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
