex
    • Plasma, semen, intestinal secretions, CSF
  • Mother to child (in utero)
  • If it’s dried, it’s died
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11
Q

What are CD4 cells?

A

Include monocytes (dendritic cells, macrophages) and TH

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12
Q

HIV requires both ____ and ____ for entry

A
  • CD4; co-receptor
    • gp120 binds CD4
    • gp41 binds co-receptor
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13
Q

HIV-1 enters CD4 cells via ____

A
  • fusion
    • Conformational change in gp41 and gp120
      • Hydrophobic gp41 contacts gp120, which binds to CCR5
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14
Q

Who is Stephen Crohn?

A

Man who can’t catch AIDS

CCR5-Δ32

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15
Q

Who is Timothy Ray Brown?

A

Received stem cells transplant for myeloid leukemia w/ CCR5-Δ32 = majority of his CD4 immune to HIV

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16
Q

Who is Adam Castillejo?

A
  • 2nd individual to receive CCR5-Δ32 stem cell transplant; Hodgkin lymphoma
  • ~99% of CD4 immune to HIV
17
Q

How does HIV exit?

A

By budding

18
Q

Transcription of the viral mRNA only begins after the CD4 cell is ______

19
Q

How is TC, NK, and Dendritic cells related to HIV?

A
  • TC (CD8) & Natural Killer Cells attack infected TH
  • Dendritic cells trap HIV and deliver it to CD4 cells
20
Q

What is AIDS?

A
  • Acquired Immune Deficiency Syndrome
    • Caused by HIV
    • Appears 5/10/20 yrs after HIV infection
    • TH cell below 200 uL (mm3)
      • Normal is 500 - 1600
21
Q

What opportunistic/rare infections do HIV/AIDS patients suffer and die from?

A
  • Candiasis of bronchi, trachea, esophagus, lungs
  • HSV-1 on lips and mouth
  • Salmonella diarrhea; Cytomegalovirus diseases, Toxoplasmosis, Coccidioidomycosis, Cryptococcosis
22
Q

95% HIV+ develop Abs w/in _ weeks

99% HIV+ develop Abs w/in _ weeks

23
Q

What tests can be used to detect HIV/AIDS?

A
  • Finger stick. oral/saliva Abs, Antibody/Antigen
  • VIiral Load detects HIV 9-11 days after infection; DNA PCR test / NAAT

All tests should be accompanied with counseling.

24
Q

What are the stages of HIV/AIDS?

A
  • Stage 1: Acute HIV Infection
    • 2-4 weeks after infection; flu-like
  • Stage 2: Clinical latency
    • 2-15 years; initial immune response knocks viral load
  • Stage 3: AIDS
25
Q

Why hasn’t a vaccine developed for HIV?

A
  • Reverse transcriptase is sloppy
  • Antigenic shift
26
Q

What is Anti-Retroviral Therapy (ART)?

A
  • RIP MEN
    • _Reverse transcriptase i_nhibitors
    • Integrase inhibitors
    • Protease inhibitors
    • Maturation inhibitors (bind to peptides - stop protease)
    • Entry / fusion inhibitors (attach to TH)
    • Nucleotide / nucleoside analogues (mimic nucleotides)
27
Q

U = U

A
  • Undetectable = Untransmittable
    • Condoms not required to prevent HIV tranmission
28
Q

Describe PARTNER 1 (2010-14).

A
  • 888 serodiscordant couples
  • 548 hetero = 36000x
  • 340 gay couples = 22000x
    • None of HIV- partners became +
29
Q

Describe PARTNER 2 (2014-18).

A
  • 972 gay couples (480 from PARTNER 1) = 76991x
  • 15 HIV- became HIV+
    • Every case, was from a different partner
30
Q

Describe Pre-exposure Prophylaxis (PrEP)

A
  • Anti-retroviral drugs
    • Reduce chance of transmission by 100x
31
Q

Post-exposure prophylaxis (PEP)

A
  • Exposure to HIV via sex partner, sexual assault, needle stick
    • Start w/in 72 hours
    • 28-day course
32
Q

Statistics of HIV/AIDS in US

A
  • 1.2 million adults HIV+ (13 years and older)
  • 1 in 7 (14.2% unaware of infection)
    • 176k individuals
  • (2018) 36,400 new individuals
  • (2010-17) Deaths declined from 9/.1 to 4.7 (48%)
  • (2017) 16,358 died; 5,534 deaths HIV-related
33
Q

Charts of HIV Incidence (13 years and older)

34
Q

New HIV Diagnoses in US and Dependent Areas by Race/Ethnicity, 2018

A
  • Blacks/AA= 16k (42.2%)
  • Hispanics/Latinos = 10.2k (27.0%)
  • Whites = 9.5k (25.2%)
  • Multiple Races = 944
  • Asians = 875
  • AI/AN = 186
  • Native Hawaiians/PI = 68
35
Q

More Charts (lmao)

36
Q

HIV/AIDS - HVB & HVC

A
  • HepB more likely than HepC to be transmitted sexually
    • 1 in 10 have HepB
    • 1 in 4 have HepC
      • Both in utero
  • IDU: Sharing needles, syringes, & other injection equipment
37
Q

HIV/AIDS - TB

A
  • 1/3 of 40 mil. HIV+ indiviuals co-infected w/ TB
    • Leading cause of death of HIV+ ppl
38
Q

HIV - Syphilis

A
  • 2- to 5-fold increasd risk of acquiring HIV when Syphilis is present
    • More likely to shed HIV when they have urethritis or genital ulcer
  • Not considered a factor that contributes to deaths of HIV+ individuals