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afsha - infections > HIV > Flashcards

HIV Flashcards

1
Q

what type of virus is it

A

retrovirus

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2
Q

how does it cause immunodeficiency

A

infecting and destroying cells of immune system, particularly the CD4 cells

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3
Q

When does AIDs occur

A

when number of CD4 cells falls below 200 cells/microlitre

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4
Q

why is AIDS dangerous

A

opportunistic infections and malignancies (AIDS defining illnesses) can develop

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5
Q

what is the greatest risk to excess mortality and morbidity

A

delayed HIV diagnosis and treatment

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6
Q

aims of treatment

A
  • achieve undetectable viral load
  • preserve immune funciton
  • reduce motility and morbidity associated with chronic HIV infection
  • reduce onward transmission of HIV Infection
  • minimise drug toxicity
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7
Q

which patients with HIV need to be given immediate treatment?

A

ALL irrespective of CD4 cell counts

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8
Q

a patient has just been diagnosed as HIV positive. their CD4 cell count is relatively unaffected at the moment. when should you initiate treatment

A

straight away for all patients regardless of CD4 cell count

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9
Q

what does treatment naive mean

A

never taken ARV drugs

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10
Q

treatment of HIV Infection in treatment-naive pt

A

backbone is two nucleoside reverse transcriptase inhibitors (NRTIs) + one of the following as a third drug: integrase inhibitor (INI), non nucleoside reverse transcriptase inhibitor (NNRTI), or a boosted protease inhibitor (PI)

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11
Q

regimen of choice for treatment of HIV Infection in treament naive patients
(2 NRTIs + NNRTI/INI/bPI)

A

backbone: emtricitabine and tenofovir disoproxil/aladenamide
alternative backbone: abacavir and lamivudine

The third drug of choice is either atazanavir or darunavir both boosted with ritonavir, or dolutegravir, or elvitegravir boosted with cobicistat, or raltegravir, or rilpivirine.

Efavirenz may be used as an alternative third drug.

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12
Q

Patients who require treatment for both HIV and chronic hepatitis B should be treated with antivirals …

A

active against both diseases as part of fully suppressive combination ART

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13
Q

regimens of choice for pt who need treatment for both HIV and chronic Hep B (they ned to be active against both diseases)

A

tenofovir disoproxil + emtricitabine

tenofovir alafenamide + emtricitabine

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14
Q

when may you need a change in therapy in pt taking HIV treatment

A

e.g. CD4 cell count changes, clinical, virological changes

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15
Q

what is vertical transmission

A

mother to baby

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16
Q

management of HIV infection in pregnancy should focus on

A
  • ell being of pt
  • ensure ART regimen maximally suppresses viral replication ASAP, if possible before conception in order to minimise vertical transmission
17
Q

does treatment need to be stopped or changes in women who are living with HIV who become pregnant whilst on effective ART

A

no continue this treatment throughout pregnancy

18
Q

what to do if a woman gets HIV whilst pregnant

A

start ART treatment during pregnancy

19
Q

recommended regimen for ART for HIV for a woman who gets HIV whilst pregnant

A

NRTI backbone: tenofovir disoproxil or abacavir with either emtricitabine or lamivurdine

3rd drug: efavirenz or atazanir boosted with ritovavir

all need to be assessed by specialist

20
Q

do pregnancies in women with HIV and babies born to them need to be reported?

A

yes to National Study of HIV In pregnancy and childhood care AND to the ARV pregnancy register

21
Q

can mothers with HIV positive mothers breast feed infant?

A

avoid because this can cause HIV Infection in the infant

22
Q

risk of acquiring HIV is higher in these 3 sets of people

A
  • MSM (unprotected anal intercourse)
  • sexual partners of people who are HIV positive WITH a detectable viral load
  • HIV negative heterosexual people who have unprotected intercourse with HIV positive pt and are likely to repeat this with the same person or another person with a similar status
23
Q

a patient is a sexual partner of a person who is HIV positive with an undetectable viral load. do they have a high risk of acquiring HIV

A

no, sexual partners of people who are HIV-positive with a detectable viral load do

24
Q

what treatment may be appropriate for pre exposure prophylaxis to reduce risk of sexually acquired HIV-1 infection in combination with safer sex practices in adults at high risk

A

emtricitabine with tenofovir disoproxil

TD alone is an alternative for HIV negative heterosexuals when E is contraindicated

25
Q

post exposure prophylaxis of HIV - what to do and does it require treatment

A

prompt prophylaxis with ARV drugs (unlicensed indication)
seek immediate expert advice
may also be approbate following potential sexual exposure to HIV where there is a significant risk of viral transmission

26
Q

recommended treatment for post exposure prophylaxis

A

emtricitabine + tenofovir disoproxil + raltegravir
28 days

afsha - infections (30 decks)

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