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Infection 2023 > Blood Borne Viruses > Flashcards

Blood Borne Viruses Flashcards

1
Q

Conditions associated with HIV later stage

A 
Oral candidiasis 
Kaposis sarcoma (rash)
Pneumocystis pneumonia (PCP)
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2
Q

Pathogen complications HIV

A

Reactivation of virus (those that lie dormant and then reappears (latent)

Fungus (yeast, mould) common

Protozoa common

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3
Q

Outcomes for HIV

A

Chronic infection +/- disability
Death
Management

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4
Q

Structure virus

A

Genome (RNA vs DNA) double/signle strand

Capsid (protein shell) - helical vs icsohedral

Lipid envelope (derived from host cell membrane) present/absent

Replication strategy

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5
Q

HIV virus type

A

Retrovirus - inserts RNA into host cell, uses reverse transcriptase to convert it to DNA, converts back

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6
Q

Genetic material HIV

A

Single stranded RNA

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7
Q

How does HIV infect?

A

Gp120 (glycoprotein on HIV) infects cells that have CD4 surface receptor

(Mostly T helper lymphocytes)

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8
Q

Cells with CD4 receptor

A

T helper lymphocytes

Monocytes/macrophages

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9
Q

What does HIV do once inside cell?

A

Replicates:
Destroys cell
Causes inflammation
Spreads to/infects more cells

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10
Q

Enzymes important in HIV

A

Reverse transcriptase - ssRNA converted to dsDNA

Integrase - Viral DNA intergrated into host cells DNA

Protease - new viral particles cut to combine to form new activated virus

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11
Q

Receptors HIV binds to

A

CD4
CCR5
CXCR4

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12
Q

Transmission of HIV

A

Sexual contact

Transfusion

Contaminated needles

Perinatal (usually during delivery through infected birth canal or through breast milk)

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13
Q

Stages of HIV infection

A

Primary infection (seroconversion)

Latent infection

Symptomatic

Severe infection/AIDS

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14
Q

Primary infection

A

Flu like symptoms (CD4 low)

Viral load high - infectious

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15
Q

Latent infection

A

Viral load lowers
CD4 count recovers

Dormant virus

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16
Q

Symptomatic infection

A

CD4 count below 350

Viral load increasing

17
Q

Severe infection/AIDS

A

CD4 count below 200 cells per microlitre

Viral load very high

18
Q

Symptoms of HIV

A 
Malaise
Headache
Rash
Nausea/vomitting
Enlarged spleen
Mouth sores/thrush
Fever
Weight loss
19
Q

Factors affecting HIV transmission

A

Tye of exposure
Viral load in blood
Condom use
Breaks in skin/mucosa (from other STI’s/sexual assault)

20
Q

Highest risk of transmission from exposures

A

Transfusion (very high risk)
Anal intercourse (receptive) (1.1%)
Injection (1/149)

21
Q

Living with HIV now

A

Life expectancy and quality of life very good

80 years

22
Q

Factors affecting life expectancy with HIV

A

Early detection (good starting CD4 levels)
Treatment
Adherence
Healthy habits (no smoking, limit alcohol, exercise)

23
Q

HIV tests

A

Blood test - serology (test for antigen and antibody) - falso negative possible

PCR - highly sensitive (used for follow up not initial as expensive)

Rapid at home tests - low cost (finger prick, oral) false positives - confirm with serology

24
Q

Who should be tested?

A 
Everyone
Resp: bacterial pneumonia/TB
Neuro: meningitis/dementia/neurotoxoplasmosis
Derm: severe psoriasis 
Gastro: chronic diarrhoea/weight loss
Haem: anaemia with no cause?
Onc: lymphoma, anal cancer
Gynae: cervical intraepithelial neoplasia
ANY STI, HEPB, HEPC
25
Q

Treatment HIV

A

Anti-retroviral drugs

26
Q

Aims of HV treatment

A

Undetectable viral load = 0 risk of transmission
Restablish CD4 and immune system
Reduce systemic inflammation
Normal lifespan/quality of life

27
Q

Drug targets HIV

A

Attachment
Reverse transcriptase inhibitors
Protease inhibitors
Integrase inhibitors

28
Q

When to start HIV treatment?

A

CD4 <350

As early as possible

29
Q

Anti retrovirals classes

A

Nucleoside reverse transcriptase inhibitor AND

  • non nucleoside reverse transcriptase inhibitor OR
  • Protease inhibitor
    OR
  • Integrase inhibitor
    OR
  • CCR5 (entry) inhibitor
30
Q

Why do HIV patients need more than 1 ARV?

A

Virus mutates
Resistance to drug develops
2-3 drugs = harder to develop resistance

31
Q

Strategies to reduce HIV prevalance

A 
Condom use
ARV prevention treatment 
Testing/screening
Post exposure prophlaxis 
Male circumcision (voluntary)
32
Q

New HIV treatments

A

Pre exposure prophlaxis (if dont have HIV but at risk)

Dual therapy

Injectable drugs (every 2 months instead of daily)

Monoclonal antibodies (Ibaluzimab attachment inhibitor)

VACCINE??

33
Q

Ethical dilemmmas HIV

A

Psychological impact of diagnosis
Stigma
Patient confidentiality vs health of others

34
Q

Blood borne viruses examples

A

HIV
Hep B
Hep C

35
Q

Neurological problems associated with HIV

A

Neurotoxoplasmosis - parasite in brain

Infection 2023 (29 decks)

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