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Clinical Microbiology > HIV > Flashcards

HIV Flashcards

(52 cards)

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1
Q

Which type of HIV virus is responsible for the vast majority of HIV infections?

A

HIV-1

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2
Q

Which virus, found in chimpanzees and gorillas in west Africa, is closely related to HIV1?

A

Simian immunodeficiency virus

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3
Q

When are HIV viruses through to have crosses species from primaries to humans in Africa?

A

late 19th / early 20th century

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4
Q

What is the bush meat theory of how HIV transmitted to humans?

A

The theory that a hunter was bitten or cut while butchering an animal resulting in transmission of HIV to humans

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5
Q

What factors may have triggered or contributed to an epidemic of transmission of HIV when it first emerged in Africa?

A

Social changes and urbanisation
Unsterile injections
Genital ulcer diseases
Sexual promiscuity

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6
Q

How can HIV be transmitted?

A 
Sexually transmitted
IV drug use (sharing needles)
Mother to child vertical transmission
Contaminated blood products
Occupation e.g. needle stick injuries
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7
Q

How does HIV enter the body?

A 
Open cuts
Sores
Breaks in the skin
Mucous membranes (aus/vagina)
Direct injection
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8
Q

HIV contains three of its own enzymes which can each be used as drug targets. What are these enzymes?

A

Integrase
Reverse transcriptase
Protease

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9
Q

Which immune cells does HIV infect?

A

T helper cells
Macrophages
Dendritic cells

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10
Q

What receptor allows the entry of HIV into immune cells?

A

CD4+

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11
Q

How does HIV infection cause depletion of CD4+ T cells?

A

Direct viral killing of cells
Apoptosis of unaffected bystander cells
CD8+ cytotoxic T cell killing of infected CD4+ T cells

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12
Q

How can HIV infection result in inappropriate/excess immunoglobulin production?

A

By inducing abnormal B cell activation by infected CD4+ T cells

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13
Q

What is the critical level of CD4+ cells at which a person becomes at risk of opportunistic infections and some cancers?

A

<200

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14
Q

What are the six types of antiretroviral drug used to treat HIV?

A

Fusion inhibitor
R5 inhibitor
Nucleoside reverse transcriptase inhibitor
Non-nucleoside reverse transcriptase inhibitor
Integrase inhibitor
Protease inhibitors

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15
Q

What type of genetic material does HIV have?

A

Single stranded RNA

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16
Q

HIV is a non-enveloped virus. T/F?

A

False - it is an enveloped virus and some of the surface proteins in this envelope have been considered as potential drug treatments

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17
Q

What is viral latency?

A

A state of reversibly non-productive infection of individual cells

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18
Q

What does the term ‘latency’ refer to in HIV?

A

The long asymptomatic period between initial infection and advanced HIV

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19
Q

At what point in infection is there no way of curing HIV?

A

Once the HIV virus genetic material is incorporated into the host DNA as there is no way of removing this

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20
Q

What can help to reduce the risk of drug resistance in HIV?

A

Taking HIV medications very day, exactly as prescribed

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21
Q

How can drug resistant HIV develop?

Study These Flashcards
A

As HIV multiplies in the body, the virus sometimes mutates and produces variations of itself. Variation of HIV that develop while a person is taking HIV medicines can lead to drug resistance

22
Q

What is the main theoretical safety concern against the development of a live attenuated HIV vaccine?

Study These Flashcards
A

The possibility of reversion to a live virus through mutation

23
Q

HIV, is diagnosed early and treated appropriately, has a near normal. life expectancy. T/F?

24
Q

When is HIV universally tested for?

Study These Flashcards
A

Antenatal screening
GUM clinics
IV drug users
Populations in which the prevalence fo HIV is >2/1000

25
What populations are at higher risk of HIV?
``` Patients from sub-saharan Africa MSMs Children of people with HIV IV drug users People who have transactional sex ```
26
What does the HIV blood test look for?
The presence fo the p24 antigen and His antibody
27
What is the window period for HIV testing?
4 weeks
28
If a positive HIV test is done, a confirmatory test is conducted. T/F?
True
29
What is the other name for primary HIV infection?
HIV seroconversion
30
What are the differential diagnoses of HIV seroconversion?
Infectious mononucleosis Secondary syphilis Drug rash Other viral infections
31
What are the main symptoms of acute HIV infection?
``` Fever Weight loss Malaise Headache Neuropathy Pharyngitis Sores and thrush in the mouth Lymphadenopathy Rash Myalgia Nausea Vomiting Enlargement of liver and spleen ```
32
Give examples of conditions which can be indicators of HIV infection?
``` TB Pneumocystitis Cerebral toxoplasmosis Primary cerebral lymphoma Crytococcal meningitis Progressive multifocal leucencephalopathy Kapsoi's sarcoma Persistent crytosporidosis Cervical cancer Cytomegalovirus Non-hodgkin;s lymphoma ```
33
What is the aim of treatment in HIV infection?
To maintain an undetectable viral load
34
What is the definition of an undetectable viral load globally?
<200 copies per ml
35
What is the definition of an undetectable viral load in Scotland?
<40 copies per ml
36
When should antiretroviral treatment be started in HIV infection?
As soon as possible to reduce morbidity/mortality and reduce risk of onwards transmissions
37
What drugs are used in triple therapy against HIV?
2 nucleoside reverse transcriptase inhibitors plus a drug from another class (usually an integrase inhibitor)
38
What factors influence the choice of therapy in HIV patients?
Patient choice Comorbidities Interactions Drug resistance
39
What are the possible short term side effects of HIV treatment?
``` Rash Hypersensitivity CNS side effects GI side effects Renal and septic effects ```
40
What are the possible long term toxicities of HIV infection?
``` Body shape changes (lipoatrophy, lipodystrophy) Renal Hepatic Lipid Bone ```
41
Why does antiretroviral treatment for HIV have so many. drug interactions?
It effects the CYP450 enzyme resulting in reduced/increased drug levels of other medications
42
Partner notification is carried out for all people following a HIV diagnosis. T/F?
True
43
How can HIV infection be prevented?
``` Use of condoms Treatment as prevention Post exposure prophylaxis Pre exposure prophylaxis Prevention of mother to child transmission Harm reduction measures ```
44
How soon after exposure does post exposure prophylaxis for HIV. need to be initiated?
72 hours
45
For how long is post exposure prophylaxis for HIV continued?
28 days
46
Breast-feeding should be avoided in HIV positive mothers. T/F?
True - there is no data on the safety of breastfeeding in HIV infection
47
How is a pregnant women with HIV managed to prevent transmission of HIV to the baby?
Antiretrovirals given to mother during pregnancy | Post exposure prophylaxis given to baby
48
P.jiroveci infection is an opportunistic infection which can occur in individuals with HIV. Give an account of the pathogenesis of this infection
It is an extracellular pathogen (fungus) which causes interstitial plasma cell pneumonia with foamy exudates int he alveoli
49
What are the symptoms of p.jorveci infection?
Progressive and disproportionate shortness of breath, fever, dry cough with failure to respond to usual antibiotic regimes
50
What are the possible complications of p.jiroveci infection?
Respiratory failure | Pneumothorax
51
What is the first line treatment for p.jiroveci infection?
Cotrimoxazole and steroid therapy
52
What signs of p.jiroveci infection may be seen on CXR?
Perihilar interstitial shadowing in moderate disease and white out in sever disease

Clinical Microbiology (17 decks)

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