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HIV Flashcards

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1
Q

WHat does it mean to be a retrovirus?

A
  • use of reverse transcriptase to replicate its RNA strand (for a second RNA strand)
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2
Q

WHere is HIV-2 commonly seen?

A
  • in west Africa

- less frequent thus not often seen

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3
Q

What is the target site for HIV ? What is their role?

A
  • CD4+ receptors
  • —-a glycoprotein found on the surface of a range of cells
  • —import. for inducing adaptive immune response
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4
Q

How does HIV infections affect immune responses?

A
  • reduced prolif. and circulation of CD4+ CELLS
  • reduced C8+ activation
  • reduced antibody class switching —reduced Ab affinity
    • chronic immune activation in the GUT
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5
Q

What is the CD4 count that puts an individual at risk of opportunistic infections?

A
  • CD4 count below 200 cells/mm3
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6
Q

How rapid is HIV replication ?

A
  • RAPID in EARLY and VERY late infection

- new gen every 6-12 hrs

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7
Q

What is the time to death w.o HIV rx?

A
  • 9-11 years
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8
Q

How long does it take for HIV to establish infection?

A

within 3 days of entry

therefore ….72 hrs to intervene with prophylaxis

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9
Q

WHat are the symptoms of Primary HIV infection?

A
  • rash; maculopapular
  • fever
  • swollen glands
  • pharyngitis
  • Myalgia
  • headache/ aseptic meningitis
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10
Q

When does primary HIV infections set in?

What is the risk of person experiencing Primary HIV infection?

A
  • ~2-4 weeks after infection

- VERY high risk of TRANSMISSION

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11
Q

If the glandular test comes out as negative…

A
  • do HIV testing
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12
Q

Define opportunistic infections.

A

infection caused by a pathogen that does not normally produce disease in a healthy individual—-seeks the Opportunity with a weakened immune system

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13
Q

Most COMMON opportunistic infection in HIV pt?

Wht is the CD4 count like?

A

pneumocystis pneumonia by pneumocystis jiroveci

  • <200
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14
Q

What are the symptoms of p.pneumonia?

A

insidious onset

  • SOB
  • Dry cough
  • —signs: EXERCISE desaturation (make them walk a flight of stairs 5 times)
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15
Q

How to dx PP?

A
  • PCR
  • bronchoalveolarlavage
  • immunofluorescence
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16
Q

How to treat pneumocystic pneumonia?

A
  • high dose Co-trimoxazole (w/ or w/o steroid)

–low-dose for Prophylaxis

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17
Q

Symptoms of Cerebral toxoplasmosis?

A 
Headache
Fever
Focal neurology
Seizures
Reduced consciousness
Raised intracranial pressure

—–very specifc neuro symptoms d/t cerebral abscess

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18
Q

What are symptoms of CMV infection present as?

A

Reduced visual acuity
Floaters
Abdo pain, diarrhoea, PR bleeding
—-colitis (tender abdomen)

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19
Q

How does HIV- associated neurocognitive impairm/ present as?

A

Reduced short term memory
+/- motor dysfunction
—-age-related dementia

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20
Q

How may PML appear on CT scan?

A
  • like multiple sclerosis
  • —-white matter pathology
  • —FRONTAL lobe changes (personality change/ confusion/ focal neurology)
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21
Q

How does HIV- associated wasting present as?

A
  • Slim’s disease (extremely cachexic)

- —-multifactorial (anorexia/metabolic- chronic metabolic activ./ malabsorption/ hypogonadism)

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22
Q

Name an AIDS related cancer. and the causal virus?

A

Kaposi’s Sarcoma

- Herpes virus 8

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23
Q

EBV causing, AID-related cancer? Presentation?

Study These Flashcards
A
  • non-Hodgkin’s Lymphoma
  • More advanced
    B symptoms
    Bone marrow involvement
    Extranodal disease
    ↑ CNS involvement
24
Q

Main hematological manifestation of HIV?

Study These Flashcards
A

Anemia
—-affects up to 90%
Thrombocyotpenia

25
Factors increasing transmission risk of HIV
Anoreceptive sex Trauma Genital ulceration Concurrent STI - injection drug use and SHARING - iatrogenic - infected blood products In utero/trans-placental Delivery Breast-feeding
26
Which groups should be tested for HIV?
- universal testing in HIGH prevalence areas (cost-effective) - opt-out HIV testing in clinical settings (enter a sexual health clinic, drug users) - screening of HIGH risk groups (MSM/ female partners of BISEXUAL men/ drug injectors/ hiv partner) - testing on clinical grounds (those with SYMPTOMS
27
HIV markers for testing?
- HIV antigen develops faster | - --- better to test for this than antibodies (appears in 3 months)
28
What is occurring during asymptomatic HIV infection?
- ongoing VIRAL infection - ongoing CD4 count depletion - ongoing IMMUNE activation - ----onward transmission if UNDIAGNOSED
29
What is seen on CXR of pneumocystic pneumonia?
- normal OR - reticulonodular markings - interstitial infiltrates
30
What does HIV cause?
- AIDS | (Acquired Immunodeficiency Syndrome) ----> opprotunistic infections or AIDS-related cancers
31
Is AIDS preventable?
YES - by early HIV dx and rx HIV infection is ALSO preventable
32
Where does Hiv-1 originate from?
- CENTRAL and WEST African chimpanzees
33
What does CD4 activate?
- Bcells - cytotoxic T-cells (CD8+) - cytokine release - recog. of MHC2 Ag-presenting cell
34
With HIV's impact on the immune response, what does this ultimately make one susceptible tO?
VIRAL infections FUNGAL infections Mycobacterial infections Infection-induced cancers
35
What forms of TB may be seen with HIV infections?
- ones NOT commonly seen in those who are HIV- - miliary TB - Lymphadenopathies - extrapulmonary TB - Multi-drug resistant TB - Immune reconstitution Syndrome
36
What cuases Cerebral Toxoplasmosis? What is the CD4 count at,?
- causes by Toxoplasma Gondii | - CD4 <150
37
What occurs is Cerebral toxoplasmosis?
- reactivation of a LATENT infection | - --> MULTIPLE cerebral abscess !
38
Reactivation of of LATENT CMV infection, results in what?
- retinitis - colitis - esophagitis -CD4 < 50
39
WHta skin infection may arise IIary to HIV infection?
1. Herpes Zoster 2. Herpes Simplex 3. Human Papilloma virus 4. Weird/ Wonderful
40
WHich skin infection is multidermatomal and RECURRENT ?
- Herpes Zoster !
41
Which skin infection is extensive and ACLIOCVIR -resistant?
Herpes Simplex
42
What does HIV-1 cause? WHen may it occur?
HIV-associated Neurocognitive Impairment - incr. incidence with Incr. short term immunosuppression
43
How does HIV-associated Neurocognitive Impairment present as?
- reduced short term memory | +/- MOTOR dysfxn
44
What does JC virus cause?
at CD4 <100 | > progressive multifocal leukoencephalopathy
45
How does progressive multifocal leukoencephalopathy present as?
- focal neurology - rapidly progressive - CONFUSION - personality change
46
What are other neurological pres. of HIV>
``` Distal sensory polyneuropathy Mononeuritis multiplex Vacuolar myelopathy Aseptic meningitis Guillan-Barre syndrome Viral meningitis (CMV, HSV) Cryptococcal meningitis Neurosyphilis ```
47
How may HIV affect weight?
- Slim's Disease (HIV-associated Wsting) ``` - could be d.t: > metabolic cause > anorexia > diarrhoea >hypogonadism ```
48
Name the 3 cancers HIV may cause?
1. Kaposi's CA 2. NON-Hodgkins Lymphoma 3. Cervical Cancer
49
What causes Kaposi's sarcoma caused by?
Herpes Virus 8 (HHV8) | ----used to affect 40% before antiretroviral drugs era
50
What is kaposi's Sarcoma? How is it treated?
1. Vascular tumor | 2. HAART; Local therapies; systemic chemotherapy
51
WHat virus causes Non-hodgkin's lymphoma? | How does it present as?
- EBV | - > bone marrow involvement; extranodal disease; ^ CNS involvement
52
How does cervical cancer occur ?
- persistence of HPV infection | rapid progression of SEVERE dysplasias and INVASIVE disease
53
What specific testing should be offered to ALL complicated HPV disease?
- HIV testing | - those with high grade CIN/ VIN/ AIN/ PIN
54
Name some NON-opportunistic infections for symptomatic HIV.
1. mucosal candidiasis 2. seborrhoeic dermatitis 3. diarrhoea 4. fatigue 5. worsening of PSORIASIS 6. parotitis 7. lymphadenopathy 8. (STIs/ Hep B/ Hep C)
55
Name Hematological manifestations in HIV pts. Why may it occur?
Anaemia (90%) Thrombocyotpenia (ITP) d.t HIV, Opportunistic inf./ AIDs-Malignancies

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