HIV

Question 1

tat

Answer 1

transactivator of transcription: enhances rate of transcription
drives from latent to active replicative state

Question 2

rev

Answer 2

affects mRNA transport out of nucleus

Question 3

nef

Answer 3

contribute to virus pahtogenesis; nonessential in cell culture

Question 4

vpr

Answer 4

contribute to virus pahtogenesis; nonessential in cell culture

Question 5

vpu

Answer 5

contribute to virus pahtogenesis; nonessential in cell culture

Question 6

vif

Answer 6

contribute to virus pahtogenesis; nonessential in cell culture

Question 7

env

Answer 7

gp160: gets cleaved to p120 and p41

envelope proteins

Question 8

reverse transcriptase

Answer 8

generation of a sDNA copy of the genome after virus uncaring

req. for replication

Question 9

p11

Answer 9

protease
req. for maturation
cleaved from pr170

Question 10

p32

Answer 10

integrase
req. for replicaiton
cleaved to pr170

Question 11

unique feature of HIV integration

Answer 11

does not req. cell division

Question 12

gp120

Answer 12

receptor binding

Question 13

gp41

Answer 13

membrane fusion activity

Question 14

pol

Answer 14

polymerase/RT

cleaved from pr170

Question 15

protein inhibitors

Answer 15

prevent cleavage of core protein

results in release of non infectious particles

Question 16

What is gag cleaved into?

Answer 16

aka pr55
cleaved into
1. nucleocapsid (p7)-> binds RNA genome
2. capsid (p24)-> forms cylindrical core
3. matrix (p17)-> lines inner surface of viral envelope

Question 17

RRE

Answer 17

rev response element

Question 18

ELISA

Answer 18

detects p24 capsid protein and HIV Ab

Question 19

Rapid oral, whole or serum test

Answer 19

HIV Ab detection

latent and active

Question 20

Western blot

Answer 20

p24 and gp120 detection needed

Question 21

most important HIV receptor in outcome of HIV infection

Answer 21

CCR5: delta 32 mutations
homozygous mutation in CCR5: infected, but never get full blown AIDS
heterozygotes: AIDS is developed more slowly
Nef deletion: also has long term survivors

Question 22

RT-PCR

Answer 22

quantitates viral RNA levels

Question 23

PCR

Answer 23

quantitates amount of provirus in lymphocytes (latent and actively dividing)

Question 24

bDNA assay

Answer 24

no amplification needed
hybridization with highly ranched, labeled DNA probe
quantitate viral RNA levels in blood

Question 25

preganancy HIV Tx

Answer 25

NRTI: lamivudine, zidovudine NNRTI: Nevirapine PI: Lopinavir/ritonavir

Question 26

NRTIs

Answer 26

oral NO CYP3A4 tenofovire, didanosine, abacavir, , emtricitabine lamivudine, zidovudine, stavudine

Question 27

NNRTIs

Answer 27

oral | efavirenz, nevirapine, delavirdine

Question 28

HIV-1 protease inhibitors

Answer 28

atazanavir, ritonavir, darunavir, fosamprenavir, indinavir, lopinavir, saquinavir

Question 29

fusion inhibitors

Answer 29

enfuvirtide | maravaroc

Question 30

DNA strand transfer inhibitor

Answer 30

raltegravir

Question 31

What is unusual about abacavir?

Answer 31

metabolized by alcohol dehydrogenase

Question 32

nevirapine

Answer 32

induces CYP3A4 and 2B6: oral contraceptive failure

Question 33

efavirenz

Answer 33

induces CYP3A4 and 2B6: oral contraceptive failure | OK with rifampin and rifabutin (CYP inducers) if dose is increased (because metabolized faster with CYP induction)

Question 34

delavirdine

Answer 34

inhibits CYP3A4, CYP2D6, CYP2C9, CYP2C10

Question 35

atazanavir

Answer 35

inhibits 3A4 and UGTNOT used with rifampin

Question 36

daunavir and lopinavir

Answer 36

3A4 substrates | used with ritonavir to boost serum drug levels

Question 37

ritonavir

Answer 37

inhibits 3A4, 2D6, P-gp, UGTNOT used with rifampin

Question 38

enfuvirtide

Answer 38

NOT orally active | SC

Question 39

cobicistat

Answer 39

oral CYP3A4 inhibitor use with: lopinavir

Question 40

saquinavir

Answer 40

inhibits 3A4, UGT | NOT used with rifampin

Question 41

atripla

Answer 41

once daily pill: complete regimen MOST common tenofovir, emtricitabine, efavirenz

Question 42

NRTI side effects

Answer 42

BBW: lactic acidosis, hepatic disease (contra in abacavir) AVOID ALCOHOLs :( most often in obese women

Question 43

NRTIs: pancreatitis

Answer 43

didanosine and stavudine | pain in back and digestion issues

Question 44

NRTIs: neutropenia and anemia and myopathy

Answer 44

zidovudine

Question 45

NRTIs: neuropathy

Answer 45

stavudine>> didanosine

Question 46

NRTIs: hypersensitivity

Answer 46

abacavir

Question 47

NNRTIs: hypersensitivity

Answer 47

females | hypersensitivity

Question 48

NNRTIs: vivid dreams and CNS symptoms

Answer 48

efavirenz

Question 49

NNRTIs: contraindicated in pregnancy

Answer 49

efavirenz and delavirdine

Question 50

NNRTI: SE

Answer 50

rash and hepatotoxicity

Question 51

protease inhibitor SE

Answer 51

GI intolerance, lipodystrophy, hyperglycemia/DM, dyslipidemia, severe rash in steven johnson's syndrome *atazanavir most likey to get lipodystrophy

Question 52

pneumocystis jiroveci or toxoplasmosis

Answer 52

trimethoprim-sulfamethoxazole

Question 53

TB

Answer 53

isoniazid and pyridoxine

Question 54

CMV retinitis

Answer 54

ganciclovir valganciclovir (only oral one and prophylaxis too) Res: mutation to viral kinase NO viral kinase needed: foscarnet cidofovir

Question 55

cryptococcus, candidiasis, endemic, fungal infections

Answer 55

fluconazole

Question 56

valganciclovir: SE

Answer 56

leukopenia, neutropenia, thrombocytopenia, renal toxicity CI: excretion is in excess of renal blood flow due to filtration and active renal tubular secretion; renal failure: accumulation over time

Question 57

foscarnet: SE

Answer 57

hospital admin. nephrotoxicity need saline hydration by infusion pump because highly insoluble: can get genital ulcerations due to high levels of ionized drug in urine

Question 58

EBV

Answer 58

vidarabine: applied to eye | nucleoside analog

Question 59

Kaposi

Answer 59

cidofovir, IV | renal clearance, active tubular secretion; nephrotoxicity