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Flashcards in HIV Deck (12)
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1

Pathology

HIV binds to CD4
-Depletion and impaired function of CD4+ cells →
immune dysfunction

2

Virology

ssRNA retrovirus
1. After entry, viral reverse transcriptase makes DNA
copy of viral RNA genome.
2. Viral integrase enzyme integrates this with host DNA
3. Core viral proteins synthesised by host and then cleaved by viral protease into mature subunits
4. Completed virions released by budding

3

Acute infection

Normally asymptomatic
Transient illness 2-6wks after exposure
Fever, malaise, myalgia, pharyngitis, macpap rash

4

AIDS

AIDS

5

Diagnosis

ELISA: detect serum (or salivary) anti-HIV Abs
Western Blot: for confirmation
PCR: can detect HIV virions Rapid Antibody Tests: results should be confirmed by Western Blot

6

Stages

Stage 1:
- Primary infection - Cd4+ > 500 cells - asymptomatic

Stage 2:
Latent infection - Cd4+ < 500 cells - mild symptoms

Stage 3:
Symptomatic infection- Cd4+ < 350 cells - advanced symptoms

Stage 4 AIDS- cd4+ < 200 cells - HIV or AIDs - severe symptoms

7

AIDs defining illnesses

Kaposi's sarcoma - vascular neoplasm caused by herpes
Pneumocystis Pneumonia - pneumocystis jiroveci fungus
Oral candidiasis

8

Testing

Opt out approach

9

HAART

2 x nucleoside reverse transcriptase inhibitors
AND 1 :
• Non-nucleoside reverse transcriptase inhibitor
• Protease inhibitor
• Integrase inhibitor
• CCR5 inhibitor

10

When to give HAART

As soon as possible

11

HIV exposure

Post-needle-stick = 0.3% (1/300)
- Report to occupational health
- Immunise against hep B (active + passive)
- Test blood from both parties: HIV, HBC, HCV
- Repeat recipient testing @ 3 and 6mo

12

PEP

Post exposure prophylaxis
- In high-risk exposure from HIV + or unknown source.
- Start ASAP
- Continue for at least 28d