HIV Flashcards
(26 cards)
What are the three methods of vertical transmission of HIV?
- In utero transmission 2. During delivery 3. Through breastfeeding
What are the major drivers of mother-to-child transmission (MTCT)?
- Maternal viral load
- Mode of delivery
- Breastfeeding
What are the prevention methods for transmission in a reactive mother? x3
- ART therapy
- Avoiding mixed feeding
- Avoiding prolonged rupture of membranes
Which babies are considered high risk for HIV transmission?
- Maternal interruption of ART
- Initiation of ART in 2nd or 3rd trimester
- Low level viremia or VL >1000 during pregnancy, birth or 4weeks post partum
What are the contents of 2P?
- Lamivudine, zidovudine and nevirapine
What is the management for low-risk and high-risk infants?
Low-risk: 1. Nevirapine syrup 2. CPT
High-risk: 1. Lamivudine, zidovudine and nevorapine ie 2P 2. CPT
Why is a rapid test not done for exposed infants? x2
- False negatives for window period
- False positive due to maternal antibodies
Describe the testing and management for infants under 12 months.
If Rapid test is positive and there is signs of AIDS initiate ART, if not continue HCC
If DNA PCR is positive initiate ART, if not continue HCC
When is cotrimoxazole prophylaxis therapy (CPT) started? And why
CPT is started at 4-6 weeks of age for HIV-exposed infants. After neonatal period because of risk of jaundice and kernicterus since it’s MOA is to dislodge bilirubin from albumin
When do you discharge from the HIV care clinic (HCC)?
Discharge occurs when the infant has a negative rapid HIV test more than 6 weeks after stopping breast feeding
What drug is used when there is hepatitis B co-infection?
Entecavir
What are the side effects of AZT and ABC?
AZT: 1. Lactic acidosis 2. Bone marrow failure
ABC: 1. Hypersensitivity reaction
What is the first-line ART for children?
LAD: Abacavir, lamivudine and dolutegravir
What is the side effect of TDF and alternative drugs?
Side effect: Renal toxicity. Alternatives: 1. ABC 2. AZT
What are the drug interactions for DTG and their solutions x2
Antiepileptic drugs eg Carbamazepine. Solutions: Increase dosage of DTG, Change the AEDs
Which classes are considered as backbone in ART?
Protease and integrase inhibitors
How do you calculate CD4 percentage?
CD4 % is calculated by dividing the absolute CD4 count by the total lymphocyte count and multiplying by 100.
What are opportunistic infections that can occur at all CD4 count levels x5
- Tuberculosis
- Influenza
- Hep A
- Hep B
- Strep pneumo
What are the differential diagnoses for respiratory distress in an HIV-infected infant?
- Pneumocystis pneumonia
- Bacterial pneumonia 3. Miliary Tb
- CMV pneumonitis
- Lymphoid interstitial pneumonitis
What is the treatment x2 and duration for PJP?
- Trimethoprim sulfamethoxazole TMP-SMX for 21 days.
- Steroids
What are the features of lymphocytic interstitial pneumonia (LIP)? x5
- Hepatomegaly
- Parotid enlargement
- Lymph node enlargement
- Refractory TB
- Finger clubbing
What is the management of LIP? x2
- Prednisone
- Treat secondary bacterial pneumonia
Differential diagnosis for reactive child with seizures x4
Meningitis -Tb or crypto
HIV encephalopathy
CNS toxoplasmosis
Stage 2 HIV x7
Seborrhea
Recurrent URTI
Herpes zoster
Angular chelitis
Recurrent oral ulcers
Parotid enlargement
Molliscum contagiosum
