Exam 3 - AIDS Flashcards

1
Q

What does AIDS stand for?

A

Acquired Immunodeficiency Syndrome

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2
Q

What does HIV stand for?

A

Human Immunodeficiency Virus

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3
Q

Name the two aggressive cancers are associated with AIDS.

A

1) Kaposi’s Sarcoma

2) B cell lymphoma

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4
Q

AIDS is characterized by susceptibility to infection with _____ _____.

A

AIDS is characterized by susceptibility to infection with OPPORTUNISTIC PATHOGENS.

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5
Q

What is another name for CD4+ cells?

A

Helper T Cells

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6
Q

T/F: HIV kills CD4+ cells.

A

TRUE

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7
Q

T/F: AIDS is accompanied by a profound increase in the number of CD4+ cells.

A

FALSE

-AIDS is accompanied by a profound DECREASE in the number of CD4+ cells.

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8
Q

What are the 2 types of HIV?

A

1) HIV-1

2) HIV-2

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9
Q

Which type of HIV is endemic in West Africa?

A

HIV-2

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10
Q

What type of HIV causes AIDS worldwide?

A

HIV-1

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11
Q

T/F: HIV infection, with some exceptions, does not produce enough immune response to eliminate it.

A

TRUE

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12
Q

HIV continues to replicate _____ and damages existing ____ _ ___.

A

HIV continues to replicate RAPIDLY and damages existing CD4+ T Cells.

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13
Q

How is HIV carried through the body?

A

In infected CD4+ T cells, or as free virus in body fluids (plasma, serum)

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14
Q

What does an acute infection with HIV cause?

A

Flu-like illness with the presence of virus in the peripheral blood and depletion of circulating CD4+ cells

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15
Q

Which MHC class of molecules kills helper T cells in AIDS?

A

MHC Class I molecules

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16
Q

T/F: Initially, all AIDS pts produce a humoral response followed by a cell-mediated immune response resulting in the production of HIV-specific CD8+ T cells.

A

TRUE

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17
Q

What is another name for CD8+ T cells?

A

Cytolytic T cells

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18
Q

What 2 ways does killing occur in AIDS?

A

1) Virus itself killing CD4+ cells
2) Human immune response generating cytolytic T cells, which are specific for the virus - killing CD4+ cells because they are infected with HIV virus

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19
Q

T/F: Most patients infected with HIV do not ever develop AIDS.

A

FALSE

-Most pts infected with HIV are eventually expected to develop AIDS

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20
Q

What is the term for the period after HIV infection and before the development of the disease?

A
  • Clinical latency

- Asymptomatic period

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21
Q

What is the average latency period without therapeutic intervention?

A
  • Between 3-15 years

- He said in class usually ~2-5 years

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22
Q

The asymptomatic period is not silent and there is a gradual decline of __ __ ___.

A

The asymptomatic period is not silent and there is a gradual decline of CD4+ T cells.

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23
Q

What is the normal ratio of CD4+ to CD8+ cells?

A

2:1

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24
Q

What is the ratio of CD4+ to CD8+ in HIV infected patients that develop AIDS?

A

0.5:1

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25
Q

At what ratio of CD4+ to CD8+ do AIDS infected patients develop opportunistic infections?

A

0.5:1

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26
Q

The structure of HIV is composed of __ proteins and __ genes.

A

The structure of HIV is composed of 19 proteins and 9 genes.

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27
Q

What type of virus is HIV?

A

Enveloped Retrovirus

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28
Q

How many copies of an RNA genome does each HIV virus particle have?

A

TWO

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29
Q

What transcribes RNA into DNA to integrate it into the host cell chromosome?

A

REVERSE TRANSCRIPTASE

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30
Q

What is the viral core of HIV composed of?

A

Protein p24

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31
Q

What 2 enzymes are contained in p24 in the viral core of HIV?

A

1) Reverse transcriptase
2) Integrase
3) Protease

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32
Q

What 3 enzymes (“RIP”) are required for viral replication?

A

1) R - Reverse transcriptase
2) I - Integrase
3) P - Protease

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33
Q

How many genes is HIV composed of?

A

NINE

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34
Q

How many of the nine genes that HIV is composed of are structural genes?

A

THREE

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35
Q

What are the 3 structural genes (“PEG”) that HIV is composed of?

A

1) P - pol
2) E - env
3) G - gag

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36
Q

What does gag encode?

A

Gag encodes major structural proteins of the HIV virus

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37
Q

What does pol encode?

A

Pol encodes the reverse transcriptase, the proteases, and the viral integrases

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38
Q

What does env code?

A

Env codes the proteins that are responsible for the attachment of the virus and entry into the cell

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39
Q

What are the other 6 genes responsible for in the HIV virus?

A

The translation of regulatory proteins required for infection

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40
Q

Name the 3 structural genes of an HIV virus.

A

“PEG”

1) P - pol
2) E - env
3) G - gag

41
Q

How many genes is HIV composed of?

A

NINE GENES

42
Q

Name the structural gene that encodes major structural proteins of the HIV virus.

A

gag

43
Q

Name the structural gene that encodes the reverse transcriptase, the proteases, and the viral integrase.

A

pol

44
Q

Name the structural gene that codes the proteins that are responsible for the attachment of the HIV virus and entry into the cell.

A

env

45
Q

T/F: The HIV virus replicates in human cells.

A

TRUE

46
Q

What is the term for small viruses formed resulting from replication?

A

VIRONS

47
Q

How do new viral particles escape from the cell in HIV?

A

New viral particles escape from the cell by BUDDING from the plasma membrane

48
Q

How does the HIV virus enter cells (CD4+)?

A

-By gp120 and gp41

49
Q

HIV enters cells by means of a complex of two non-covalently associated viral glycoproteins, ___ and ___, in the viral envelope.

A

HIV enters cells by means of a complex of two non-covalently associated glycoproteins, gp120 and gp41, in the viral envelope.

50
Q

Which portion of the glycoprotein binds with high affinity to CD4 on the cell surface?

A

gp120 portion

51
Q

What draws the HIV virus to CD4 T cells and to macrophages, which also express some CD4 receptors?

A

gp120

52
Q

What component of the glycoprotein mediates fusion of the viral envelope with the plasma membrane of the cell?

A

gp41

53
Q

What allows the viral genome and associated viral proteins to enter the cytoplasm?

A

gp41 mediating fusion of the viral envelope with the plasma membrane of the cell

54
Q

Which glycoprotein is responsible for binding to target host cell?

A

gp120

55
Q

Which glycoprotein is involved in fusing 2 cells and allowing HIV to enter?

A

gp41

56
Q

T/F: HIV does not kill macrophages.

A

TRUE

57
Q

In HIV, the interactions involve the trimeric envelope complex, (____), CD4, and a _____ receptor.

A

In HIV, the interactions involve the trimeric envelope complex, (gp160), CD4 and a CHEMOKINE receptor.

58
Q

What are the names of the chemokine receptors that interact?

A

CCR5 or CXCR4

59
Q

What 3 things are required for HIV to enter CD4+ cells?

A

1) gp160 (which is gp140 and gp41 together)
2) CD4 receptor
3) Chemokine receptor

60
Q

T/F: Virus cannot replicate unless the host cell, the lymphocyte is replicating.

A

TRUE

61
Q

T/F: Replication of lymphocytes is necessary for the replication of the HIV virus.

A

TRUE

62
Q

___ ___ T cells are susceptible to infection.

A

MEMORY CD4+ T cells are susceptible to infection.

63
Q

What happens after activation of infected memory cells in the lymph nodes?

A

It results in viral replication and the destruction of infected cells

64
Q

Does HIV kill macrophages?

A

NO

65
Q

HIV causes abnormal patterns of ___ secretion from macrophages that could account for wasting that commonly occurs in AIDS pts.

A

HIV causes abnormal patterns of CYTOKINE secretion from macrophages that could account for wasting that commonly occurs in AIDS pts.

66
Q

What type of cell is an important reservoir of infection, and also a means of spreading the virus to other tissues such as the brain?

A

MACROPHAGES

67
Q

Name 4 criteria for AIDS diagnosis.

A

1) Certain opportunistic infections
2) Certain cancers - Kaposi Sarcoma, B cell lymphoma
3) HIV-related encephalopathy
4) HIV-induced wasting syndrome

68
Q

Name the two common forms of cancer.

A

1) Kaposi Sarcoma

2) B cell lymphoma

69
Q

In the lifecycle of HIV in CD4 T cells, how does the virus bind to CD4?

A

gp120

70
Q

In the lifecycle of HIV in CD4 T cells, what mediates fusion with the target cell?

A

gp41

71
Q

In the lifecycle of HIV in CD4 T cells, once in the cytoplasm, the RNA genome is ____ ____ into double-stranded ____.

A

In the lifecycle of HIV in CD4 T cells, once in the cytoplasm, the RNA genome is REVERSE TRANSCRIBED into double-stranded cDNA.

72
Q

What happens with cDNA in the lifecycle of HIV in CD4 T cells?

A

It migrates to the nucleus, is integrated into the host cell genome and is called a provirus

73
Q

List the four “steps” in HIV lifecycle.

A

1) Virus particle binds to CD4 on T cell
2) Viral envelope fuses with cell membrane allowing viral genome to enter the cell
3) Reverse transcriptase copies viral RNA genome into double-stranded cDNA
4) Viral cDNA enters nucleus and is integrated into host DNA; it remains quiescent until T cell is activated

74
Q

Name the two regulatory genes in the lifecycle of HIV.

A

1) Tat

2) Rev

75
Q

What do Tat and Rev develop into?

A

Regulatory proteins

76
Q

Name the term that describes a large family of small chemotactic cytokines released by many cell types.

A

CHEMOKINES

77
Q

T/F: Chemokine receptors are a family of G protein-coupled receptors.

A

TRUE

78
Q

Name two G protein-coupled receptors involved in the binding of gp120, resulting in penetration of gp41 into cell membrane.

A

1) CCR5

2) CXCR4

79
Q

What are the two G protein-coupled receptors that are involved in binding of gp120, which results in penetration of gp41 into the cell membrane?

A

1) CCR5

2) CXCR4

80
Q

What is the generic name for Maraviroc?

A

Selzentry

81
Q

What is the brand name for Selzentry?

A

Maraviroc

82
Q

_____ is an antagonist of a chemokine receptor, CCR5.

A

MARAVIROC is an antagonist of a chemokine receptor, CCR5.

83
Q

What is Maraviroc indicated for?

A

Pts infected with only CCR5-tropic HIV-1, in combination with other antiretroviral agents

84
Q

What drug is indicated for CCR5-tropic HIV-1?

A

Maraviroc (Selzentry)

85
Q

Name the drug that is a an antagonist of a chemokine receptor, CCR5.

A

MARAVIROC

86
Q

T/F: Maraviroc is a first-line drug treatment.

A

FALSE

-Not a beginning drug; used when pts have developed resistance to other anti-retroviral agents

87
Q

Maraviroc inhibits entry of ____ into ___ ___.

A

Maraviroc inhibits entry of HIV into CD4+ cells.

88
Q

What two things are important for administration of Maraviroc (Selzentry)?

A

1) Tropism testing

2) Treatment hx

89
Q

T/F: Maraviroc is not recommended in pts with CXCR4-tropic HIV-1.

A

TRUE

90
Q

What are the SE of Maraviroc (Selzentry)?

A
  • Hepatotoxcity
  • Cardiovascular events
  • Increased risk of infection
  • GI disorders
91
Q

What are people called when they are living with HIV without developing AIDS?

A

Long term Non-progressors

92
Q

Long term Non-progressors are _______ carriers for ____ ___ mutation in ____.

A

Long term Non-progressors are HOMOZYGOUS carriers for DELTA 32 mutation in CCR5.

93
Q

What do long term non-progressors have high levels of?

A

Alpha-defensin

94
Q

What do high levels of alpha-defensin do?

A

Slow down replication of virus

-high in saliva, thus not transmitted in saliva

95
Q

What results because of a delta 32 mutation in CCR5?

A

HIV is not able to enter CD4+ cells, but is still surviving in the blood

96
Q

What is the name of the mutation in CCR5 that allows people to live with HIV and it not progress to AIDS?

A

Delta 32

97
Q

Name 5 types/approaches to Immunorestorative therapy.

A

1) IL-2
2) CSF
3) Isoprinosine
4) Bone marrow transplantation from homonzygous Delta 32 mutation carriers
6) IV immunoglobulins

98
Q

T/F: There are many vaccines for AIDs.

A

FALSE

-There are none available, but many in developmental stages

99
Q

What are some problems associated with the development of AIDS vaccines?

A