HIV

Question 1

TRUE/FALSE even with treatment LE is significantly decreased

Answer 1

FALSE- Can have normal LE (may actually be longer due to increased contact with the NHS)

Question 2

What diseases can be described as a preventable retrovirus?

Answer 2

HIV

Question 3

What does retrovirus mean?

Answer 3

When the RNA is transcribed the reverse transcriptase enzyme is used

Question 4

What is the end result of HIV

Answer 4

AIDS, causes death

Question 5

Which strain of HIV is responsible for the global pandemic

Answer 5

HIV-1

Question 6

What strain of HIV originated in west Africa, is less virulent and less common?

Answer 6

HIV-2

Question 7

What is the target site of r HIV (via gp120)

Answer 7

CD4+ receptors

Question 8

Name 4 cells that CD4+ glycoproteins are found on

Answer 8

T helper cells
Dendritic cells
Macrophages
Microglial cells

Question 9

What 3 effects does HIV infection have on immune response?

Answer 9

Sequestration of cells in lymphoid tissues
Reduced proliferation of CD4+ cells
Reduced CD8+ T cell activation

Question 10

At what level CD4+ in the body is there risk of opportunistic infections?

Answer 10

<200 cells/mm3

Question 11

With HIV viral replication- how often is there a new generation?

Answer 11

Every 6-12 hours

Question 12

Without treatment average time to death is ………

Answer 12

10 years

Question 13

How long after entry is infection established

Answer 13

3 days (therefore 3 days to establish prophylaxis)

Question 14

How long is the average onset after infection

Answer 14

2-4 weeks

Question 15

How might HIV present

Answer 15

Fever
Rash (maculopapular)
Myalgia
Pharyngitis
Headache

Question 16

Pneumocystis Pneumonia (fungal infection of the lungs) is caused by

Answer 16

Pneumocystis jiroveci

Question 17

What is the most common opportunistic infection in HIV/AIDS

Answer 17

Pneumocystis pneumonia

Question 18

Diagnosis in Pneumocystis Pneumonia is by?

Answer 18

BAL and immunofluorescence +- PCR

Question 19

Treatment for Pneumocystis Pneumonia

Answer 19

High dose Co-Trimoxazole (+- steroid)

Prophylaxis: Low dose co-trimoxazole

Question 20

What is cerebral toxoplasmosis caused by

Answer 20

Toxoplasma gondii (from cats)

Question 21

In order to get CMV the CD4 count has to be

Answer 21

<50

Question 22

What is the preventative treatment for CMV?

Answer 22

Ophthalmic screening for all individuals with CD4+ <50

Question 23

HIV associated neurocognitive impairment has increasing incidence with

Answer 23

increasing Immunosupression

Question 24

The opportunistic infection progressive multifocal leukoencephalopathy can look like which other disease?

Answer 24

MS

Question 25

What are 3 AIDS related cancers?

Answer 25

Kaposi's sarcoma Non-Hodgkin's lymphoma Cervical cancer

Question 26

What causes Non-Hodgkin's lymphoma?

Answer 26

EBV

Question 27

TRUE/FALSE | HIV itself is neurotoxic, multiple presentations are due to this in addition to the immunocompromised

Answer 27

TRUE

Question 28

Why do people with HIV tend to lose wt?

Answer 28

Chronic immune activation wastes energy

Question 29

DDx for mucosal candidiasis

Answer 29

Inhalers Diabetes HIV

Question 30

Skin lesions that may occur with HIV inc

Answer 30

``` Opportunistic - Herpes Zoster - Herpes Simplex -HPV Non Opportunistic -Seborrheic dermatitis ```

Question 31

Psoriasis may get worse if someone has HIV, why is this?

Answer 31

It is a CD8 mediated disuse, therefore will get worse

Question 32

What condition may get better if someone is diagnosed with HIV?

Answer 32

RA (as it is a CD4+ medicated disease)

Question 33

What is the cause of 95% of the HIV transmission?

Answer 33

Sexually transmitted

Question 34

What are the high- risk groups for HIV

Answer 34

- MSM - F partners of bisexual men - People who inject drugs - Partner of people living with HIV - People from endemic areas (Sub-saharan Africa, Caribbean, Thailand)

Question 35

Who are the most likely group to be transmitting HIV?

Answer 35

Undiagnosed ( most likely Hetrosexual men)

Question 36

HIV life expectancy is -- years lower in those diagnosed late as compared to those who are receiving prompt treatment

Answer 36

10 years

Question 37

When testing for HIV what is the antibodies that you are testing fro?

Answer 37

HIV1 and HIV2 antibodies

Question 38

When testing for HIV what is the antigen that you are testing for?

Answer 38

p24

Question 39

How many weeks into the infection do the IgM antibodies peak?

Answer 39

1-2 weeks

Question 40

IgG in contrast to IgM antibodies ......

Answer 40

increase slowly over several months, maintained during chronic infection

Question 41

What is the rapid HIV test?

Answer 41

POCT | Fingerprick specimen or saliva

Question 42

What can the recent infection testing algorithm be used for?

Answer 42

Can be used to identify is an infection occurred within the preceding 4-6 months

Question 43

What does RITA measure?

Answer 43

HIV-1 antibody

Question 44

What is HAART?

Answer 44

A combination of 3 drugs from at least 2 drug classes to which the virus is susceptible

Question 45

What are the 3 purposes of therapy in HIV

Answer 45

1. Reduce the viral load 2. Restore Immunocomprimise 3. Minimise Toxicity

Question 46

DRUG-DRUG INTERACTIONS. Be aware that protease inhibitors and NNRTIs are generally....

Answer 46

potent liver enzyme inhibitors

Question 47

With HIV there is no risk by casual/household contact but what should not be shared?

Answer 47

Razors/toothbrushes

Question 48

In HIV patients when is a c-section delivery preferred?

Answer 48

If the viral load is detected (Can have vaginal delivery if the viral load is undetected)

Question 49

What is PrEP?

Answer 49

A way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day

Question 50

What is contained within the PrEP pill?

Answer 50

Tenofovir | Emtricitabine

Question 51

What is PEPSE?

Answer 51

Post exposure prophylaxis after sexual exposure to HIV | to reduce the risk of infection