HIV

Question 1

thrush

Answer 1

is a white patch on the tongue that is a classic sign of HIV

Question 2

what year did HIV begin to gain notice?

Answer 2

1981

Question 3

HIV 1

Answer 3

is from chimps and found worldwide

Question 4

HIV 2

Answer 4

is from the sooty mangabey and is found primary in west Africa

Question 5

where are majority of people with HIV living?

Answer 5

in south and central Africa

Question 6

HIV prevalence in Canada

Answer 6

is much lower compared to the rest of the world, and the prairies are affected the most

Question 7

are HIV numbers increasing or decreasing?

Answer 7

decreasing but not much

Question 8

what groups is most affected by HIV?

Answer 8

young people ages 30-39 and men who have sex with men, followed by people who inject drugs

Question 9

receptor for HIV virus

Answer 9

CD4 molecule

Question 10

unique step of HIV virus cycle

Answer 10

reverse transcription which means the virus goes from RNA to DNA that is then injected into our DNA

Question 11

what cells does HIV infect?

Answer 11

CD4+ cells

Question 12

other name for CD4+ cells

Answer 12

T-helper cells; these can also be macrophages

Question 13

normal range of CD4 cell count

Answer 13

400-1200 cells / uL

Question 14

normal range from HIV viral load

Answer 14

< 40 - 10 million

Question 15

goal of treatment in regards to HIV viral load

Answer 15

< 40 count

Question 16

criteria for HIV induced immune activation

Answer 16

increased T cell turnover, increased activation-induced death of T cells, a decline in the size of the CD4+ cell pool, and a state of activation-induced immunodeficiency

Question 17

what would a high viral load and a decreasing CD4+ count mean?

Answer 17

that you will get AIDS soon

Question 18

what does a low viral load and high CD4+ count mean?

Answer 18

that AIDs is delayed

Question 19

primary infection stage

Answer 19

is right after initial exposure and is the first stage of sickness when the immune system hasn’t caught up yet, but it recovers which leads to the phase of clinical latency

Question 20

clinical latency stage

Answer 20

is the stage lasting about 4-7 years when the virus and CD4+ cells are balanced, no symptoms are present here

Question 21

AIDS

Answer 21

is the acquired immunodeficiency stage of HIV when opportunistic infections are present, leading to death

Question 22

CD4+ count of pneumocystis pneumonia

Answer 22

< 200

Question 23

CD4+ count for cerebral toxoplasmosis

Answer 23

< 100

Question 24

cerebral toxoplasmosis

Answer 24

infection in the brain due to the activation of antigens that we are exposed to from being around pets

Question 25

CD4+ count for cytomegalovirus retinitis

Answer 25

< 50

Question 26

2 broad stages to approaching HIV infection in adults

Answer 26

1. confirm diagnosis and 2. confirm symptoms

Question 27

2 step process to confirm HIV diagnosis

Answer 27

initial screening and confirmatory immunoblot

Question 28

initial screening of HIV stage

Answer 28

detects antibodies to HIV virus but is highly sensitive so a lot of false positives can occur

Question 29

confirmatory immunoblot stage for HIV diagnosis

Answer 29

is an EIA test that looks for the presence of multiple antibodies and this is a true diagnosis test

Question 30

window period for HIV

Answer 30

14-21 days for the antigen and 7-10 days for RNA

Question 31

eclipse period

Answer 31

is the first 10 days following HIV exposure and no test can confirm diagnosis at this point

Question 32

diagnosing HIV during acute infection period

Answer 32

is not really accurate and looks at RNA testing

Question 33

accuracy for diagnosing HIV antigens

Answer 33

after 2.5 weeks and is 50% certainty

Question 34

when can a 100% certainty diagnosis of HIV be made?

Answer 34

around 6 weeks

Question 35

confirming symptoms phase of HIV diagnosis

Answer 35

looking for symptoms related to acute, advanced, and opportunistic infections and evaluating for co-infection

Question 36

symptoms related to acute HIV infection

Answer 36

fever, sore throat, headaches, and rash

Question 37

symptoms related to advanced HIV infection

Answer 37

weight loss, lymphadenopathy, and night sweats

Question 38

symptoms related to opportunistic infections

Answer 38

head to toe review, e.g. headaches (from meningitis), visual changes, shortness of breath, and dirrhea

Question 39

what infections have similar modes of transmission to HIV?

Answer 39

hep B and C, syphilis, and tuberculosis

Question 40

when to start antiretroviral therapy?

Answer 40

ASAP following diagnosis

Question 41

example of actions of antiretroviral drugs?

Answer 41

reverse transcriptase, integrase inhibitors, protease inhibitors, CCR5 antagonist, and entry inhibitors

Question 42

HIV drug cocktail

Answer 42

3 agents: this includes 2 nucleoside reverse transcriptase inhibitors + 1 integrase inhibitors or 1 non-nucleoside reverse transcriptase inhibitors or 1 protease inhibitor

Question 43

HIV treatment in the 1990s

Answer 43

was lots of different pills with lots of different side effects

Question 44

HIV treatment in 2010s

Answer 44

was a 2 pill combination and less side effects

Question 45

how many pills for PEP and PrEP now?

Answer 45

1 a day or injections x2/week

Question 46

UNAIDS 2020 goals

Answer 46

90% diagnosed, 90% on treatment, and 90% virally suppressed

Question 47

UNAIDS 2030 goals

Answer 47

95% diagnosed, 95% on treatment, and 95% virally suppressed

Question 48

is male-to-female or female-to-male HIV transmission higher?

Answer 48

male-to-female

Question 49

below what value of HIV virus can you not transmit HIV?

Answer 49

> 40

Question 50

U=U meaning

Answer 50

undetectable = untransmittable

Question 51

PEP meaning

Answer 51

post exposure prophylaxis

Question 52

PEP

Answer 52

provision of standard combination antiretroviral therapy to prevent HIV transmission after a consensual high risk exposure (sexual, needle sharing)

Question 53

PrEP

Answer 53

provision of antiretroviral agents to prevent HIV infection prior to high risk exposure

Question 54

steps of PEP

Answer 54

1. consider type of exposure 2. assess type of exposure

Question 55

body fluids that can be infectious for HIV

Answer 55

CSF, pleural/peritoneal/amniotic fluid

Question 56

what bodily fluids are not considered infectious for HIV?

Answer 56

tears, saliva, sweat, vomitus, urine, and stool (those that don't contain blood)

Question 57

what type of exposure is the highest risk for HIV?

Answer 57

hollow bore/large gauge needle, 1/300

Question 58

highest risk of sexual exposure for HIV

Answer 58

condomless anal sex

Question 59

how long is the course of PEP?

Answer 59

28 days

Question 60

how late is it to start PEP?

Answer 60

after 72 hours

Question 61

what is done following PEP?

Answer 61

HIV testing at week 6 and 12

Question 62

what group of those who took PrEP had 0% incidence?

Answer 62

those taking at least 4/7 pills a week

Question 63

application of HIV to PT

Answer 63

PTs often treat those with co-morbidities (especially in older age groups), those with muscle pain, and those living with joint pain