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Flashcards in Diagnosis of HIV pts Deck (96)
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31

How long can HIV-1 RNA be detected before the detection of HIV ab?

1-3 weeks

32

Do HIV antibodies assays detect HIV-1 or HIV 2?

Both

33

True or false: HIV antibody/antigen testing, if positive, needs to be followed up by a second test.

True

34

What is the gold standard for diagnosing HIV?

ELISA (99.7% sensitive, 99.9% specific)

35

How sensitive/specific are the rapid tests for HIV?

Very, both above 99.5%

36

What is the confirmatory tests for HIV?

-Multispot HIV-1/HIV-2

37

If the reactive HIV ag/ab test is positive, and the multispot confirmatory test is negative, what is the next step in diagnosis?

HIV-1 nucleic acid testing

38

What is the sequence of HIV testing?

-HIV ab/ag screen
-Multispot
-HIV1 nucleic acid testing if multispot is negative

39

What is the role of HIV screening?

-Opt-out testing
-Offered to all pregnant women

40

Where, geographically, is HIV-1 found more often? HIV-2?

HIV-1 = US
HIV-2 = Africa

41

How does HIV-2 compare to HIV-1 in terms of virulence and transmissibility?

HIV-2 is less virulent, and less easily transmittable

42

What are the two receptors on CD4 cells for HIV? Which is more common, and which progresses more rapidly?

-CCR5 or CXCR4

-CCR5 = major one that is transmittable
-CXCR5 = more rapid progression

43

What is the role of gp120?

Antigen that varies--determines tropism

44

What happens to the pathogenicity of an HIV virus if the tropism changes from CCR5 to CXCR4?

more virulent

45

What is the role of delta 32 deletion in humans (hetero and homozygous)?

If have homozygous, then less susceptible to HIV virus

If heterozygous, then slower progression

46

What is the ligand for CCR5 on cells?

beta-chemokine

47

What is the treatment for kids born to HIV+ mothers? (3)

-Have mom on HIV antiretrovirals
-Do not breastfeed
-Give baby post-exposure prophylaxis

48

True or false: the placenta is a good barrier for the prevention of HIV positive infants

True

49

What is the most common route of transmission of HIV from mother to fetus?

During vaginal delivery

50

What is the viral load goal for mother's who are HIV+? Can they deliver vaginally if they meet this requirement?

-Less than 100
-Vaginal delivery okay if this is met

51

Can breast milk transmit HIV?

Yes

52

What is the normal CD4 count?

More than 750

53

True or false: syphilis occurs at any CD4 count

True

54

True or false: syphilis occurs mostly in women

False

55

True or false: syphilis usually spares the eyes

False

56

True or false: syphilis rarely involved the oral mucosa

False

57

What are the ssx of secondary shyphilis?

Patchy rashes--condyloma lata

58

How infectious are the condyloma lata of syphilis?

Very

59

In what risk group is syphilis incidence rising?

MSM

60

Should you wait to treat suspected pneumocystis in order to obtain a good culture?

Nah--will not affect culture