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Spring 2022 > HIV > Flashcards

HIV Flashcards

1
Q

What class of drugs does Zidovudine (AZT) belong to?

A

Nucleotide Reverse Transcriptase Inhibitors (NRTIs)

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2
Q

What are the seven drug classes used to treat HIV?

A

Nucleotide Reverse Transcriptase Inhibitors (NRTIs)
Nucleoside Analogs
Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Protease Inhibitors (PT)
Entry Inhibitors
Integrase Inhibitors

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3
Q

Which two drugs make up Combivir?

A

Zidovudine (AZT) and Lamivudine

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4
Q

What three drugs make up Trizivir?

A

Zidovudine (AZT), Lamivudine, and Abacavir

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5
Q

Initial HIV treatment options

A

Three drugs from two different classes including an integrase inhibitor

  • Dolutegravir + Abacavir + lamivudine (Tiumeq)
  • Dolutegravir + Emtricitabine/TAF (Descovy)
  • Emtricitabine/TAF/elvitegravir with cobicistat boosting (Genvoya)
  • Raltegravir + Emtricitabine/TAF (Descovy)
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6
Q

Which two drugs make up Descovy, Truvada

A

Emtricitabine and Tenofovir Alafenamide (TAF)

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7
Q

Which drug is used for HIV PrEP?

A

Emtricitabine/Tenofovir Alafenamide

AKA Descovy or Truvada

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8
Q

What route of transmission carries the greatest risk for HIV?

A

Needle, especially large bore

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9
Q

What route of transmission is the most common in HIV?

A

Sex

Highest-to-lowest risk: Anal, vaginal, oral

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10
Q

Symptoms of acute HIV infection

A 
Listed by highest frequency to lowest:
Fever
Morbilliform rash**
Pharyngitis
Lymphadenopathy
Headache
Mucocutaneous ulcers
Thrombocytopenia
Leukopenia
Transaminase elevations

Differential: Mononucleosis
Dx: Monospot
Key differences: EXUDATIVE pharyngitis, rash rare unless PCN-like drug given, no ulcers, rarely GI symptoms, abundant atypical lymphocytes

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11
Q

HIV detection times for 3rd and 4th generation antibody tests

A

3rd gen: 21-24 days
4th gen: 14-15 days

Plasma HIV RNA within about 10 days

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12
Q

HIV Confidentiality Laws

A

Disclosed on a “Need to Know” basis only

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13
Q

HIV Testing Laws

A

Mandated to offer HIV testing to 13+
Must disclose 7 points of info r/t HIV available to patient
Verbal consent allowed
Must arrange follow-up if positive
HIV info may be released to medical providers and insurance without patient consent

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14
Q

Delivering HIV results

A

Negative - may be informal, remote

Positive - in person only

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15
Q

Reporting of Positive HIV Results

A

Mandated reporting to DOH

Identify partners/exposed

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16
Q

Can HIV+ individuals transmit the virus if their levels are undetectable?

A

No

17
Q

Management of HIV+ women in pregnancy

A

AZT (ZDV) administered orally during second and third trimester (14-34 weeks of pregnancy)
AZT IV infusion before and during delivery
AZT administered to infant for six weeks

18
Q

Indications for PEP

A

Occupational exposure
Sexual assault
nPEP - isolated incidence of exposure (sex, needle)

19
Q

Initiating PEP

A

Best within 2 hours or up 24 hours
Case-by-case basis if >36 hours (efficacy wanes)
Continue for 28 days

20
Q

PEP Regimens

A

Truvada [TRV]
(tenofovir [TDF] 300 mg/emtricitabine [FTC] 200 mg) one tablet daily + Isentress (raltegravir [RAL]) 400 mg BID

Duration X 28 days (or until PUI ruled out for HIV)

Follow-up x 12 weeks

Baseline LFTs, BUN, creatinine, CBC. HIV test, pregnancy test
Repeat LFTs, BUN, creatinine, CBC at 2 & 4 wks
HIV test at 4 and 12 weeks

21
Q

Injectable PrEP

A

Apretude (Cabotegravir)
Long-acting
Initiation: Give IM monthly x 2 months
Given every 2 months

May give PrEP to adolescents without parental consent

22
Q

Baseline data prior to initiating PrEP

A

4th generation HIV test, perform NAAT/viral load if acute HIV is suspected
Basic metabolic panel- PrEP contraindicated if CrCl<60ml/min for F/TDF; CrCl<30ml/min for F/TAF
Urinalysis
Serology for Hepatitis A, B, C - Vaccinate for A and B in non-immune individuals
STI screening. Perform 3 site (genital, rectal, pharyngeal) NAAT screening for GC, Chlamydia and RPR
Pregnancy test

23
Q

Monitoring during PrEP therapy

A

HIV test and NAAT/Viral Load q3m for oral regigen
HIV test and NAAT/Viral Load q2m for CAB inj
Confirm negative before refilling

STI testing q6m

Pregnancy test q3m

BUN, Cr, HepC, U/A q12m

Spring 2022 (14 decks)

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