HIV virology Flashcards

1
Q

What are mandatory surface antigen tests for pregnant women?

A
  • Syphillis
  • HIV
  • Hep B
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2
Q

What animal has been identified as the source of HIV infection in humans?

A

Chimpanzees

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3
Q

Regarding HIV epidemiology in Africa, what are the routes of infection?

A
  • Heterosexual
  • Mother-to-child
  • Unscreened blood
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4
Q

In Europe what are main routes of contracting HIV?

A

Sexual

  • MSM
  • Heterosexual

Injecting drug use
-less common but can be higher in certain areas

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5
Q

What is the more predominant virus worldwide - HIV-1 or HIV-2?

A

HIV-1

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6
Q

What cells does the HIV virus target before attaching?

A

> Cells with CD4 on surface (T-helper) lymphocyte

>Cells with certain chemokine receptors

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7
Q

Is HIV a DNA or RNA virus?

A

RNA. Converted to DNA in cell by reverse transcriptase

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8
Q

What is the group of HIV retroviruses called?

A

Lentiviruses

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9
Q

For replication, what does the virus need?

A

> Host cell

>RNA to be transcribed to DNA

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10
Q

What enzyme integrates the viral DNA into the nuclear genome?

A

Integrase

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11
Q

What enzyme helps produce enzymes needed for maturation of the replicated virus?

A

Protease

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12
Q

What lab tests are done to diagnose HIV?

A

Antigen/antibody tests (ELISA assays)

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13
Q

Lab testing to help in managing HIV?

A
  • Viral load
  • HIV resistance testing
  • Avidity testing
  • Subtype determination
  • Tropism testing
  • Drug levels
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14
Q

What is the diagnostic window? Why is it significant?

A

Time during which markers for HIV infection are not detectable/before seroconversion. Varies between individuals.

Testing in this time can lead to false negative results

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15
Q

What is measuring viral load useful for?

A
  • Monitor effectiveness of treatment

- Diagnosis in presence of maternal antibody

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16
Q

What is HIV resistance testing used for? (identifying specific mutations conferring resistance to ART drugs)

A
  • Baseline at diagnosis
  • Suboptimal treatment response
  • Treatment failing
  • Changing treatment
17
Q

What is the use of tropism testing and for drug levels?

A

Tropism testing - what co-receptor virus uses to enter cell. For CCR5 antagonist use

Drug levels - compliance

18
Q

Does your work require you to have an HIV test? When may you need one? And when may you need to avoid situations putting you at risk of HIV?

A

> If work doesn’t need test you don’t need to inform work
If working abroad you may need HIV test
If in healthcare you need to avoid exposure-prone procedures (EPPs)

19
Q

What happens to viral load and CD4 count when ART treatment is commenced?

A

Viral load: fall

CD4 count: rise

20
Q

What are the potential routes of transmission to healthcare workers of blood borne viruses? Give an example of each.

A

Percutaneous exposure (eg sharp instrument accidentally penetrating skin). At risk of:

  • Hep B
  • Hep C
  • HIV
Mucocutaneous exposure (eg blood splashing into eyes/mouth/broken skin. At risk of:
-HIV
21
Q

Other than blood which other bodily fluids should be handled with precaution?

A
  • CSF
  • Pleural/peritoneal/pericardial fluid
  • Breast milk
  • Amniotic fluid
  • Vaginal secretions/semen
  • Saliva
22
Q

Can corpses be infected with HIV?

A

Yes - may be for days after death. Avoid leaking of body fluids

23
Q

What actions should be done after body fluid exposure?

A

> Wash off splashes on skin with soap and running water
Encourage bleeding if skin broken
Wash out splashes in eye/nose/mouth
REPORT to senior manager or doctor AND to OHS

24
Q

How is the risk of getting HIV from injury judged?

A

> Source of contamination
Extent of injury/type of sharp
Likelihood of B/C/HIV in source
Vaccination history

Ideally test source with informed consent

25
Q

Ways to avoid exposure to blood borne viruses in healthcare setting?

A

> Good hygiene + regular handwashing
Cover existing wounds with dressings
Take protective measures to avoid contamination of clothing and person
Protect mucous membranes from splashes
Prevent puncture wounds, cuts and abrasion in presence of blood
Avoid sharps usage when possible
Use safe procedure in handling sharps
Clear spillage of bodily fluids promptly and disinfect surfaces
Follow procedure for disposal of contaminated waste