T4-HIV

Question 1

HIV causes a weakened immune system by killing what type of cells?

Answer 1

CD4 T cells

Question 2

T/F: HIV puts patients at increased risk for certain cancers

Answer 2

TRUE

Question 3

What is the technical definition of AIDS?

Answer 3

A syndrome in which the individual is HIV+ and has either

1. CD4 T count below 200 cell/mL OR
2. Has 2 AIDS defining illnesses

(Pheumocytosis pneumonia, TB, Kaposi Sarcome, discemminated histoplasmosis, cytomegalovirus retinitus)

Question 4

What is ART?

Answer 4

Standard antiretroviral therapy

Question 5

How many drugs does ART consist of?

Answer 5

3-4

Question 6

What is another name for ART therapy?

Answer 6

HAART (highly active antiretroviral therapy)

Question 7

T/F: Current drug therapy (HAART) can decrease plasma HIV to levels that are undetectable with current technology?

Answer 7

TRUE

Question 8

ART has reduced age related deaths by ___%

Answer 8

72%

Question 9

T/F: Patients compliant with ART can become noncontagious.

Answer 9

FALSE; ART does NOT eliminate HIV

Question 10

HIV is a retrovirus. What do retroviruses lack?

Answer 10

The machinery needed for SELF-REPLICATION–and thus are OBLIGATE INTRACELLULAR PARASITES

Question 11

How many types of HIV are there?

Answer 11

2

HIV1 and HIV2

Question 12

What type of HIV is most common is the US?

Answer 12

HIV1

Question 13

What are 2 reasons why HIV replication is massive during the initial phase of infection?

Answer 13

1. Population of CD4 T cells is large! (large breeding ground)
2. Host has not yet mounted immune system against HIV, so replication can proceed unopposed

Question 14

What is the name for the stage of initially high viral load?

Answer 14

Acute retroviral syndrome

Question 15

Why is it essential that clients be treated with a combination of antiretroviral drugs?

Answer 15

To minimize the emergence of resistance (same strategy fro treating TB)

Question 16

T/F: Male circumsion can decrease the risk of acquiring HIV sexually?

Answer 16

TRUE

Question 17

What are the S&S of acute retroviral syndrome?

Answer 17

Flu-like:

• Fever
• Lymphadenopathy
• Pharyogitis
• Rash
• Myalgia
• Headache

Question 18

The average duration that people with HIV are symptomatic is ___.

Answer 18

10 years

Question 19

How many antiretroviral drugs do we have at this time?

Answer 19

5

Question 20

What are the 5 types of antiretroviral drugs?

Answer 20

Reverse Transcriptase Inhibitors
Integrase Strand Transfer Inhibitors (INSTIs)
Protease Inhibitors (PIs)
Fusion Inhibitors
Chemokine Receptor 5 Antagonists (CCR5)

Question 21

Which type of drug is this: Interfere with HIV DNA replication. These do this by either binding to the DNA strand and causing premature termination, or binding to the enzyme that is building the DNA strand.

Answer 21

Reverse transcriptase inhibitors (NRTIs and NNRTIs)

Question 22

What type of drug is this: Inhibits the enzyme that initially integrates HIVs DNA into human DNA

Answer 22

Integrase strand transfer inhibitors (INSTIs)

Question 23

What type of drug is this: Prevent the maturing of new HIV into its active form

Answer 23

Protease Inhibitors

Question 24

What type of drug is this: Block HIV from entering CD4T cells

Answer 24

Fusion inhibitors and CCR5 antagonists

Question 25

Which 3 drugs work by inhibiting enzymes needed for HIV to replicate?

Answer 25

Reverse transcriptase inhibitors (NRTIs NNRTIs) INSTIs PIs

Question 26

Which 2 drugs work by inhibiting HIV entry into cells?

Answer 26

Fusion inhibitors | CCR5 antagonists

Question 27

Which antiretroviral were the first used and remain the backbone of therapy today?

Answer 27

NRTIs (reverse transcriptase inhibitors)

Question 28

**What are the 5 major adverse effects of the protease inhibitors?

Answer 28

1. Hyperglycemia/diabetes 2. Increased bleeding i people with hemophilia 3. Increases serum transaminase (indicates liver injury) and increase lipids (hyperlipidemia) 4. Fat redistribution 5. Reduced bone mineral density

Question 29

Most patients take 2 ___ combined with either a __ or __.

Answer 29

Take 2 NRTIs combined with a PI or NNRTI

Question 30

Which lab test is a major factor in deciding when to initiate retroviral therapy and when to change the drug regiment?

Answer 30

CD4 T cell counts

Question 31

Which lab test is the best measurement available for predicting clinical outcomes?

Answer 31

Plasma HIV RNA (viral load)

Question 32

**The goal of therapy is to decrease HIV RNA plasma levels to below what value?

Answer 32

An undetectable level--below 20-75 copies/mL of plasma

Question 33

T/F: When a clients plasma HIV RNA is undetectable, they can still transmit HIV to other people.

Answer 33

TRUE

Question 34

**The current recommendation is to begin antiretroviral therapy when the CD4 count drops below ___.

Answer 34

500cells/mm^3

Question 35

This recommendation of 500cells/mm^3 is ___ that what was recommended in the past.

Answer 35

HIGHER- it used to have to drop to 350 cells/mm^3 in the past

Question 36

Oral preexposure prophylaxis can reduce infection risk by ___.

Answer 36

44-73%

Question 37

When should post exposure prophylaxis be initiated?

Answer 37

ASAP after HIV exposure--preferably 1-2 hours and NO more than 72 hours and should be continued 28 days

Question 38

In the absence of antiretroviral drugs, the rate of perinatal transmission of HIV in the US is ___%

Answer 38

25%

Question 39

When zidovudine is given IV to the mother during labor and delivery, and then IV or PO to the infant, the rate of HIV transmission is ______.

Answer 39

Essentially zero