Viral infections Flashcards
Destruction of CD4 T cells
HIV and AIDS
attack on entire immune system
primary phase of HIV/AIDS
very high viral load due to massive HIV replication
flu-like symptoms
latent phase of HIV
chronic asymptomatic phase
host’s immune system working
third phase of HIV
overt AIDS
AIDS phase
CD4 count < 1000
⇡ viral load
w/o antiretroviral therapy, leads to death w/in 2-3 years
Highly Active Anti-Retroviral Therapy (HAART)
Meds for life
Need > 95% adherence or virus can become resistant to meds
A medication “cocktail”
antiretroviral agents
- each drug blocks one of the steps in viral replication
- goal of Rx: ⇡ CD4 count (> 1000/mm3)
SE: bone marrow suppression hepatotoxicity fat metabolism defects osteoporosis diabete
Fusin inhibitors
inhibit fusion of HIV to CD4 T cells
Enfuvirtide (Fuzeon)
- SQ injection BID
- SE injection site rxn
NI: rotate site of injection
CCR5 antagonist
block viral entry by binding to CCR5 coreceptor on CD4 T cells
- only works on pts w/CCR5 tropic HIV infection
Aplaviroc
Vicriviroc
Maraviroc
SE: hepatotoxicity, postural hypotension, immunosuppression
NRTIs
nucleoside reverse transcriptase inhibitor
block viral enzyme reverse transcriptase
- inhibits copying of viral RNA into DNA
Ziovudine (AZT)
Ziovudine (AZT)
1st anti-HIV drug
- only one used during pregnancy
- reduces risk of prenatal transmission
SE:
GI intolerance - N/V/D
bone marrow suppression
hepatotoxicity
NNRTI
Non-Nucleoside Reverse Transcriptase inhibitor
inhibit reverse transcriptase but differently than NRTIs
Sustiva
Rescriptor
Viramune
INSTIs
integrase inhibitors
block the action of integrase
Raltegravir (Isentress)
SE: diarrhea, nausea, HA, fever
PIs
Protease inhibitors
Works at last stage of viral reproduction
- prevents HIV from being assembled and released from infected CD4 T cells
SE: kidney stones - must drink 8 lrg glasses of water q day GI problems redistribution of fat deposits DM osteoporosis
