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Flashcards in HIV Deck (39):
1

are youth afflicted by HIV

yes. 25% of new infections are between 13-24

2

what is HIV

infection with human immunodeficiency virus

3

what is AIDS

end-stage HIV infection

4

is HIV enveloped

yes

5

HIV genome

ssRNA

6

how does HIV replicate

via DNA intermediate

7

where did HIV come from

zoonoses from central and western africa. primate-to-human jumping events. simian is the immediate precursor.

8

how is HIV transmitted

sexual at genital or colonic mucosa. exposure to infected fluids such as blood. mother-to-infant. accidental occupational exposure.

9

how does HIV enter the cells?

initial interaction between gp120 and CD4, secondary interaction between gp120 and CCR5. the distal tips of gp41 are inserted into the membrane. gp41 undergoes a significant conformational change and pulls the virus and cellular membranes together, fusing them

10

steps of HIV replication

fusion > reverse transcriptase synthesizes RNA into DNA > integrase integrates the DNA into the host genome > replication and transcription occur after

11

why is HIV so successful

because of its remarkable variability. this results in phenotype diversity, immune escape, resistance to RT and protease inhibitors. there is underlying variation caused mutation, high rate of viral turnover, selection of viral variants.

12

what is the most common source of transmission

male homosexual contact

13

what are the factors that influence HIV spread

sexual behavior, male circumcision, demography and social context, gender, stigma and discrimination

14

stage 0 HIV

negative test within 180 of positive test

15

stage 1 HIV

CD4>500 %>26

16

stage 2 HIV

CD4 cells 200-499 %14-25

17

stage 3 HIV

CD4 cells <14

18

bacterial AIDS defining infections

multiple or recurrent bacterial infections, mycobacterium disseminated or extrapulmonary, salmonella species recurrent.

19

fungal AIDS defining illnesses

candidiasis of esophagus or upper airway, coccidiomycoses disseminated or extrapulmonary, cryptosporidiosis chronic intestinal, histoplamosis disseminated or extrapulmonary, pneumocystis jirovecii pneumonia

20

viral AIDS defining illness

CMV other than liver, spleen, nodes, CMV retinitis (with loss of vision), progressive multifocal leukoencephalopathy.

21

parasitic AIDS defining illnesses

isosporiasis, chronic intestinal, toxoplasmosis of the brain

22

AIDS defining cancers

invasive cervical cancers, karposi sarcoma, lymphoma (burkitt, immunoblastic, brain

23

what is the clinical presentation of acute HIV infection

fever, weight loss, malaise, headache, neuropathy, pharyngitis, mouth sores, thrush, esophageal sores, myalgia, liver and spleen enlargment, LAD, skin rash, nausea and vomiting.

24

symptoms of AIDS

meningitis, encephalitis, retinitis, pneumocystis pneumonia, TB, tumors, skin tumors, GI esophagitis, chronic diarrhea, tumors.

25

what are the clinical suspicions for AIDS

high risk behavior or exposure, febrile illness, mononucleosis syndrome, aseptic meningitis, rash, mucocutaneous ulcers, diarrhea, LAD.

26

IgM/IgG + p24 antigen time

15-24 days

27

HIV RNA test

10-15 days

28

HIV antigen tests?

they have variable sensitivities

29

western blots?

35-50 days indeterminate, 45-60 positive

30

what is in the differential for HIV

mononucleosis, toxoplasmosis, rubella, syphilis, hepatitis, gonococcal infection, lupus or other autoimmune diseases.

31

what bacterial infections are suspected in HIV patients

recurrent pneumonias, tuberculosis ,

32

what fungal infections are suspected in HIV patients

jirovecii, and other endemic fungus

33

what viral and parasitic infections are suspected in HIV

rare.

34

when there is cough and fever in HIV with CD4 count DDX

sinusitis, bronchitis, bacterial pneumonia, tuberculosis

35

when there is cough and fever in HIV with no CD4 count DDX

PCP, disseminated fungal disease, CMV

36

small bowel diarrhea

watery large volume, bloating, gas, cramping, weight loss.

37

large bowel diarrhea

frequency, small volume, painful, weight loss uncommon

38

anorectal diarrhea

history of receptive anal intercourse, severe tenesmus, dyschezia, urgency.

39

what antiviral drugs can cause diarrhea

lopinavir, fosamprenavir, atazanavir