PBL 2

Question 1

What does HIV stand form?

Answer 1

human immunodeficiency virus

Question 2

what does AIDS stand for?

Answer 2

acquired immunodeficiency syndrome

Question 3

how can HIV or AIDS be transferred?

Answer 3

blood, serous effusions, cerebral spinal fluid, vaginal fluid, breast milk (and other body fluids contain infected blood)

Question 4

What are the 2 types of HIV?

Answer 4

HIV 1 - global pandemic

HIV 2- much rarer, less transmissible but most prevalent in Western Africa and Southern Asia

Question 5

what type of virus is HIV? what is this?

Answer 5

a retrovirus
a type of virus that inserts a copy of its RNA genome into the DNA of a host cell that it invades, thus changing the genome of that cell

Question 6

describe how HIV targets cells?

Answer 6

the virus attaches to cells bearing CD4 protein via glycoprotein 120, it then uses another glycoprotein 120 to attach to the coreceptor.
the viral envelope fuses to the host cells membrane and viral RNA is released into the hosts cytoplasm.
reverse transcriptase converts RNA genes into pro-viral DNA that becomes circular and is then integrated into the host DNA using integrase.
pro-viral mRNA is transcribed by the cell’s ribosomes to make new copies of the virus.

Question 7

what is the aim of HIV?

Answer 7

to decrease the number of functional CD4 cells and to increase the viral load of HIV

Question 8

What are the 3 AIDS tests?

Answer 8

nucleic acid test
antigen/antibody test
antibody test

Question 9

how long after exposure can a NAT test tell you have HIV?

Answer 9

10-33 days

Question 10

what are the 2 ways to do an antigen/antibody test? how long does it take, after exposure, to show positive for HIV?

Answer 10

blood from a vein- 18-45 days

blood from a finger prick- 18-90 days

Question 11

how long does an antibody test take to show positive for HIV after exposure?

Answer 11

23-90 days

Question 12

why do we use blood tests for HIV rather than oral tests?

Answer 12

the level of antibody in the blood is higher than in oral fluid

Question 13

when might you get a false-negative HIV test result?

Answer 13

if you take the test during the window period- after exposure but before the test can find antibodies

Question 14

what happens if you get tested positive for HIV?

Answer 14

you have to take another test

Question 15

what is the treatment for HIV? without this, what happens?

Answer 15

antiretroviral therapy

without treatment HIV gets worse and overwhelms the immune system

Question 16

what is the first stage of HIV? when is it? what are the symptoms?

Answer 16

Acute Retroviral syndrome
2-4 weeks after HIV infection
flu-like symptoms e.g. fever, swollen glands, sore throat, rash, muscle and joint ache, headache

Question 17

what happens immunologically in the acute retroviral syndrome stage of HIV?

Answer 17

large amounts of HIV are being produced in the body. CD4 levels drop rapidly because the virus is using them to replicate and so destroys them in the process. eventually the immune response will begin to bring the level of virus in the body down to the viral set point and CD4 levels begin to increase a little

Question 18

why is there high risk of transmistting HIV in the acute retroviral syndrome stage?

Answer 18

levels of HIV in the blood stream are high

Question 19

what is the second stage of HIV? what are the symptoms?

Answer 19

clinical latency stage

virus is living in a person without producing symptoms

Question 20

what happens immunological in the clinical latency stage of HIV?

Answer 20

HIV virus continues to reproduce at very low levels

Question 21

Is HIV transmissible in the clinical latency stage?

Answer 21

yes but if the patient is on ART then the chances are low

Question 22

what happens in the clinical latency stage is the patient is not on ART?

Answer 22

the viral load begins to rise and the CD4 count will begin to decline.
symptoms will begin to increase

Question 23

what is the 3rd stage of HIV?

Answer 23

AIDS

Question 24

what is the diagnosis of AIDS dependant on?

Answer 24

CD4 count (if below 200 cells/mm3) or/and the clinical stage i.e. anyone who has had an AIDS defining definition/symptoms

Question 25

what factors may shorten the time between HIV and AIDS?

Answer 25

older age
HIV subtype
co-infection with other virus
poor nutrition
severe stress
genetic background

Question 26

which factors may delay the time between HIV and AIDS?

Answer 26

taking antiretroviral therapy
staying in regular HIV care
closely adhering to Drs reccomendations
eating healthy foods
taking care of themselfves
genetic background

Question 27

what is the purpose of a pre-HIV test discussion?

Answer 27

to establish informed consent

Question 28

what must be discuss in the HIV pre-test talk?

Answer 28

the benefits of testing to the individual

details on how the results work

Question 29

why is written consent not normally used for HIV testing?

Answer 29

as it exceptionalizes it which may put people off

Question 30

what happens if a patient does not want to tell all their sexual partners they have HIV?

Answer 30

the doctors should get in contact and anonymously tell them as they have a duty to protect others from the risk

Question 31

when is it not practicable to seek patient consent?

Answer 31

when the patient is not competent, when seeking consent could put people at harm, when seeking consent would undermine the purpose of disclosure or when action must be taken quickly