Micro 5.

Question 1

What led to a decrease in AIDS diagnoses and deaths?

Answer 1

HAART

Question 2

What is the order of HIV infection transmission categories from most diagnoses to lease?

Answer 2

male-male sexual contact, heterosexual contact, injection drug use, male-male sexual contact and IDU, other

Question 3

Where are the highest rates of HIV infection in the US?

Answer 3

big cities and down south

Question 4

When is viral load highest in a patient with HIV?

Answer 4

6-9 weeks, then drops down to essentially zero, rises again when constitutional symptoms of AIDs begins

Question 5

What happens to the CD4 count in a patient with HIV?

Answer 5

drops initially after primary infection, raises slightly during clinical latency (after viral load drops) and remains steady. Slowly drops.

Question 6

What diseases come when CD4 count drops initially, but still in latency phase (between 200-600CD4/mm3)

Answer 6

skin disease, fatigue, pulmonary TB, oral thrush, night sweats, fever, oral hair leukoplakia, weight loss (down by 200)

Question 7

What diseases begin to appear when AIDS starts? (

Answer 7

kaposi’s sarcoma, pneumonia, non-hodgkin’s lymphoma, esophageal candida, cyptosporidiosis, chronic herpes, cerebral toxoplasmosis, cryptococcosis, cytomegalovirus retinitis, mycobacterium avium complex

Question 8

Seborrheic Dermatitis

Answer 8

caly patches, red skin and stubborn dandruff - mainly affects scalp

Question 9

Risk factors for seborrheic dermatitis

Answer 9

stress or fatigue, weather extremes, oily skin, infrequent shampoos/skin cleaning, using lotions with alcohol, obesity

Question 10

What is typically the first disease from HIV? At what CD4 count?

Answer 10

skin disease (seborrheic dermatitis and/or nodular prurigo); CD4 around 500

Question 11

What other diseases can seborrheic dermatitis be a sign of?

Answer 11

parkinson’s, head injury, stroke

Question 12

Nodular prurigo

Answer 12

skin disease characterized by very itchy nodules

Question 13

What is a normal CD4 count?

Answer 13

800

Question 14

Oral hairy leukoplakia

Answer 14

benign white patch on the side of the tongue with a corrugated or hairy appearance typically appears in immunocompromised

Question 15

Kaposi’s Sarcoma

Answer 15

a cancer that causes patches of abnormal tissue to grow under the skin, in the lining of the mouth, nose, and throat or in other organs. patches usually red or purple and are made of cancer cells and blood cells

Question 16

What virus causes Kaposi’s Sarcoma

Answer 16

HHV8

Question 17

What are the goals of antiretroviral therapy?

Answer 17

suppress HIV-1 replication and prevent/delay destruction of immune cells

Question 18

When does initiation of therapy for a chronic HIV infection typically begin?

Answer 18

symptomatic patients at any CD4 count; asymptomatic at CD count 100,000 NOW: begin treatment for ANY value of CD4 count, viral load for BOTH symptomatic and asymptomatic patients

Question 19

What are concerns about early therapy of HIV?

Answer 19

ARV-related toxicities, non-adherence, drug resistance, cost

Question 20

When should deferral of ART be considered?

Answer 20

significant barriers to adherence, “elite controllers” and long term non-progressors

Question 21

What are targets of HIV therapy?

Answer 21

entry inhibitors, reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors