Pharm Exam #1: HIV/AIDS

Question 1

Stages of HIV

Answer 1

1. Acute HIV Infection
2. Chronic HIV Infection
3. AIDS

Question 2

Acute HIV Infection

Answer 2

Initial stage with flu like symptoms

Question 3

Chronic HIV Infection

Answer 3

Virus cannot be controlled with antiretroviral therapy (ART)

Question 4

AIDS

Answer 4

-Immune system is severely weakened
-Opportunistic infections and malignancies

Question 5

HIV-1

Answer 5

Most common worldwide

Question 6

HIV-2

Answer 6

Primarily found in West Africa

Question 7

HIV Target

Answer 7

-CD4 T cells
-Transforms its RNA into DNA using reverse transcriptase, integrating into human cells and replicating

Question 8

Macrophage role in HIV

Answer 8

-Reservoirs
-Allows HIV to remain undetected in the body

Question 9

AIDS Diagnostic Criteria

Answer 9

CD4 count falls below 200 cells/mm^3

Question 10

CDC HIV Testing Reccomendation

Answer 10

-EVERYONE age 13-64 at least once
-Annual testing for high-risk groups

Question 11

Preventative Strategies for HIV

Answer 11

1. Pre-Exposure Prophylaxis (PrEP)
2. Post-Exposure Prophylaxis (PEP)

Question 12

PrEP

Answer 12

-Daily ART for HIV-neg individuals at high risk
-Reduces HIV risk by 99% (sex) and 74% (drug use)

Question 13

PEP

Answer 13

-Emergency ART taken within 72hrs of exposure
-Includes 28 day course of triple ART

Question 14

AIDS-defining Cancers

Answer 14

-Kaposi’s Sarcoma
-non-Hodgkin’s lymphoma
-Invasive cervical caner

Other Cancers:
-Anal cancer
-Liver cancer
-Lung cancer

Question 15

Prognosis of HIV

Answer 15

-ART makes HIV a chronic manageable disease

-Early diagnosis and treatment allow for people with HIV to live near-normal lifespans

Question 16

Daily oral PrEP

Answer 16

Tenofovir disoproxil fumarate/emtricitabine (Truvada)

OR

Tenofovir alafenamide/emtricitabine (TAF/FTC, Descovy)

Question 17

Injection PrEP

Answer 17

Cabotegravir (CAB, Apretude)
-Initial dose, 2nd dose 1mo later, then every 2mo

Question 18

PrEP Contraindications

Answer 18

-HIV infection

-<77lbs

-Creatinine clearance ,60mL/min for TDT/FTC
OR
<30mL/min for TAF/FTC

-Possible HIV exposure within 72hrs (instead offer nPEP, then consider PrEP)

Question 19

PrEP Labs

Answer 19

-HIV test within 1 week before starting PrEP

-STI testing

-Oral PrEP: creatinine, hep B, cholesterol, triglycerides

-Labs every 3mo

-Every 6mo: CrCl for people >50yo

-Injection PrEP: every 2mo, HIV Ag/Ab and HIV RNA

Question 20

PrEP Client ED

Answer 20

-Use as directed

-IF stopping, continue for 28 days after last HIV exposure

-PrEP not STI/pregnancy preventative

Question 21

PrEP Side Effects

Answer 21

-GI upset (resolve in 1mo)
-Renal dysfunction
-Slight bone density loss
-TAF: possible weight gain
-Injection: site reaction