Lecture 6 Flashcards

1
Q

What is the pathology of HIV?

A

Retrovirus(uses own RNA to replicate) invades CD4 T helper, dendrite, and monocytes to replicate
Causing our body to be susceptible to infections and cancers

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2
Q

What is the pathology of AIDS?

A

Outcome of chronic HIV
Depletion of CD4 (<200 cells) OR had AIDS defining condition

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3
Q

Who are at risk populations for HIV?

A

Men who have sex with men
Transgender people
People who inject drugs
Sex workers
Heterosexuals
Healthcare workers (needle sticks 3/1000)

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4
Q

How is HIV transmitted?

A

Blood
Semen
Pre-seminal fluid
Rectal fluids
Vaginal fluids
Breast milk

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5
Q

What is the common entry for HIV?

A

Anogenital mucosa
Notes: anal intercouse

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6
Q

How does HIV invade cells?

A

Infects T cells by interacting between glycoprotein(gp120) and T-cell coreceptor (CXCR4) and monocyte by interacting with CCR5 co-receptor

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6
Q

How does HIV invade cells?

A

Infects T cells by interacting between glycoprotein(gp120) and T-cell coreceptor (CXCR4) and monocyte by interacting with CCR5 co-receptor

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7
Q

How does HIV transfer from DCs to CD4?

A

DCs capture and bind HIV
HIV is traveled along with the DC
HIV is transferred to CD4 T cells through trans-infections

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8
Q

What are the stages of HIV infection?

A

Viral transmission/ HIV acquisition
Acute HIV infection/Acute retroviral syndrome(symptomatic stage)
Chronic HIV infection
Advanced HIV infection (CD4 count <50cells/mL)

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9
Q

Can features help define a chronic HIV infection?

A

Can be asymptomatic
Aids <200 cells/mL
Presence of AIDS defining condition

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10
Q

What are the clinical manifestations of of acute retroviral syndrome?

A

Nonspecific viral syndrome (fever, chills, diaphoresis, pharyngitis, lymphadenopathy, myalgias/arthrlagias, cephalgia, fatigue)

Spontaneous resolution
Latent until profession into AIDS

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11
Q

Who should be tested for HIV?

A

Known or suspected sexual or hematologic exposure
Have sexual history
Known drug abuse, especially IVDU
Accidental needlestick
Pregnancy
Recent sexually transmitted infection
CDC recommends routine screening ages 13 - 64 years at least once in their lifetime

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12
Q

What should you take if you test positive on an ELISA test for HIV to make sure?

A

Western Blot (this test is expensive)
Second ELISA

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13
Q

What are other tests to consider when diagnosing for HIV?

A

Pregnancy Test
Serum hepatitis B serology
Serum hepatitis C serology
CBC with Diff
BMP or CMP
UA, LFTs, Fasting plasma glucose, Lipid profile
Human leukocyte antigen-B*5701 testing
PPD, CXR

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14
Q

What can you take for Pre-exposure prophylaxis (PrEP)?

A

For high-risk patients
Behavioral changes
Tenofavir(Truvada, drug class NRTI)

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15
Q

When someone has HIV what should we also test for?

A

Tuberculosis

16
Q

What are some routine immunizations to help prevent HIV?

A

Pneumococcal vaccine
Inactivated influenza vaccine annually in season
Hepatitis A/B vaccine
Tdap vaccine
HPV vaccine for patients <45 years of age
Haemophilus influenzae type b vaccine

17
Q

What non-medical things can we do that helps prevent HIV?

A

Safe sex practice
Avoids consumption of raw meat, eggs, shellfish (toxoplasma, salmonella, campylobacter)
Avoid cleaning cat litter (toxoplasma)
Avoid cat scratches/bites (bartonella)
Consider consumption of bottled water(cryptosporidium)

18
Q

What is the goal of antiretroviral therapy?

A

Suppression of HIV replication

19
Q

What are the types of drugs used for antiretroviral therapy?

A

NuecleoSIDE reverse transcriptase inhibitors(NRTI)
NueloTIDE reverse transcriptase inhibitors(NRTI)
Non-nucleoside reverse transcriptase inhibitors (NNRTI)
Protease inhibitors
Entry inhibitors / Fusion inhibitors
Integrase inhibitors

20
Q

What do we need to consider when choosing antiretroviral therapy?

A

Prior treatment experiences
Medication side effects
Underlying conditions
Convenience of formulation
Genotypic resistance testing
Results of resistance testing → 15 - 20% of treatment naive patients resistant!

21
Q

Do we need to know specific drugs?

A

NOPE, only class

22
Q

What are PIs used for?

A

Suppress HIV replication
Administered as combination therapy
Metabolized by P450 (high potential for drug interaction)
Used to boost other regimens

23
Q

What are some aids defining conditions?

A

Mucocutaneous candidiasis
Oral hairy leukoplakia
Genital herpes
Herpes zoster/ shingles
Molluscum Contagious
Community acquired pneumonia
Pnuemocystis jiroveci penumonia
Esophageal candidiasis
Kaposi’s sarcoma
Wasting syndrome
Mycobacterium avium infection
Crytococcal meningitis
Cytomegalovirus retinitis
Toxoplasmosis