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immune 1 lec > HIV > Flashcards

HIV Flashcards

1
Q

Lymphadenopathy Associated Virus (LAV)

A

Luc Montagnier at the Pasteur Institute in France

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2
Q

1983:

A

Luc Montagnier at the Pasteur Institute in France

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3
Q

Human T Lymphotropic Virus Ill

A

Robert Gallo of US confirmed the discovery of the virus

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4
Q

1984

A

Robert Gallo of US confirmed the discovery of the virus

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5
Q

HUMAN IMMUNODEFICIENCY VIRUS (HIV)

A

President Mitterand of France and President Reagan of US resolved the issue

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6
Q

TWO TYPES OF HIV VIRUS

A

HIV-1

HIV-2

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7
Q

: HIV virus common worldwide

A

HIV-1

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8
Q

: HIV virus isolated in Africa

A

HIV-2

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9
Q

3 Groups of HIV-1

A

Group M
Group N
Group O

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10
Q

– major group

A

Group M

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11
Q

– non m/non

A

Group N

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12
Q

– outlier group

A

Group O

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13
Q

HIV Genus

A

Lentivirinae

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14
Q

HIV Family

A

Retroviridae

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15
Q

HIV Contains 2 positive single stranded RNA

A

SSrNA

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16
Q

HIV Structure

[?] in diameter

A

100nm

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17
Q

You can get HIV from:

A

 Sex without condom
 Passed from mother to baby (Vertical and perinatal)
 Sharing of equipment
 Contaminated transfusion transplants and blood organ

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18
Q

You cannot get HIV from:

A

 Kissing
 Hugging
 Sharing food
 Insect bites
 Toilet seats
 Bathing together
 Sneezes and cough
 Heat

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19
Q

HIV main MOT

A

Sex without condom

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20
Q

Target cell of HIV:

A

CD4 T cells (T helper cells)

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21
Q

Important Proteins

A

Gp41/Gp120 comples

p24

p17

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22
Q

• Large glycoprotein that traverses the bilipid layer

A

Gp41/Gp120 comples

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23
Q

• Gp120 and CD4 complex will interact with CCR5 and CXCR4 receptors of CD4 T cells p24

A

Gp41/Gp120 comples

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24
Q

• Nucleocapsid core protein

A

p24

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25
Q

One of the earliest marker to HIV infection

A

p24

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26
Q

The presence of [?] does not mean (+) for HIV

A

p24

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27
Q

• Matrix shell protein

A

p17

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28
Q

Important Enzymes

A

Reverse transcriptase

Integrase

Protease

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29
Q

• Enables the virus to convert viral RNA to DNA

A

Reverse transcriptase

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30
Q

• (Normal process: [?])

A

DNA to RNA

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31
Q

• Inserts viral DNA into host DNA

A

Integrase

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32
Q

Making it impossible to kill the virus; ability to persist in the host

A

Integrase

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33
Q

• Cleaves other enzymes and structural proteins from their polyproteins; important in formation of new virion

A

Protease

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34
Q

• Progressive deterioration of the immune system due to the destruction of CD4 cells

A

HIV INFECTION

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35
Q

Normal CD4:CD8 ratio =

A

2:1

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36
Q

CD4:CD8 ratio With HIV =

A

0.5:1

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37
Q

can occur in HIV INFECTION

A

Opportunistic infections

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38
Q

STAGES OF HIV INFECTION

A

Primary Stage

Intermediate Stage

Final Stage

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39
Q

Acute HIV

A

Primary Stage

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40
Q

Clinical Latency

A

Intermediate Stage

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41
Q

Opportunistic infections

A

Final Stage

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42
Q

• May be asymptomatic

A

Primary Stage

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43
Q

• Development of flu-like symptoms

A

Primary Stage

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44
Q

• Lymphadenopathy

A

Intermediate Stage

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45
Q

• Fever

A

Intermediate Stage

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46
Q

• Weight loss

A

Intermediate Stage

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47
Q

• Diarrhea

A

Intermediate Stage

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48
Q

• Fatigue, night sweats

A

Intermediate Stage

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49
Q

Intermediate Stage Labs:

A

T4 cells < 400/mm2
CD4:CD8 ratio is <1 (vs. normal ratio of 2:1)
Thrombocytopenia, Leukopenia, Anemia

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50
Q

Aka HIV dormancy

A

Clinical Latency

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51
Q

Some may show s/s, while others may show little to none

A

Clinical Latency

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52
Q

Lasts 10 years or longer for some

A

Clinical Latency

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53
Q

rapid multiplication of the virus

A

Acute HIV

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54
Q

high viral load = high risk of transmission

A

Acute HIV

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55
Q

(inflamed/swollen lymph nodes)

A

Lymphadenopathy

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56
Q

Acquired Immune Deficiency Syndrome - AIDS (after 2-10 years)

A

Final Stage

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57
Q

Final Stage Labs:

A

T4 cells < 200/mm2

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58
Q

Opportunistic infections in Final Stage:

A

Pneumocystis jiroveci (formerly carinii)
Candidiasis
CMV
Herpes simplex
M. tb
Kaposi’s sarcoma
Hairy leukoplakia

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59
Q

(formerly carinii)

A

Pneumocystis jiroveci

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60
Q

HIV IMMUNOLOGIC FEATURES

A
  1. Progressive depletion of T4 cells
  2. Reversing the normal CD4:CD8 ratio (normal 2:1) to as low as 0.5:1
  3. First detectable serologic marker is the core protein p24
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61
Q

HIV Screening tests

A

ELISA

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62
Q

HIV Confirmatory tests

A

Western blot assay

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63
Q

Solid phase assay

A

ELISA

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64
Q

> 99.5% sensitivity

A

ELISA

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65
Q

Gold standard

A

Western blot assay

66
Q

Most sensitive and specific for HIV-1

A

Western blot assay

67
Q

Detects IgG Ab specific to HIV Ag (Ab against core protein p24)

A

Western blot assay

68
Q

Positive results are bands on nitrocellulose membrane strip

A

Western blot assay

69
Q

Why is antibody detection more commonly used?

A
  1. Small size of pathogen especially HIV
  2. Antibodies are widely distributed
  3. Longer detection time of antibodies
  4. Antibody testing is more practical
70
Q

Assay Generations

A

1st Generation
2nd Generation
3rd Generation
4th Generation

71
Q

• viral lysate

A

1st Generation

72
Q

• recombinant disrupted virion

A

1st Generation

73
Q

• use of biological vehicle

A

2nd Generation

74
Q

• Synthetic peptide - mimics CHON

A

3rd Generation

75
Q

• Peptide synthesizer

A

3rd Generation

76
Q

• Recombinant Ag, Synthetic Peptide, and Monoclonal antibodies

A

4th Generation

77
Q

1st Generation

A

western blot

78
Q

2nd Generation

A

recombinant Ag - placed in fungi

79
Q

3rd Generation

A

most of the test (test kits)

80
Q

4th Generation

A

ELISA

81
Q

“lateral flow” assay

A

Immunochromatography

82
Q

Most widely used test for HIV screening

A

Immunochromatography

83
Q

Easy to carry; used in outreaches; HIV tests in Session Road and lab exp in the lab

A

Immunochromatography

84
Q

Advantages
storage at room temperature, ease of use, and fast results, field testing

A

Immunochromatography

85
Q

Disadvantages
less sensitive and not recommended in blood banks

A

Immunochromatography

86
Q

One of the first serological test developed for HIV

A

Enzyme-linked Immunosorbent assay (ELISA)

87
Q

worldwide use

A

Enzyme-linked Immunosorbent assay (ELISA)

88
Q

Advantages
high sensitivity and specificity

A

Enzyme-linked Immunosorbent assay (ELISA)

89
Q

Disadvantages
false positives and machine maintenance; due to high sensitivity

A

Enzyme-linked Immunosorbent assay (ELISA)

90
Q

Used by big hospitals and laboratories

A

Luminescence Assays

91
Q

Relative light unit (luminometer)

A

Luminescence Assays

92
Q

Advantages
high sensitivity and specificity

A

Luminescence Assays

93
Q

Disadvantages
false positives, expensive maintenance issues

A

Luminescence Assays

94
Q

Widely used in blood banks before

A

Agglutination

95
Q

Results are difficult to distinguish; Need expertise

A

Agglutination

96
Q

gelatin particles or RBC as carriers (TPHA)

A

Agglutination

97
Q

Advantages
differentiating test, high sensitivity and specificity

A

Agglutination

98
Q

Disadvantages
subjective reading, prozone phenomenon or Ab excess

A

Agglutination

99
Q

obsolete test

A

Immunoconcentration

Immunodot Assay

100
Q

Aka “flow through” assay

A

Immunoconcentration

101
Q

Same as Lateral flow or Immunochromatography

A

Immunoconcentration

102
Q

Advantages
storage at room temperature, ease of use, and fast results, field testing

A

Immunoconcentration

103
Q

Synthetic test

A

Line Immunoassay

104
Q

Disadvantages
less sensitive, less specific, subjective reading

A

Immunoconcentration

105
Q

Principle: Solid-phase ELISA

A

Immunodot Assay

106
Q

Aka “dipstick” ELISA

A

Immunodot Assay

107
Q

Same as Lateral flow but observation on dots instead of band or line

A

Immunodot Assay

108
Q

Advantages
highly specific, ease of use

A

Immunodot Assay

109
Q

Disadvantages
need ref for storage, subjective

A

Immunodot Assay

110
Q

gold standard for HIV

A

Western blotting

111
Q

Protein detection

A

Western blotting

112
Q

Confirmatory test

A

Western blotting

113
Q

Performed by the National Reference Laboratories

A

Western blotting

114
Q

: followed to confirm truly (+) results

A

CDC/ASPHL criteria

115
Q

Advantages
very specific

A

Western blotting

116
Q

Disadvantages
tedious procedure, trained personnel

A

Western blotting

117
Q

Requires electrophoresis after testing

A

Western blotting

118
Q

According to these criteria, a result should be reported as positive if at least two of the following three bands are present:

A

o p24
o gp41
o gp120/gp160

119
Q

A [?] test result is reported if either no bands are present.

A

negative

120
Q

Specimens that have some of the characteristic bands present but do not meet the criteria for a positive test result are considered to be [?]

A
121
Q

Neither positive nor negative; in between

A

indeterminate

122
Q

Repeat result after 3 months

A

indeterminate

123
Q

Only 1 of the bands mentioned in the criteria for (+) result is present

A

indeterminate

124
Q

Ex. Not diagnostic if only p24 is present

A

indeterminate

125
Q

Monitoring test (for effectiveness of treatment)

A

CD4 and Viral Load

126
Q

To check for viral load

A

CD4 and Viral Load

127
Q

Low/high count = ineffective treatment

A

CD4 and Viral Load

128
Q

Hallmark feature of HIV: presence of reverse transcriptase and integrase

A

CD4 and Viral Load

129
Q

Laser counting

A

CD4 count

130
Q

FACS (fluorescence activated cell sorter)

A

CD4 count

131
Q

Detects RNA/DNA ; HIV (RNA)

A

PCR/NAT/Viral load

132
Q

Viral load (quanti)

A

PCR/NAT/Viral load

133
Q

Qualitative or quantitative

A

PCR/NAT/Viral load

134
Q

old name of HIV

A

Lymphadenopathy Associated Virus (LAV)

135
Q

Common signs and symptoms: swollen lymph nodes

A

Lymphadenopathy Associated Virus (LAV)

136
Q

Theories for HIV:

A

An individual made a sexual contact with a monkey
Most accepted: due to Bush meat

137
Q

Butchering different types of meat in Africa; Animal blood enters the body; High conc in blood, saliva, and sweat

A

Bush meat

138
Q

Body fluids containing high viral load:

A

blood and sexual fluids (semen and vaginal)

139
Q

vertical transmission or perinatal
- Treatment:

A

Antiretroviral therapy

140
Q
  • Decreases viral load in the blood to prevent transmission
A

Antiretroviral therapy

141
Q

Contaminated blood transfusion and organ transplants other viruses

A

Hepa B, Hepa C, HIV, Syphilis

142
Q
  1. HIV attaches to [?]
A

host CD4 cell

143
Q
  1. DNA is made from HIV’s RNA via [?]
A

reverse transcriptase

144
Q
  1. HIV DNA is [?] into host DNA (integrase)
A

integrated

145
Q
  1. Viral components are [?]
A

reproduced

146
Q
  1. HIV virus is [?]
A

assembled

147
Q
  1. HIV virus is [?]
A

distributed

148
Q

1st thing to happen once infected with HIV

A

Progressive depletion of T4 cells

149
Q

Ab rises during the [?] of infection (Ab test kits)

A

6th week

150
Q

Ag is present as early as the [?] of infection (expensive machines)

A

0 week

151
Q

CD4 T cells is high during the [?]; declines during the acute phase, but eventually rises with Ab as Ag declines

A

0 week

152
Q

Normal RBC size: 7-8 micrometers; HIV is like a dot compared to RBC

A

Small size of pathogen especially HIV

153
Q

Not only detected in serum but also in other body fluids

A

Antibodies are widely distributed

154
Q

Once increased, there will be a constant production

A

Longer detection time of antibodies

155
Q

Ag is expensive (PCR, NAT, RIBA; Ab is cheaper (rapid test kits)

A

Antibody testing is more practical

156
Q

Ab-testing Principle:

A

Target and Capture

157
Q

(reagent)

A

Capture analyte

158
Q

Target and Capture:

A

Antigen (capture analyte) + Antibody (target analyte) = antigen-antibody complex

159
Q

Western blotting HCV:

A
  • Srip Immunoblot Assay (SIA)
  • Recombinant Immunoblot Assay(RIBA)
160
Q

PRINCIPLE OF WESTERN BLOT

Look for [?]
1st reagent: [?]
Add [?] to stop the reaction
Detection signal (?)

A

target protein

Primary Antibody

enzyme-conjugated secondary antibody and enzyme substrate

colorimetric or chemiluminescent

161
Q

Criteria for determining a positive test result have been published by the [?].(Stevens)

A

Association of State and Territorial Public Health Laboratory Directors and CDC, the Consortium for Retrovirus Serology Standardization, the American Red Cross, and the FDA

immune 1 lec (27 decks)

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