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Microbio > Viral STIs I > Flashcards

Viral STIs I Flashcards

1
Q

What is the indicator for AIDS infection?

A

CD4 count less than 200/microliters

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2
Q

What are the surface proteins on the AIDS virus?

A 
gp120
gp41
pol
p17
p24
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3
Q

What is the family and genome type of HIV?

A

Retroviridae famiy

+ssRNA

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4
Q

Is HIV enveloped?

A

Yes

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5
Q

Where is HIV-2 found in the world?

A

Africa

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6
Q

What is the difference in HIV-2 compared to 1?

A

Lower CD4 decline
Lower mortality
Longer asymptomatic period

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7
Q

What is the function of the gp120 protein on HIV?

A

attachment to CD4

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8
Q

What is the function of gp41 protein on HIV?

A

Fusion protein

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9
Q

How many genome copies does HIV have?

A

2

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10
Q

What is the pol gene with HIV?

A

Reverse transcriptase

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11
Q

What is the p17 protein on HIV?

A

matrix protein

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12
Q

What is the p24 protein on HIV?

A

Capsid protein

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13
Q

What are the four layers of the HIV virus?

A

Envelope
Matrix
Nucleocapsid
Genome

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14
Q

What is the step that must occur outside the cell for HIV to become mature?

A

Protein cleavage of gag-pol polyproteins

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15
Q

What are the two coreceptors that allow for a conformational change in gp120 to allow binding to the cell?

A

CCR5

CXCR4

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16
Q

What is the R5 tropic HIV? When in the disease progression is this seen?

A

Uses CCR5 as a coreceptor

Usually early in infection

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17
Q

What is the X4 tropic HIV? When in the disease progression is this seen?

A

virus that uses CXCR4

Associated with later, and more deadly

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18
Q

Some individuals contain a deletion in what gene that prevents HIV from binding to gp120? Does this make them resistant to HIV?

A

CCR5 gene (either homo or heterozygous)

Not resistant b/c may still be affected with other

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19
Q

What is the protein that allows for the fusion of the HIV virus?

A

gp41

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20
Q

How error prone is the reverse transcriptase of HIV viruses? What is the significance of this?

A

Very (1/2000 nucleotides).

This means a high rate of mutations and evolution

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21
Q

What is the enzyme that integrates the HIV DNA?

A

Viral integrase

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22
Q

What is the viral DNA called when it is integrated in the host’s DNA?

A

Provirus

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23
Q

What is HIV egress?

A

Budding of HIV out of the cell

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24
Q

Where on the cell membrane does budding occur for HIV?

A

In lipid rafts made of viral proteins

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25
Q

Once outside the cell, HIV virus has to do what to mature? What mediates this?

A

Viral protease cleaves gag and gag-pol polyproteins

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26
Q

How do mature HIV particles look under EM?

A

have a central capsid

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27
Q

Which way is more effective for HIV transmission (male to female or female to male)?

A

Male to female

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28
Q

What can increase the chances of infection for HIV?

A

presence of other STIs that generate lesions

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29
Q

What is the chance that a mother will transmit HIV to her child (if not treated)? When is the chance highest?

A

25%

Highest during the birthing process (50-65%)

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30
Q

What is the risk of contracting HIV with a contaminated needle?

A

0.3%

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31
Q

What is the risk of contracting HIV from mucous membrane exposure?

A

0.09%

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32
Q

How can you lower the risk of contracting HIV when exposed/

A

Post-exposure prophylaxis

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33
Q

When is the p24 antigen seen in infection?

A

Peaks early in infection, and does not return until later in infection

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34
Q

When is the gp120 seen in infection?

A

Throughout infection

35
Q

Which viral protein is used for diagnosing HIV? Why?

A

gp24 Seen in highest [C] throughout

36
Q

When does acute HIV syndrome occur in infection? Symptoms? Will HIV antibodies be present?

A

3-6 weeks
Similar to mono
Rash

Antibodies not seen yet

37
Q

What is the first viral particle detected in HIV infection? How long does this last for?

A

p24 antigen. Not last long

38
Q

What happens immediately after the acute phase of HIV?

A

Curtailed viral particles

39
Q

What occurs in chronic phase of HIV infection?

A

A low level of viremia

40
Q

How can HIV cause chronic infection? (3)

A

Genetic drift of gp120

Inactivation of Immune response

cell-cell fusion hiding

41
Q

Are patient symptomatic during a chronic infection? How long can this last?

A

No symptoms

up to 10 years

42
Q

What is the significance of the HIV set point?

A

used for predicting death based on the initial level of viruses in the blood at one year

43
Q

How does HIV progress to AIDS?

A

Reduction of CD4+ T-cells via copious budding

44
Q

What causes the oral hairy leukoplakia seen in HIV pts?

A

epstein barr virus

45
Q

What causes the pneumonia seen in HIV pts?

A

Pneumocystis carinii

Mycobacterium TB

46
Q

What causes thrush?

A

Candida albicans

47
Q

What causes CMV retinitis seen in HIV pts? What can this cause?

A

Cytomegalovirus

May cause blindness

48
Q

What causes the neoplasms seen on HIV pts?

A

Kaposi’s sarcoma

B cell lymphoma

49
Q

What are the two causes of diarrhea seen in HIV pts?

A

Crytosporidium

Isospora belli

50
Q

What are the first two antigens seen in HIV infection?

A

RNA

p24

51
Q

When is HIV antibody seen in an infection relative to the onset of the initial antigens?

A

Shortly after, but stays elevated unlike the antigens

52
Q

What is the first step in screening for HIV?

A

HIV1/2 antigen/antibody combination immunoassay

53
Q

What is the next step in diagnosing HIV infection if an HIV1/2 antigen/antibody immunoassay is positive?

A

HIV1/2 antibody differentiation immunoassay

54
Q

How does the HIV1/2 antigen/antibody immunoassay work?

A

Immobilize an antibody/antigen on surface.

Add pt sample.

Add enzyme detection reaction

55
Q

Besides immunoassays, what can be used for detecting HIV infections?

A

NAT

PCR

56
Q

Which five steps can be inhibited in HIV replication pharmacologically?

A
  1. Attachment
  2. Fusion
  3. Reverse transcription
  4. Integration
  5. Protein cleavage
57
Q

What is the MOA of chemokine coreceptor antagonists?

A

Binds co-receptor and prevents gp120 interaction

58
Q

What is the MOA of fusion inhibitors?

A

Prevent gp41 binding/conformational change

59
Q

What are the two varieties of reverse transcriptase inhibitors?

A

Nucleoside inhibitors

Nonnucleoside inhibitors

60
Q

What is the MOA of nucleoside inhibitors?

A

Incorporation into growing DNA chain and causes chain termination

61
Q

What is the MOA of non-nucloeside inhibitors?

A

Binds to reverse transcriptase and inhibit its activity

62
Q

What is the MOA of integrase inhibitors?

A

Blocks the integration of the DNA copy of the viral genome into cell genome

63
Q

What is the MOA of protease inhibitors?

A

Peptidomimetic (peptide mimicry) inhibitors of the viral protease

64
Q

What is the goal of HIV therapy?

A

Reduce viral load

65
Q

Why isn’t monotherapy used to treat HIV?

A

Rapid resistance

66
Q

What is involved in highly active antiretroviral therapy?

A

Combination therapies

67
Q

Prophylatic treatments for opportunistic infections depends on what?

A

CD4 count

68
Q

What is the standard of care for antiretroviral therapy?

A

three ARV drugs from two different classes

69
Q

Can HIV + mother breast feed safely?

A

No

70
Q

Why is a caesarian section indicated for pregnant HIV pts?

A

Reduce chance of fetus infection

71
Q

What are the three combination therapies recommended for HIV?

A

1 NNRTI + 2 NRTIs
1 PI + 2 NRTIs
1 II + 2 NRTIs

72
Q

HIV viruses that utilize both CXCR4 and CCR5 are called what?

A

R5X4

73
Q

Which HIV type are some people resistant to? Do they have to be homozygous or heterozygous?

A

CCR5

Have to be homozygous

74
Q

What is the pneumonia type that is seen in AIDS patients, but very rarely in immunocompetent people?

A

Pneumocystis carinii

75
Q

What is the fungal infection that AIDS patients often get?

A

Cryptococcosis

76
Q

Herpes lasting over a month may indicate what?

A

AIDS

77
Q

What is different in a chronic infection (like HIV) compared to a latent infection (like HSV)?

A

In chronic infections, there is still replication occurring

78
Q

What is the significance of cell to cell transmission of HIV?

A

HIV can hide from the immune system this way

79
Q

How does HIV kill cells?

A

Copious budding

Other viral like mechanisms

80
Q

What is the end all test for HIV?

A

NAT for viral RNA

81
Q

What is the purpose of the HIV-1/2 antigen/antibody combination immunoassay? What is detected?

A

p24 antigen or any antibody

Purpose = screening

82
Q

What is the purpose of the HIV-1/2 antigen/antibody differentiation immunoassay? What is detected?

A

Only antibodies are detected

Differentiates 1 and 2

83
Q

Why do you not use the rapid tests for in office tests often?

A

Requires follow up test

Microbio (50 decks)

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