Retrovirus Flashcards

1
Q

Retrovirus family includes

A

Oncoviridae - HTLV 1,2
Lentiviridae - HIV 1,2

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2
Q

Which HIV is more common in India

A

HIV 1&raquo_space; HIV 2

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3
Q

Features of HIV Virus

A

Unsegmented ssRNA
2 copies of RNA
100-120 nm
Reverse transcriptase activity

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4
Q

HIV 1 Serotypes

A

M - M/C
N
O
P

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5
Q

Subtypes of M serotype of HIV 1

A

10 subtypes - A to K

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6
Q

Which serotype of HIV 1 is most common in Worldwide and India

A

Worldwide - HIV 1 Group M subtype B
India - HIV 1 Group M subtype C

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7
Q

Circulating recombinant forms of HIV

A

CRF-AE : Combination of A and E Serotypes

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8
Q

HIV proteins are classified into

A

Structural
Non structural

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9
Q

Structural proteins of HIV includes

A

Env (Envelope)
Gag
Pol

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10
Q

Env (Envelope proteins) of Hiv

A

Envelope - gp160
Surface - gp120
Transmembrane - gp41

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11
Q

Gag proteins of HIV

A

Matrix - p17
Capsid - p24
Nucleocapsid - p7
Budding protein - p6

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12
Q

Pol proteins of HIV

A

RIP
Reverse transcriptase - p66
Integrase
Protease

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13
Q

Non structural proteins of HIV

A

Tat (Transcriptional transactivator)
NeF (Negative factor gene)
ReV (Regulation of virus)
ViF (Viral infectivity factor)
Vpu/Vpx - unload/release of virus
Vpr - transport from cytoplasm to nucleus
LTR (Long terminal repeats)

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14
Q

Which non structural protein of HIV is responsible for Unloading/release of virion

A

Vpu/Vpx

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15
Q

Which non structural protein of HIV helps in transport of HIV from cytoplasm to nucleus

A

Vpr

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16
Q

Attachment of HIV Virus is mediated by

A

Envelope proteins (gp129, gp41) - attaches to Macrophages or CD4 Cells and Coreceptor binding to Chemomine receptors
R4 strains - Binds to CXCR4 on CD4 cells
R5 strains - Binds to CCR5 on macrophages

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17
Q

Pathogenesis of HIV

A

Attachment - Endocytosis - Uncoating - conversion of viral RNA to DNA with the help of Reverse transcriptase - viral DNA transported to nucleus (Vpr) - Integration of viral DNA with host DNA mediated by Integrase enzyme - Transcription (RNA formation) - Protein synthesis - new viral particles formed - Release (by Protease enzymes)

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18
Q

Transmission of HIV

A

Sexual (0.1-1%) - Homosexual routes, Heterosexual routes, unprotected receptor anal course, vaginal intercourse
Blood transfusion (>90%)
Needle stick injury - 1:300
Needle sharing - 1:150
Vertical (30%)

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19
Q

Clinical forms of HIV

A

Acute HIV syndrome
Clinical latency
PGL (Persistent generalized Lymphadenopathy)
ARC (AIDS related complex)

20
Q

Clinical features seen in Acute HIV Syndrome

A

Fever/weight loss
Headache
Pharyngitis
Lymphadenopathy
Skin rash
Myalgia
Nausea/vomiting
Hepatosplenomegaly

21
Q

Clinical latency form of HIV

A

Asymptomatic
CD4 Count goes down
HIV RNA levels increases

22
Q

Persistent generalized Lymphadenopathy form of HIV

A

Enlarged LN - two or more than 2 non contagious extrainguinal sites LN

23
Q

AIDS related complex

A

When CD4 <200/mm3 - definition of AIDS
Opportunistic infections

24
Q

Opportunistic infections when CD4 count is less than 500

A

Tb
Bacterial pneumonia
Oropharyngeal Candidiasis
Non typhoid Salmonellosis
Kaposi sarcoma
Non Hodgkin’s lymphoma
Herpes zoster

25
Q

Opportunistic infections seen in Hiv when CD4 <200

A

Pneumocystis jiroveci pneumonia
Oesophageal Candidiasis
Herpes simplex ulcer
Isospora belli diarrhea
HIV Associated dementia

26
Q

Opportunistic infections seen in HIV when CD4 <100

A

Cerebral Toxoplasmosis
Cryptococcal Meningitis
Cryptosporidiosis
CMV
MAC
PMLE

27
Q

Opportunistic infections seen in HIV when CD4 <50

A

CMV
MAC
Toxoplasma gonii retinitis

28
Q

CDC AIDS Definition

A

CCCCCCPPHKM
Candida - trachea, esophagus
Cryptococcus - meningitis
Cryptosporidium - chronic diarrhea (>1 month)
CMV colitis - Seringous ulcers
Cerebral toxoplasmosis - Seizures
CNS Lymphoma
PMLE
Pneumocystis CD<200
HSV
Kaposi sarcoma (HHV8)
MAC - CD<50

29
Q

WHO Definition of AIDS

A

Atleast 2 major signs in combination with at least 1 minor signs
Major Signs - Weight loss (>10% of body weight), Chronic diarrhea, Prolonged fever
Minor signs -
Persistent cough for > 1 month, generalized pruritic dermatitis
H/O of herpes zoster
Oropharyngeal Candidiasis
Generalized Lymphadenopathy

30
Q

Most common opportunistic infection in HIV Pt

A

Tb

31
Q

Most common opportunistic fungal infection in HIV pt

A

Candida

32
Q

Most common space occupying tumor in HIV pt

A

CNS Lymphoma

33
Q

Most Common glomerulonephritis in HIV Patients

A

FSGS (HIVAN)

34
Q

Most common Non Hodgkin’s lymphoma in HIV pt

A

DLBCL

35
Q

Most common Hepatitis in HIV pt

A

Hepatitis B

36
Q

Most common skin symptom in HIV

A

Seborrheic dermatitis

37
Q

Most common endocrine symptom in HIV pt

A

Lipodystrophy

38
Q

Which one to treat first im case of Tb with HIV

A

First give ATT then after few weeks start ART (To prevent immune reconstitution inflammatory syndrome)

39
Q

Lung infections and X rays findings seen in case of HIV

A

Pneumococcus - Lobe consolidation
TB - Snow storm/Hazzy pattern
Pneumocystis jiroveci - Perihilar opacities (CD4 <200)

40
Q

Diagnosis methods for HIV

A

CD4 Count
ELISA - Sensitive (4th generation enzyme immunoassay)
Western blot - specific
Immunofluorescence assay
Lind or dot immunoassays
RT PCR (Even 40 copies detected)
Pediatric HIV - DNA PCR

41
Q

ELISA (4th generation enzyme immunoassay) in HIV

A

Detection of p24 antigen + antibodies
If +ve - Do HIV 1/HIV 2 antibody differentiation immunoassay - If negative - HIV 1 NAT (Definitive)

42
Q

Western blot findings according to WHO

A

Antibody against 2 envelope bands (gp120,gp41) with or without gag/pol bands

43
Q

1st to rise in HIV, HIV RNA or p24

A

HIV RNA > p24

44
Q

HTLV- 1 Causes

A

Human T cell leukemia lymphoma virus
Causes adult T cell leukemia lymphoma, Tropical spastic paresis

45
Q

Microscopic examination finding in case of Adult T cell leukemia Lymphoma

A

Clover leaf cells

46
Q

Mode of transmission of HTLV -1

A

Blood
Body fluids (breast milk)