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T&D 1 > HIV > Flashcards

HIV Flashcards

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1
Q

Hallmark of AIDS

A

profound immuno deficiency

affecting cell mediated immunity

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2
Q

loss of CD4+ T cells is from

A

infection of cells

direct cytopathic effect

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3
Q

most CD4+ T cells are found in

A

mucosal and peripheral lymphoid organs

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4
Q

steady attrition of CD4 cells

A

productive infection in a fraction of latently infection by cytokines and Ags

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5
Q

Direct cytopathic effect of replicating virus

A

inc plasma mem permeability
– budding
virus replication interferes with cell protein synthesis

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6
Q

does virus kill or infect more T cells

A

kill>infect

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7
Q

type of apoptosis

A

activation induced apoptosis

due to chronic activation of UNinfected cells by HIV

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8
Q

infection leads to cell death called what?

A

Pyroptosis

infl cytokines, cell contents released for recruitment of new cells for infection

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9
Q

progressive destruction of architecture seen in

A

spleen
lymph nodes
tonsils

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10
Q

qualitative defercts of CD4+ T cells

A

Dec in Th1 type response
defect in intracellular signaling
selevtive loss of memory subset

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11
Q

an important featuer of HIV

where is it found

A

latent infection
CD4+T cells, Macs in lymph nodes

protects from antiviral therapy, persistent reservoir

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12
Q

Monocytes vs Macs, which are more infected

A

Macs in TISSUE&raquo_space; Monocytes in Blood

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13
Q

which cell becomes a virus factory later in infection when CD4+ counts are low?

A

Macs

  • few viruses bud
  • store large number of virus particles
  • allow replication, but resistant to cytopathic effects
  • protected from host defenses
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14
Q

what plays an important role in CNS infection

A

Monocytes

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15
Q

What are the functional defects seen in UNinfected Macs?

A
  • impaired microbicidal activity
  • dec chemotaxis
  • dec secretion of IL-1
  • Inapp secretion of TNF
  • poor capacity to present Ag
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16
Q

Which DC are initially infected by virus

A

Mucosal

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17
Q

Mucosal DC transport virus to

A

regional LN —> CD4 T cells

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18
Q

what are the two reservoirs of HIV

A

Macs

Follicular DC

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19
Q

how do follicular DC trap HIV virions

A

receptor for Fc of Ig coating HIV

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20
Q

Do B lymphocytes get infected?

A

No, only affected

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21
Q

How are B lymphs affected?

A
  • hyperplasia due to polyclonal activation
  • BM plasmacytosis
  • Hypergammaglobulinemia
  • circulating immune complex
  • can’t mount Ab resp to new Ag, lack of T helper/ intrinsic defect
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22
Q

Impaired humoral immunity renders ptns vulnerable to what

A

disseminated inf caused by encapsulated bacteria

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23
Q

Major target of HIV infection

A

Nervous system

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24
Q

predominant cell types infected in CNS

A

macs

microglia

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25
what carries HIV to brain
monocytes
26
are neurons infected?
no
27
Is the CNS involvement direct or indirect?
indirect
28
CNS damage is caused by cytokines:
IL1 TNF IL6
29
Early infection characterized by
inf of memeory CD4 T cells - mucosal Lymphoid tissue and death
30
After early infection
dissemination to LN by infected DC
31
Virus enters thru
mucosal epithelia
32
how does virus pass to CD4 t cells in LN
direct cell-cell contact
33
what leads to viremia
replication in LN
34
what corresponds to drop in serum titers? how long after exposure
Seroconversion | 3-7 wks
35
Acute retroviral syndrome
40-90% ptns 3-6 wks after inf, resolves in 2-4 wks = sore throat, myalgias, fever/sweats, weight loss, fatigue = rash, cervical adenopathy, diarrhea, vomiting
36
what characterizes Primary infection
virus dissemination and retroviral syndrome
37
what characterizes Chronic inefction
clinical latency
38
Sites of continuous HIV replication/destruction
LN, Spleen
39
opportunistic infections
candidiasis, herpes zoster, TB
40
Diagnosis of AIDS
- opportunistic infections/ cancer | - CD4+
41
AIDS presents w/
fatigue weight loss diarrhea
42
majority of deaths in untreated AIDS ptns
opportunistic infections
43
Candidiasis
most common fungal infection oral cavity, vagina, esophagus
44
CMV
dissemintaed | eyes and GI
45
Toxoplasmosis gondii
encephalitis | cerebral abscess
46
JC virus
human papovavirus progressive multifocal leukoencephalopathy
47
Oncogenic DNA virus
seen with AIDS
48
most common cancer in AIDS ptn
Kaposi's sarcoma - vascular neoplasm - purple skin lesions/disseminated disease in LN, skin, GI, lungs - HHV8
49
Co-factor of kaposi's sarcoma
immunosuppression
50
which canceri s often in late in disease course of IADS pt
High grade B cell lymphomas peripheral LN, brain, body cavities EBV assoc risk inc with low CD4
51
High risk of ____ in women, ____ in men assoc with _____ infection
cervical dysplasia anal cancer HPV
52
Long term side effects of antiretroviral therapy
- lipoatrophy - loss of facial fat - excess fat deposition centrally - premature cardiovascular, kidney, liver disease
53
Major cause of morbidity in AIDS ptn
premature cardiovascular, kidney, liver disease
54
what anatomic changes are seen in HIV/AIDS
none
55
Lesions are characteristic of
opportunistici nfections
56
Morphology of LN:
- follicular hyperplasia (early) - follicular involution (later) - depletion of cells/disrupted org network of follicular DC - trapped virus; small burnt out lymph nodes, spleen, thymus
57
Rapid HIV test
simultaneous detection of HIV-1 p24 ag/Ab to both HIV | Ag provides earlier detection than Ab
58
Ab studies
Ab develops w/in 3 months
59
CD4+ T cell count
- absolute levels are prognostic - disease progression - used for CDC classification
60
Viral load test
- level of HIV-1 RNA - predicts clinical outcome - effectiveness of antiviral therapy
61
CDC algorith for HIV diagnostic testing
1 Ag (HIV1 p24) in blood ( Ab appears later) 2 immunoassay to differentiate HIV1 and 2 ab 3 positive Ag, but neg or indeterminate Ab diff - use HIV-1 nucleic acid testing

T&D 1 (7 decks)

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