HIV

Question 1

What type of virus is HIV?

Answer 1

Retrovirus and lentivirus.

Retroviruses reverse the usual flow of genetic information (RNA → DNA). Lentiviruses cause long incubation diseases with cancer and immune suppression.

Question 2

What does AIDS represent?

Answer 2

Progressive immune suppression caused by chronic HIV infection.

Question 3

What is the primary effect of HIV on the immune system?

Answer 3

Loss of CD4+ T lymphocytes, vital for cell-mediated immune function.

Question 4

How does HIV-1 differ from HIV-2?

Answer 4

HIV-1 is more common (95% of infections), rapidly disseminates, and progresses to AIDS in ~10 years untreated; HIV-2 is less common and less infectious.

Question 5

What are the primary modes of HIV transmission?

Answer 5

Blood, sexual contact, vertical (mother-to-child).

Question 6

What factors influence the risk of HIV transmission?

Answer 6

Viral load and exposure level.

Question 7

What are the stages of the HIV life cycle?

Answer 7

Binding and fusion, reverse transcription, integration, latency, transcription and translation, assembly and budding.

Question 8

What is the goal of Antiretroviral Therapy (ART)?

Answer 8

Achieve viral load < 50 copies/mL.

Question 9

What are predictors of success for ART?

Answer 9

Adherence, baseline viral load, resistance patterns.

Question 10

How many active medications are typically in an ART regimen?

Answer 10

Minimum of 2–3 active medications.

Question 11

What is the purpose of integrase inhibitors in ART?

Answer 11

Prevent viral genome integration.

Question 12

What do protease inhibitors do?

Answer 12

Prevent virus assembly.

Question 13

What is the nature of ART therapy?

Answer 13

Always combination therapy.

Question 14

What is a challenge regarding HIV medications?

Answer 14

Costly.

Question 15

What do AIDS Drug Assistance Programs (ADAPs) provide?

Answer 15

Support for HIV medications.

Question 16

What is the effect of ART on perinatal HIV transmission?

Answer 16

Reduces transmission to < 2%.

Question 17

What is recommended if maternal RNA is ≥ 1,000 copies/mL?

Answer 17

Cesarean section.

Question 18

What is discouraged in the U.S. regarding breastfeeding in HIV positive mothers?

Answer 18

Breastfeeding due to a 5% risk even with ART.

Question 19

What is Zidovudine (ZDV/Retrovir)?

Answer 19

A reverse transcriptase inhibitor.

Question 20

What is the half-life of Zidovudine?

Answer 20

3–6 hours.

Question 21

When should Zidovudine be started in neonates?

Answer 21

Within 6–12 hours of birth.

Question 22

What are the common adverse effects of Zidovudine?

Answer 22

Myelosuppression, fatigue, emesis, dark urine, jaundice.

Question 23

What are the monitoring requirements for Zidovudine?

Answer 23

Monitor CBC, educate parents, maintain 100% compliance.

Question 24

What are Lamivudine and Nevirapine classified as?

Answer 24

Reverse transcriptase inhibitors.

Question 25

What is a key difference between Nevirapine and Zidovudine?

Answer 25

Nevirapine is a non-nucleoside RTI and undergoes liver metabolism.

Question 26

What is necessary for ongoing monitoring of patients on ART?

Answer 26

LFTs, bilirubin.

Question 27

What are the side effects of Nevirapine?

Answer 27

Rash, hyperbilirubinemia.

Question 28

What should be monitored in case of ART failure?

Answer 28

Adherence, mental health, metabolic changes, co-infections, substance use.

Question 29

What are the transmission routes of pediatric HIV?

Answer 29

In utero, delivery, or breastfeeding.

Question 30

When should ART be started during pregnancy?

Answer 30

During pregnancy.

Question 31

When should antibody testing occur for pediatric HIV?

Answer 31

From birth to 18 months.

Question 32

What is the approach to treating infants with HIV?

Answer 32

More aggressive; early treatment needed.