Winkler - HIV

Question 1

Know HIV-1, group M, subtype B.

Answer 1

OK

Question 2

Transmission of HIV?

Answer 2

Unprotected sex
-anal sex>vaginal sex»»oral sex (rare)

IV drug use if sharing needles

Mother to child transmission
-In utero/delivery or during breastfeeding

Occupational exposures
-Needle sticks>blood-mucosal exposures»>blood-compromised skin contact

Blood or blood factor transfusions
-US blood supply is considered safe

Question 3

How does the HIV attach to the host CD4 cell?

Answer 3

GP-120

Question 4

Tell me about the HIV.

Answer 4

Retrovirus
-RNA virus
-They must make a DNA copy of their RNA
-Reverse transcriptase to convert their RNA into DNA which can be incorporated into the host cell’s genes
—Life-long latent infection

Question 5

Why has an HIV vaccine been difficult to produce?

Answer 5

Each infected CD4 cell produces 100 new HIV virions
-10 billion new HIV virions each day

HIV replication error prone: 1 in 4000 basepair changes
-Very poor at replicating, so it is constantly changing

Question 6

What causes cell loss in HIV?

Answer 6

Direct cell killing

Apoptosis

Anergy

Damage to precursor cells

Question 7

Normal CD4 T cell count is what?

Immunocompromised pt count?

Answer 7

800-1200 CD4 T cells/mL

Below 200 CD4 T cells/mL

Question 8

Viral load is equivalent to ?

CD4 is equivalent to ?

Answer 8

Speed or rate of change in immunodeficiency

Distance to immunodeficiency

Question 9

Oral manifestations of HIV?

Answer 9

Oral candidiasis

Hairy leukoplakia

Question 10

CD4 T cell categories?

Answer 10

1 - >/= 500 cells/microL (Normal, low risk of opportunistic infections)

2 - 200-499 cells/microL

3 - <200 cells/microL (High risk of opportunistic infections)

Question 11

T/F - On average, w/o tx, a pt’s CD4 cell count will decrease by 50-100 cells/mL/year.

Answer 11

TRUE

Question 12

HIV txs?

Answer 12

Pre-AZT

AZT
-Still has a purpose today though

Protease inhibitors - Current

HAART - Current

• cART
• ART

Question 13

T/F - Most deaths due to HIV is due to the co-morbidities rather than HIV itself.

Answer 13

TRUE

Liver disease (Hep C)

CV disease

Non-AIDS related malignancies

Question 14

HIV life cycle?

Answer 14

Gp-120 binds CD4 using the Gp-120 receptor, into cell, RNA single strand is integrated into host DNA, replicated in nucleus, comes out as genomic RNA and combines with proteins, it buds out as a mature HIV virion.

Binding
Reverse transcription
Integration
Transcription
Translation
Viral assembly and maturation