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Infectious Disease II (P3 Spring) > Exam 2: HIV (Obrien) > Flashcards

Exam 2: HIV (Obrien) Flashcards

(59 cards)

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1
Q

1 in _____ are unaware that they are infected with HIV

A

7 (about 15%)

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2
Q

There are 2 main types of HIV.
HIV 1:_____
HIV 2:________ (2)

A

HIV 1: most widespread

HIV 2: less prevalent; found mainly in western africa

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3
Q

T/F The rates of HIV and AIDS diagnoses are LOWER in the South

A

FALSE; HIGHER

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4
Q

Overall, who is at the highest risk of acquiring HIV? (2)

A
  • African Americans (MSM)

- Hispanics

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5
Q

In order for HIV transmission to happen, what 4 conditions need to be present?

A
  • presence
  • quality
  • route
  • susceptibility
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6
Q

What 5 fluids have the HIGHEST amount of HIV which allows it to be easily transmitted?

A
  • blood
  • semen
  • vaginal secretions
  • rectal secretions
  • breast milk
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7
Q

What is the MOST common mode of transmission of HIV?

A

sexual, specifically receptive anal intercourse

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8
Q

The highest cause of pediatric HIV is due to PERINATAL transmission. How can this occur? (3)

A
  • during pregnancy (cross the placenta)
  • during birth
  • breast feeding
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9
Q

T/F Despite ART being highly effective at preventing transmission, fewer than 1/3 of HIV infected individuals have suppressed viral loads

A

TRUE

-due to undiagnosed HIV infection and failure to link or retain pts care

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10
Q

What is the first step in REDUCING the spread of HIV?

A

testing

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11
Q

The CDC advises routine HIV screening of (3)…. in the health care setting in the US

A

adults, adolescents, pregnant women

EVERYONE 13-64 y/o should be tested at least ONCE

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12
Q

How often should someone with risk factors be tested for HIV?

A

annually

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13
Q

HIV tests for Screening and diagnosis

-detect the PRESENCE OF ANTIBODIES that a person’s body makes AGAINST HIV

A

antibody test

home test and rapid test

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14
Q

HIV tests for Screening and diagnosis

  • detect both HIV antibodies AND antigen (p24)
  • recommended for initial testing
A

combination OR fourth generation tests

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15
Q

HIV tests for Screening and diagnosis

  • detects HIV the FASTEST by looking for HIV in the blood
  • NOT routinely used for HIV screening
A

NAT (nucleic acid test)

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16
Q

What are the 4 phases of HIV development?

A

1 eclipse period
2 seroconversion
3 acute infection
4 established HIV infection

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17
Q

What phase of HIV?

  • there are no detectable markers
  • time between infection and first detection of HIV
A

eclipse period

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18
Q

What phase of HIV?

-time between when the pt is infected w/ HIV and when ANTIBODIES DEVELOP

A

seroconversion

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19
Q

What phase of HIV?

  • when RNA plasma is present in the body
  • antibodies start developing
A

acute infection

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20
Q

What phase of HIV?

-when pt starts to develop IgG antibodies

A

established HIV infection

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21
Q

______ is detectable by 3rd generation test

A

IgM

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22
Q

Phases of HIV antibodies and antigens (4)

A

HIV RNA—> p 24 antigen–> IgM —> IgG

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23
Q

How many tests are needed to confirm that a pt has HIV?

A

2

the second test is typically what differentiates between HIV-1 and HIV-2

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24
Q

HIV Home test?

-involves pricking finger to collect blood sample

Study These Flashcards
A

home access HIV-1 test system

25
HIV Home test? - involves swabbing your mouth for oral fluids - up to 1 in 12 infected ppl may have false- negative test
OraQuick In-Home HIV test
26
T/F Rate of sexual transmission during acute infection is 26 times as high as that during established HIV infection
TRUE
27
CD4 count vs. CD4 %
- CD4 Count: is the absolute number of CD4 cells | - CD4%: percentage of lymphocytes that are CD4
28
Stage 1 of HIV infection
greater than or equal to 500 CD4 cells
29
Stage 2 of HIV infection
200-499 CD4 cells
30
Stage 3 of HIV (3)
also known as AIDS - less than 200 CD4 cells - OR documentation of AIDs defining conditions
31
Although the clinical presentation of HIV varies and is nonspecific, most patient present with.....
mononucleosis-like illness for about 2 weeks | fever, HA, sore throat, fatigue, GI upset, weight loss, myalgia, rash, night sweats
32
What are the 2 Main laboratory markers of HIV?
- high viral load | - persistent DECREASE in CD4 lymphocytes
33
Describe the POST ACUTE PHASE of HIV latency CD4 count ________ HIV RNA plasma _____
CD4 increases in the blood again | HIV RNA declines
34
What is the best marker of immune fxn in pts w/ HIV?
CD4 count
35
How often is CD4 count obtained?
every 3-6 months
36
How often is the HIV viral load obtained? (2)
every 3-6 months OR | 2-8 weeks after initiation or change in ART
37
Genotype vs. Phenotype
GENOtype: genes known to be specific mutations within the virus (USED AT BASELINE) PHENOtype: how the drug affects the PATIENTS virus -can asses interactions between mutations (QUALITATIVE MEASURES)
38
T/F HIV is most powerful co-factor for development of active TB
TRUE
39
Besides TB, what other opportunistic infections are screened for in pts with HIV? (4)
- toxoplasmosis (IgG) - syphilis (RPR) - varicella (IgG) - STDs
40
What screening is recommended? Recommended before starting patients on ABACAVIR-containing regimens to REDUCE the risk of hypersensitivity reaction (HSR)
HLA-B* 5701 usually done at baseline if patient is POSITIVE, then they should not be prescribed abacavir
41
What screening is recommended? | Identifies pts at risk for DAPSONE or PRIMAQUINE associated hemolysis
G6PD usually done at baseline
42
A patient SHOULD NOT receive a LIVE virus if CD4 count is
less than or equal to 200/mm
43
What immunizations do pts with HIV need? (5)
- influenza (annually) - pneumococcal vaccine - tetanus and diphtheria - Hep A and Hep B
44
A patient's HIV is considered UNDETECTABLE when .....
the viral load is below 50 copies/mL
45
How do we achieve the goals associated with ART?
combo of THREE active antiretroviral agents from TWO different classes
46
When should ART be started for HIV patients?deferred?
immediately to reduce morbidity and mortality AND prevent HIV transmission UNLESS pts has clinical and/or psychosocial factors that show pt will be non-adherent (tx needs to be deferred)
47
What 2 studies showed that immediate start of ARTs resulted in a 50% reduction in morbidity and mortality?
- START - TEMPRANO regardless of CD4 count--> start immediately
48
If you are switching PK booster (Ritonavir to Cobistat OR vice versa) what do you need to consider?
drug interactions b/c both inhibit CYP 3A4
49
What is the backbone of tx for naive patients w/ HIV?
2 NRTIs PLUS - PK-enhanced PI - NNRTI - INSTI
50
Initial regimens for MOST ppl with HIV are usually _____ based
INSTI (gravir)
51
How are the NRTIs usually paired?
abacavir + lamivudine OR | tenofivir (TDF or TAF) + emtricitabine
52
Virologic Def: | HIV RNA level below the level of detection
virologic SUPPRESSION
53
Virologic Def: | inability to achieve or maintain suppression of virologic replication to an HIV RNA level <200 copies/mL
virologic FAILURE
54
Virologic Def: TWO consecutive HIV RNA levels ≥200 copies/mL after 24 weeks on an ARV regimen in a patient who has not yet documented virologic suppression
incomplete virologic response
55
GENOTYPE resistance pattern: | M184V (3)
- emtricitabine - lamivudine - PLUS/MINUS abacavir
56
GENOTYPE resistance pattern: | K65R
- tenofovir | - abacavir
57
GENOTYPE resistance pattern: | K103N
Efavirenz
58
Sometimes, we keep pts on Emtricitabine or Lamivudine even though they are resistant , why?
b/c it makes the virus LESS virulent | both drugs have less SE
59
What drug is used for PREP?
Truvada

Infectious Disease II (P3 Spring) (13 decks)

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