HIV

Question 1

What is the process of being infected with HIV

Answer 1

An initial seroconversion causes a flu-like illness occurs within a few weeks ofinfection, the infection is then asymptomatic until the condition progresses to immunodeficiency after the virus enters and destroys the CD4 T-helper cells of immune system. The patient then develops an AIDS-defining illness and opportunistic infections which can occur years after initial infection

Question 2

Transmission of HIV

Answer 2

Unprotected anal, vaginal or oral sex, mother to child at any stage of pregnancy, birth or breastfeeding, mucous membrane, blood or open wuound exposure to infected blood or bodily fluids

Question 3

What is AIDS-defining illness

Answer 3

Infections which occur when the CD4 count has dropped to a level which allows for unusual infections and malignancies to occur, it is associated with end stage HIV

Question 4

Examples of AIDS-defining illnesses

Answer 4

Kaposi’s sarcoma
PCP
CMV
Candidiasis
Lymphomas
TB

Question 5

When will antibody tests be reliable for picking up HIV infection

Answer 5

3 months after exposure

Question 6

What does PCR testing reveal

Answer 6

Testing for the HIV RNA levels tests directly for the number of viral copies in the blood, giving a viral load

Question 7

What is monitored during individuals with known HIV

Answer 7

CD4 count and viral load

Question 8

What CD4 count indicateds AIDS

Answer 8

Under 200 cells/mm3

Question 9

When is a viral load of HIV considered undetectable

Answer 9

Viral load below labs recordable range which is usually 50-100 copies/ml

Question 10

What does treatment of HIV involve

Answer 10

Antiretroviral therapy (ART)

Question 11

Examples of NRTIs

Answer 11

Tenofovir and emtricitabine

Question 12

Example regimines for HIV

Answer 12

Two NRTIs plus third agent

Question 13

Different classes of highly active anti-retrovirus therapy medication (HAART)

Answer 13

Protease inhibitors
Integrase inhibitors
Nucleoside reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
Entry inhibitors

Question 14

Additional management for prophylaxis against AIDS illnesses

Answer 14

Co-trimoxazole for PCP and those with CD4 count below 200.
CVD risk factors monitored
Cervical smears for HPV
Vaccinations such as influenza, pneumococcal, hep A and hep B, tetanus, diptheria and polio

Question 15

What is PEP

Answer 15

Post-exposure prophylaxis which is used after exposure to HIV to reduce risk of transmission.

Question 16

When must PEP be commenced

Answer 16

Within 72 hours and the sooner the better

Question 17

Current regimine for PEP

Answer 17

ART therapy using Truvada and raltegravir for 28 days

Question 18

What is PREP

Answer 18

Pre-exposure therapy which is taken before suspected sexual activity or activities which risk transmission form others

Question 19

What are the different PREP regimines

Answer 19

4 times a week - T’s and S’s
Once daily
2 tablets 2-24 hours before, day of and 1 tablet for 2 days after event

Question 20

What are the optinos for reducing transmission during birth

Answer 20

Caesarean, IV zidovudine, prophylaxis treatment.

Question 21

What is Kaposi’s sarcoma

Answer 21

Cancer cells are found withing the skin of mucous membranes which line the GI tract.

Question 22

Presentation of Kaposi’s sarcoma

Answer 22

Purple patchs or nodules on the skin and/or mucous membranes
Lymphadenopathy

Question 23

Cause of kaposi’s sarcoma

Answer 23

HHV-8

Question 24

What is pneumocystis pneumonia (PCP)

Answer 24

Infection of lungs by the fungus pneumocystis jirovecii

Question 25

Presentation of PCP

Answer 25

Fever, cough, dyspnoea, respiratory failure