Secondary Immunodeficiency and HIV Infection ✅ Flashcards

1
Q

By what mechanisms can secondary immunodeficiencies be acquired?

A
  • Immunosuppressive drugs
  • Hyposplenism
  • Chronic illness
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2
Q

What is sufficient in the management of many patients with secondary immunodeficiency?

A

General advice on preventing exposure to infection

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3
Q

What effect does optimising management of the underlying disorder have on secondary immunodeficiencies?

A

It can significantly reduce the risk of infection

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4
Q

What may be required in the treatment of more severe secondary immunodeficiencies?

A
  • Prophylactic antimicrobials
  • Judicious use of vaccines
  • Immunoglobulin therapy
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5
Q

Give an example of when the development of secondary immunodeficiency can be anticipated?

A

Elective splenectomy

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6
Q

What can be done in situations where the development of secondary immunodeficiency can be anticipated?

A

Planned vaccination can be administered prior to immunosuppression

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7
Q

Why is the number of people living with HIV increasing?

A
  • Ongoing transmission

- Improving survival

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8
Q

What is improving the survival from HIV?

A

Increasing access to anti-retroviral drugs

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9
Q

How many children in the UK are living with HIV?

A

Around 900

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10
Q

How many new cases of HIV are identified in children in the UK annually?

A

50-60

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11
Q

Why are the numbers of children being diagnosed with HIV in the UK low?

A

Due to the success of universal HIV screening in pregnancy and prevention of mother-to-child transmission

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12
Q

Of what age are most children with HIV in the UK?

A

Adolescence

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13
Q

What is focused on with care of children with HIV in the UK?

A
  • Adherence
  • Complex resistance
  • Long-term drug toxicity
  • Sexual and mental health
  • Transition to adult services
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14
Q

What testing is done when an infant is born to a HIV positive mother?

A

PCR testing

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15
Q

Is antibody testing a child born to a HIV positive mother useful?

A

No

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16
Q

Why is antibody testing for HIV in a child born to a HIV positive mother not useful?

A

As HIV IgG antibody is placental transferred

17
Q

What is the limitation of a HIV PCR at birth?

A

It has a low sensitivity, and does not rule out infection

18
Q

Why is the sensitivity of a HIV PCR low at birth?

A

Due to low viral load

19
Q

What is the sensitivity of HIV PCR testing by 3 months of age?

A

> 99%

20
Q

When is HIV infection deemed to be very unlikely in an infant born to a HIV positive mother?

A
  • Two negative PCRs, one after 3 months
  • Two negative antibody tests if <12 months
  • One negative antibody test after 18 months