viral infections

Question 1

varicella/herpes zoster

Answer 1

treat with antivirals - aciclovir famciclovir valaciclovir

varicella zoster - chickenpox
- pts > 14 treated with anti-virals within 24 hours of onset

herpes zoster - shingles
- tingling itchy burning fluid filled blisters
- shingles will follow pattern of individual nerves on one side of your body - and look like belt around torso/rib cage
- oral anti-virals

Question 2

covid-19 treatment and prevention

Answer 2

treatment:
oxygen

corticosteroids - dexamethasone, hydrocortisone, prednisolone

anti-virals - remdesavir, molnupiravir or nirmatrelvir with ritonavir

monoclonal antibodies

LMWH - vtep

prevention: vaccines
- spikevax (moderna)
- comirnaty (pfizer)
- vaxzervia (astra zeneca) - discontinued as thromocytopenia and thrombosis reported

don’t go for vaccine appointment if feeling acutely unwell or may have COVID

Question 3

HIV/AIDs

Answer 3

treatment - triple therapy
NRTIs - abacavir + lamivudine, emtricatabine + tenofovir

NNRTIs - etravirine, nevirapine

PIs - atazanavir, darunavir, ritonavir

INs - dolutegravir, roltegravir

EIs - enfuvurtide, maraviroc

2 NRTIs + another class

• goal to reduce viral load to a level that cant be detected by blood tests
  e.g. VL < 50 copies/ML, CD4 > 500 cells/mm3 (<200 is AIDS)

post exposure prophylaxis - need to start treatment within 72 hours for 28 days

pre-exposure prophylaxis - long term