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NRSG 477 > HIV > Flashcards

HIV Flashcards

1
Q

What type of virus is HIV?

A

Retrovirus in Lenti Virus Genus- Genetic material is carried as RNA

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2
Q

How is Retrovirus in Lenti Virus Genus, genetic material carried?

A

As RNA

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3
Q

General characteristics of Lenti viruses

A
  • Long incubation
  • Ability to transfer a lot of genetic material to host DNA
  • Can replicate in non-dividing cells.
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4
Q

HIV attacks and destroys which types of cells?

A

Immune system cells-
CD4 & T lymphocyte cells and macrophages which allows for replication
(coreceptor CXCR4 and CCR5)

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5
Q

3 primary proteins/enzymes involved with HIV

A

Reverse transcriptase
Integrase
protease

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6
Q

What are the 3 stages of HIV infection?

A

Acute HIV infection
Chronic HIV infection
AIDS

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7
Q

Acute HIV infection

A

Earliest stage of HIV
Generally develops within 2-4wks after infected
Some have flu-like symptoms: fever, sore throat, HA, rash.
Attacks CD4 cells
Level of HIV in blood is VERY HIGH, INCREASING r/f transmission

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8
Q

When does acute HIV infection develop?

A

2-4 weeks after infected

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9
Q

In what HIV stage is the risk for transmission highest?

A

Acute stage; level of HIV in blood is very high

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10
Q

S/Sx of acute HIV infection

A

Flu like Sx: fever, sore throat, HA, rash

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11
Q

Chronic HIV infection

A
  • AKA asymptomatic HIV infection or clinical latency
  • HIV continues to multiply in the body but at very low levels
  • Can still spread HIV to others
  • W/out treatment chronic HIV usually advances to AIDS in 10 years or longer though it may take less time for some.
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12
Q

“Asymptomatic HIV infection” or “clinical latency” is associated with which HIV stage?

A

Chronic stage

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13
Q

T/F those with chronic HIV have symptoms

A

False

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14
Q

T/F without treatment chronic HIV infection will advance to AIDS in 20 years

A

False; w/out treatment HIV can advance to AIDS in 10 years or longer though it may take less time in some people.

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15
Q

Latent HIV reservoir

A
  • A group of immune cells in the body that are infected with HIV but are NOT actively producing new HIV
  • Can be found throughout the body, including the brain, lymph nodes, blood and digestive tract
  • Medicine has not effect on them
  • A major challenge for researchers
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16
Q

A group of immune cells in the body that are infected with HIV but are NOT actively producing HIV.

A

Latent HIV reservoir

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17
Q

Where do latent HIV reservoirs reside?

A

Can be found throughout the body, including the brain, lymph nodes, blood and digestive tract.

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18
Q

Why are latent HIV reservoirs a problem for researchers?

A

Medicines to not effect the reservoirs

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19
Q

What is the final and most severe stage of HIV infection?

A

AIDS

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20
Q

AIDS

A

HIV severely damages the immune system and the body can’t fight off opportunistic infections

  • Aids dx if the CD4 count is <200cells/mm^3 or if they have certain opportunistic infections
  • Without tx people typically survive about 3 years
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21
Q

When is AIDS diagnosed?

A

Aids dx if the CD4 count is <200cells/mm^3 or if they have certain opportunistic infections

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22
Q

Those with AIDS who go without treatment usually live how long?

A

3 years

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23
Q

At what point do most opportunistic infections & complications develop? (CD4)

A

When CD4 count <200

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24
Q

HIV staging (0-3)

A

Stage 0- early HIV infection
Stage 1- >500CD4 and no AIDS defining condition
Stage 2- 200-499CD4 and no AIDS defining condition
Stage 3- <200 CD4 or documentation of AIDS defining condition

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25
Q

What stage is AIDS in HIV staging?

A

Stage 3

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26
Q

Def: Opportunistic infection

A

Infections that are more frequent or severe due to immunosuppresion

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27
Q

AIDS defining illness. Few example

A

TB
Toxoplasmosis
Cryptosporidosis

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28
Q

Kaposi’s sarcoma

A

Red spots that is highly incidence/ with HIV

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29
Q

HIV transmission- fluids

A

Via contact with certain body fluids from a person infected with HIV.
-Blood, semen, pre-seminal fluids, vaginal fluids, rectal fluids, breast milk.
Mother to child transmission
- Pregnancy, childbirth, breastfeeding

30
Q

T/F HIV can only be spread to a baby via breastfeeding

A

False; HIV can be spread from mom-to-baby via pregnancy, childbirth and breastfeeding

31
Q

HIV transmission activities

A
  • IV drug use, sharing needles
  • Sexual contact with an infected partner, including vaginal, anal & oral (least risk)
  • From infected woman to fetus during pregnancy or the newborn during birth
  • Breastfeeding by infected mothers to newborns
  • Transfusion of infected blood or blood products.
32
Q

T/F HIV is NOT transmitted by casual contact such as shaking hands or hugging

A

True

33
Q

T/F HIV is NOT transmitted by contact with objects such as dishes, toilet seats, doorknobs

A

True

34
Q

The top 4 highest risks for HIV transmission is

A

1) Blood transfusion
2) Needle-sharing injection-drug use
3) Receptive anal intercourse
4) Percutaneous needle stick

35
Q

Those undiagnosed an not retained in care account for what percentage of new HIV transmissions?

A

91.5% of cases; focus is to get these people into care and diagnosed

36
Q

Reproductive cycle of HIV-1 (8)

A

1) virus entry
2) reverse transcription
3) Integration
4) Transcription
5) Translation
6) Cleavage
7) Assembling
8) Budding & maturation

37
Q

HIV treatment- anti-retroviral agents

A

Combination of drugs that attack different sites involved with HIV replication
-Recommendations come from DPHHS

38
Q

How many classes of drugs stop HIV at different stages in HIV life cycle?

A

5

39
Q

5 classes of HIV tx drugs

A

Entry inhibitors
Reverse transcriptase inhibitors (non-nucleoside)
Reverse transcriptase inhibitors (nucleoside)
Integrase inhibitors
Protease inhibitors

40
Q

Pharmacokinetic (PK) enhancers (boosters) to improve the PK profiles of some ARV drugs

A

To allow meds to be more effective

41
Q

How many medications are normally utilized to tx HIV? What changes have we seen more recently?

A

Utilize three; more recently seeing 2 medications

42
Q

Trends in HIV infection

A

Increased people living with HIV
Decreased new HIV infections
Decreased deaths due to AIDS related illnesses
(This is due to treatment)

43
Q

Highest population/group of persons living with dx and un-dx HIV in the US HIV transmission categories?

A

Men who have sex with men

44
Q

What race is HIV most prevalent in?

A

African Americans

45
Q

What ages do we recommend HIV testing?

A

Ages 13-64

46
Q

T/F We see high numbers of HIV in rural areas

A

True

47
Q

T/F We are seeing new HIV diagnoses trending upwards

A

False; We are seeing HIV dx trending downwards

48
Q

T/F Lifespan for a person with HIV who takes ART is near normal and # of new infections per year is finally decreasing.

A

True

49
Q

Why has incidence finally decreased some?

A

-Expanded testing
-Efforts at linkage and retention in care
-Pre-exposure prophylaxis (PrEP)
Treatment for all and “treatment as prevention” (Give to someone who is not infected, but is at a higher risk for infection)

50
Q

T/F If viral load is decreased the risk for transmission is still high

A

False; If viral load is decreased, the risk for transmission is lower

51
Q

U=U means

A

Undetectable = Untransmittable

52
Q

What is one issue with those who use PrEP?

A

People don’t think that they need to use prevention. PrEP doesn’t protect against STD’s.

53
Q

How often should those at high risk receive testing?

A

Annually
(Those having unprotected sex with someone HIV+ or status is unknown, multiple partners, exchanging sex for $$, STD, using drugs with needles and sharing needles, )

54
Q

T/F Having an existing STD is a high risk factor for HIV

A

True

55
Q

Additional HIV testing should be conducted in those (Excluding high risk)

A

Women who are pregnant or planning to become pregnant, Those who sought tx for TB or Hepatitis, anyone sexually assaulted).

56
Q

CDC testing guidelines

A

Consent isn’t needed or required as apart of routine care.

- They have the option to decline.

57
Q

Repeat screenings of HIV in pregnant women in high risk areas are performed when?

A

In the 3rd trimester

58
Q

There are 4 generations of HIV testing. What generation do we use?

A

4th generation

59
Q

How does the 4th generation of HIV testing work?

A

Tests the core of the virus and HIV antibodies (but can take a while to show up)

60
Q

Acute (primary) HIV: Eclipse phase

A

5-10 days that you are infected but rna-transcription hasn’t occurred yet.

61
Q

Acute (primary) HIV: Window period

A

When antibodies will appear

-10-25 days after acquisition, but tell others 3 months

62
Q

Laboratory dx of early HIV infection: In what order will results show?

A

1) Detect RNA first
2) Detect P24 second
3) Detection of HIV antibodies

63
Q

Positive RNA detection (10-12 days) is indicative of what?

A

Viral load

64
Q

What is used to confirm HIV cases

A

“Western blot”

65
Q

Which type of HIV is found in the US? HIV-1 or HIV-2

A

HIV-1

66
Q

If patient receives an initial + HIV antigen/antibody test and then a negative HIV antibody differentiation test what will we do?

A

A viral load; maybe in between p24 and when antibodies would show up

67
Q

T/F One positive results confirms diagnosis

A

False; 2 positive results confirm diagnosis

68
Q

PrEP

A

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 everyday.

69
Q

Truvada

A

PrEP-combination pill

70
Q

What are two types of PrEP medication?

A

Truvada and Descovy

71
Q

Those who have receptive vaginal sex cannot take which PrEP medication?

A

Descovy

72
Q

Recommended indications for PrEP

A

MSM
Heterosexually active men and women
IV drug users

NRSG 477 (11 decks)

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