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ID Drugs > HIV > Flashcards

HIV Flashcards

1
Q

Aspartate protease

A

Cleavage of proteins

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2
Q

Integrase

A

Integrate DNA into host cell DNA

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3
Q

Reverse Transcriptase

A

Makes DNA from RNA

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4
Q

Cone-shaped (conical) capsid composed of

A

Multiple copies of p24

Non-variable protein

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5
Q

HIV envelope contains

A

Env Protein

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6
Q

Cap of env protein contains

A

Glycoproteins

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7
Q

gp 120

A

attachment to T cells

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8
Q

gp 41

A

fusion and entry into T cells

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9
Q

gp120 and gp41 are both formed as

A

single protein (gp160) then cleaved

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10
Q

Gene for gp120

A

Mutates rapidly (antigenic variation)

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11
Q

Antibodies generated against which portion of gp120 (attachment to T cells)

A

V3 loop portion (highly immunogenic so antibody neutralization inhibited)

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12
Q

Gag gene

A

Codes for long polypeptide that is cleaved into pieces, including p24 (nucleocapsid)

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13
Q

Pol gene

A

Codes for long polypeptide that is cleaved into several enzymes, including reverse transcriptase, integrase and protease).

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14
Q

Env gene

A

Codes for gp160, which is cleaved into gp120 and gp41 (envelope proteins).

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15
Q

Regulatory genes (required for replication)

A

Tat and Rev

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16
Q

Tat gene

A

Activates transcription

17
Q

Rev gene

A

Transports mRNA from nucleus to cytoplasm

18
Q

Auxiliary Genes

A

Not required for replication: Nef, viv, vpr, vpu, vpx

19
Q

Nef gene

A

Decreases CD4 proteins and MHC I on T cell surfaces

20
Q

CCR5 and CXCR4

A

Major lymphocyte receptors used by HIV particles to enter cells

21
Q

CCR5-tropic virus particles

A

Replicate in monocytes/macrophages (M-tropic particles)
Can also infect dendritic cells (trafficking to lymph nodes)
Occur early: Sexually transmitted to macrophages

22
Q

CXCR4-tropic virus particles

A

Replicate more efficiently in T-cells (T-tropic virus particles)
Occur later after infection has developed

23
Q

Mutation in which gene is associated with decreased susceptibility to HIV infection?

A

CCR5 gene

24
Q

How does HIV enter human cells?

A
  1. HIV attacks cells that have CD4 on surface
  2. gp120 binds to CD4
  3. HIV particle binds to either CCR5 or CXCR4
  4. gp41 allows fusion and entry into human cells
25
Q

Which class of drugs does not work on HIV-2

A

NNRTIs

26
Q

HIV Time Course: CD4+ Lymphocyte Count

A
  1. CD4 count normal at infection and falls shortly after

2. Body begins to fight back with CD8+ T cells so CD4 Count increases before slowly dropping over many years

27
Q

HIV Time Course: Viral Load (HIV RNA Copies)

A
  1. Very low at infection then shoots up very high (acute HIV syndrome with dissemination of virus and seeding into lymphoid organs)
  2. Body fights back so lowers HIV RNA copies
  3. HIV RNA copies slowly increase over many years
  4. HIV RNA copies get very high when pt develops AIDs
28
Q

Clinical Latency Period

A

Pt has no sx but body fighting infection (CD8 cells)

29
Q

Viral Set Point

A

Lowest level of HIV RNA copies after acute phase. Lower set point = longer time before AIDS onset.

30
Q

Point of maximum CD4 count after acute phase

A

Higher = longer time before AIDS onset

31
Q

ELISA

A

Antibody-only test

Sensitive but many false positives

32
Q

Confirmatory test for (+) ELISA

A

Western Blot (more specific)

33
Q

4th Generation Tests

A

Combination Antigen/Antibody Tests

Test for both p24 antigen and HIV antibodies

34
Q

Confirmatory test for (+) 4th Generation Test

A

HIV1-HIV2 antibody differentiation assay

35
Q

Acute HIV Test

A

HIV RNA testing (viral load) will be high

Level of p24 antibodies not elevated yet

36
Q

Perinatal HIV Test

A

HIV PCR testing

Maternal HIV antibodies persist for months

37
Q

CD4 < 200

A

TMP-SMX: Pneumocystis Pneumonia

38
Q

CD4 < 100

A

TMP-SMX: Pneumocystis and Toxoplasmosis

Itraconazole (Histoplasmosis in endemic areas)

39
Q

CD4 < 50

A

Azithromycin: MAC

ID Drugs (7 decks)

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