HIV Flashcards by Jay Slater

risk factors for HIV

MSM
PWID - low risk
location - sub Saharan/African/Caribbean countries

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what type of virus is HIV

what does this cause

retrovirus

mistakes in RNA transcription

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which type of HIV caused the global pandemic

HIV1 M

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how can HIV be transmitted (4)

which is the most common form of transmission

sex - 94%
parenteral/vertical transmission - for mum to baby
infected blood products
sharing needles (PWID)

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what are the 3 enzymes involved in replication of HIV

hence are targets for treatment

reverse transcriptase enzyme
integrase enzyme
protease enzyme

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which is high and which is low in HIV between CD4+ and CD8+

CD4+ low - KNOW this

CD*+ high - less relevant, bc of negative feedback of low CD4+

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why does low CD4+ cause immunosuppression

decreased CD4+ = decreased antibody formation = immunosuppressed = more susceptible to infection

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which immune cell is predominantly low in HIV, and hence is the cause of the immunosuppression

CD4+

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CD4+ levels in HIV late stage

what is normal levels

<200 cells/mm3

normal 500-1600 cells/mm3

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how long between entry of virus and start of infection is there

clinical significance of this

3 days

can give PEP (post exposure prophylaxis)

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presentation of primary HIV infection (2-4 weeks after infection) (4)

fever
rash
pharyngitis (sore throat)
myalgia

initially presents like another other viral infection! - not good bc can be missed

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if young male with viral infection symptoms (fever, rash, sore throat, myalgia), what should you always check for

HIV!

don’t just send away to increase fluids, bc this will make them feel better but infection will go undiagnosed

reassure them its standard procedure, just checking their immunosuppression - and you just want to rule it out (better to be safe than sorry)

document if they decline

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what happens to psoriasis in HIV

why

gets worse

psoriasis is CD8+ mediated, and CD8+ is high in HIV

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what happens to rheumatoid arthritis in HIV

why

gets better

RA is mediated by CD4+, and CD4+ is low in HIV

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which neuro condition can present in HIV

HIV dementia

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which resp condition is common in HIV (be specific)

pneumocystis pneumonia

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microbio of pneumocystis pneumonia

pnemocystic jirovecii

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presentation of pneumocystis pneumonia

SOB

dry cough

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management of pneumocystis pneumonia

high dose co-trimoxazole

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?HIV

night sweats
fever
weight loss
cough

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?HIV

SOB 
dry cough (from lung consolidation)

pneumocystis pneumonia

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if someone is diagnosed with HIV what other condition must you test for

TB (where HIV is common TB is also common)

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treatment of TB

2 RIPE 4 RI

2 months of rifampicin, isoniazide, pyrazinamide and ethambutol
4 months of rifampicin and isoniazide

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what microbio cause of cerebral abscess is common in people with HIV

toxoplasma gondii

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?HIV headache fever seizures papilloedema reduced consciousness

cerebral toxoplasmosis brain abscess caused by toxoplasma gondii

?HIV blindness

CMV retinitis

if you offer someone a HIV test and they decline, what should you do

document it

what markers do you investigate for HIV infection (4)

viral load (viral RNA) - PCR p24 antibody - detects IgM and IgG CD4+ (TLC)

what investigation is used to look at viral load (PCR) and p24 and DIAGNOSE HIV

serum/salivary ELISA

what investigation is used to look at viral load (PCR) and p24 and monitor PROGRESS of HIV how long til you get results

rapid HIV test (POCT) - finger prick/saliva 30 mins = good bc decreased anxiety

is HIV treatable

yes!!

treatment for HIV

HAART (highly active anti-retroviral therapy) 3 drugs from 2 diff classes - NtRTI, NRTI, NNTRI

what is a NRTI example

nucleoside reverse transcriptase inhibitor eg emtricitabine

what is a NNRTI example

non nucleoside reverse transcriptase inhibitor eg efvirenz

NtRTI example

eg tenofovir

what is the aim of HARRT treatment for HIV

to gain an undetectable viral load

when is PEP (Post Exposure Prophylaxis) used in HIV

if condom breaks | infected person doesn't tell partner til after

within what time frame of having sex and being infected is PEP effective

<3 days

when is PrEP (PRe Exposure Prophylaxis) used in HIV

regular partner infected | MSM unprotected sex >2 per year with partners

PrEP example

eg tenofovir

what contraceptive measure is PrEP similar to (in principle)

COCP

what contraceptive measure is PEP similar to (in principle)

morning after pill

diagnosis of HIV requires what type of screening

STI screening

if someone is diagnosed with HIV what do you want to do to partner

get partner tested too

what is it called when you give the patient 1 month to tell their partner and if they don't get tested you can contact them

conditional testing

what obligations does a HIV clinician have to the partner of someone infected with HIV

none if theyre not your patient cant break confidentiality your care is to your patient - you need to get them to trust you

what obligations does a GP have to the partner of someone infected with HIV if they are also your patient

obligation to both encourage HIV patient to tell partner if not; could try test them sneakily eg if they come in with a cough, would test for 'immunosuppression' if not; give them the chance again to tell them and warn them if not youll have to break confidentiality PHONE DEFENCE UNION foe help lol

can someone with HIV still have sex what about if untreated or treated but viral load still detectable what about if treated and viral load not detectable

yes if untreated/viral load still detectable; need to use condom/partner on PrEP/PEP if treated and viral load undetectable; no risk of transmission!

is there a risk of HIV transmission if you share the same cup

is there a risk of HIV transmission if you share the same razor

yes - bc risk of bleeding

legal consequence in Scotland if you have HIV and have unprotected sex and don't tell partner

charged for reckless behavior

main complication of HIV

psychosocial wellbeing (exclusion, stigma etc) NOT AIDS! actually rare

rare complication of HIV

AIDS

how can HIV cause AIDS

if untreated

do all people with HIV get AIDS

no - not if treated in the past yes bc of lack of treatment

what does AIDS stand for

acquired immunodeficiency syndrome

which vascular tumour can occur in AIDS

Kaposi sarcoma

how does Kaposi sarcoma present

papules on skin (vascular tumour)

which type of lymphoma can occur with AIDS

non hodgekins lymphoma

what type of cancer are women with HIV screened for more regularly than normal

cervical cancer

if untreated HIV, how long til death

10 years

why are MSM higher risk for HIV

anoreceptive sex = anal mucosa is only 1 cell thick (vagina is 30)

what is viral load measuring

viral RNA

HIV Flashcards

(63 cards)