Antivirals

Question 1

Why do few antivirals exist?

Answer 1

Virus has to get into the cell to replicate which occurs before s/s develop, and often we don’t know to take them. Can take away ability to rep, then bodily response takes over.

Question 2

Virus

Answer 2

parasitic microbe that needs cells to replicate; no cell wall of their own; insert own DNA/RNA into healthy cell

Question 3

HSV 1

Answer 3

herpes above the waist

Question 4

HSV 2

Answer 4

herpes below the waist

Question 5

Herpes zoster

Answer 5

shingles

Question 6

HIV 1

Answer 6

more prevalent

Question 7

Hiv 2

Answer 7

less pathogenic, confined to W africa

Question 8

AIDS

Answer 8

acquired immune deficiency syndrome; sometimes follows HIV

Question 9

Highest risk population for HIV

Answer 9

Black, men who have sex with other men

Question 10

Retrovirus

Answer 10

Uses reverse transcriptase to translate genetic information into DNA; attacks CD4 receptors on T cells, inserts own genetic material and takes over that cell

Question 11

CD4/helper T function

Answer 11

Long term immune memory

Question 12

Characteristics of HIV pt

Answer 12

• infected for life
• virus present in blood and body fluids
• antibodies are makers of infx
• immunocomp

Question 13

Stage 1 of HIV

Answer 13

• early acute infection
• rapid replication, not detectable
• seroconversion then occurs–very infectious, antibodies detectable, flu-like sx for weeks

Question 14

Stage 2 of HIV

Answer 14

• chronic clinical latency
• can last 3-12Y w/o tx
• virus level stabilizes
• rapid virus production, CD4 T cell count decreases

Question 15

HIV sx

Answer 15

ulcers, fatigue, sore throat, rash, muscle aches, fever, swollen lymph nodes, night sweats

Question 16

AIDS diagnosis

Answer 16

AIDS defining condition or CD4 count less than 200 cell

Question 17

AIDS defining conditions

Answer 17

• HIV-related encephalopathy
• Kaposi’s sarcoma
• AIDS dementia
• invasive cervical cancer
• pneumocystis Jirovecii pneumonia
• wasting sx
• TB
• pervasive candidiasis

Question 18

Oral manifestations of AIDS

Answer 18

caused by dec CD4 counts (neutropenic)
- periodontal disease
- oral hairy leukoplakia

Question 19

HIV transmission

Answer 19

• blood and body fluids
• sex w/o condoms
• blood transfusion and organ transplant
• mother to baby (perinatal)
• sharing IV equipment

Question 20

Risk behaviors for AIDS

Answer 20

• man sex with man
• injection drug use
• parenteral transmission
• duration/frequency of contact
• blood exposure
• perinatal nutrition

Question 21

What is the best way to give ARTs

Answer 21

Combinations of 2 NRTIs and another drug

Question 22

How do all ARTs work?

Answer 22

decrease viral load so body can make more CD4

Question 23

ART principles

Answer 23

• begin ASAP
• get tested if possible contamination
• goal is to decrease viral load to undetectable level
• tx guided by CD4 count, viral load, pt pref
• usually CD4 low when viral load is high

Question 24

PrEP

Answer 24

• pre-exposure prophylaxis
• taken if want relations with HIV-pos partner
• not for all–screened
• condom use

Question 25

PEP

Answer 25

- post exposure prophylaxis - recommendation based on exposure and barriers (non-occupational and HC probs) - take for 28 days - HIV test at 6 ad 12W after exposure