HIV/AIDS Chapter 27

Question 1

What are the main types of HIV?

Answer 1

HIV 1 and HIV 2

Question 2

Which is most common HIV 1 or HIV 2?

Answer 2

HIV 1

Question 3

What does HIV stand for?

Answer 3

Human
Immunodeficiency
Virus

Question 4

Where do we believe HIV originated?

Answer 4

Chimpanzees

Question 5

What two criteria are needed to say a patient has AIDS?

Answer 5

Opportunistic Infections

T-cells under 200

Question 6

What type of virus is HIV?

Answer 6

Retrovirus

Question 7

Does the HIV virus have RNA or DNA?

Answer 7

RNA

Question 8

How many genes does HIV have?

Answer 8

9 genes

Question 9

Which enzymes does HIV need to carry with it?

Answer 9

Reverse transcriptase
Protease
Integrase

Question 10

Is HIV enveloped or non-enveloped?

Answer 10

Enveloped (has spikes for attachment)

Question 11

How is HIV transmitted from one person to another?

Answer 11

Sex
Blood
Mother to baby

Question 12

Mother to baby transmission is also defined as?

Answer 12

Vertical transfer

Question 13

What are the chances of a baby contracting HIV from a mother who takes no precautions against prevention?

Answer 13

30%

Question 14

What are some preventative measures pregnant women can take to decrease the chances of transmitting HIV to their baby?

Answer 14

Take antivirals
Have a C-section delivery
No breastfeeding
Baby takes antivirals after birth

Question 15

What are the chances of a baby contracting HIV from a mother who does take precautions?

Answer 15

> 1%

Question 16

What type of cell receptors does HIV target?

Answer 16

Cell with CD4 receptors and co-receptors

Question 17

What type of cells does HIV attack?

Answer 17

Macrophages
Dendritic cells
Helper T-cells

Question 18

What are some possible co-receptors?

Answer 18

CCR5 or CXCR4

Question 19

After the HIV virus fuses with a cell and un-coats, what is the first enzyme that comes into play?

Answer 19

Reverse transcriptase ⇒ Takes the RNA to DNA

Question 20

What other enzymes help with the integration process?

Answer 20

Integrase

Question 21

After the virus has integrated does it go latent or remain active?

Answer 21

It can go latent or go active

Question 22

What is the virus called when it becomes integrated?

Answer 22

Provirus

Question 23

What is the third enzyme that comes into play?

Answer 23

Protease

Question 24

What does protease do?

Answer 24

Cuts proteins ⇒ Makes the cut so proteins can fold into a functioning protein

Question 25

How does HIV get out of the cell?

Answer 25

It buds out

Question 26

What does it mean to have a latent HIV infection?

Answer 26

The virus is NOT making more of itself (not active) ⇒ Acting as a RESERVOIR that can become active at a later date

Question 27

In which immune system(s) does HIV use mechanisms to avoid the system(s)?

Answer 27

Both cellular and humoral systems

Question 28

Which cellular system is attacking HIV?

Answer 28

Killer T-cells

Question 29

Although killer T-cells can do a pretty good job of attacking the HIV virus, why can't killer T-cells completely get rid of the virus?

Answer 29

Because of the reservoirs ⇒ HIV virus live in reservoirs and do not present antigens - so killer T-cells do not recognize them to kill them

Question 30

What happens to killer T-cells over time (10+ years)?

Answer 30

Bone marrow is no longer able to keep up with the demand and Helper T-cells cannot activate because they have been depleted

Question 31

What is the problem in the humoral system (system in which we try and make antibodies (Ab's) against the HIV virus)?

Answer 31

The binding sites are too far apart and there is NO good bivalent binding HIV's high mutation rates prevent cells from being able to keep up with antibody production Antibodies are produced too late

Question 32

What are the three phases of pathogenesis?

Answer 32

Acute phase Asymptomatic AIDS

Question 33

What is going on during the Acute phase?

Answer 33

HIV levels go up high - coming back down when Killer T-cells kick in No significant symptoms - only flu like symptoms

Question 34

What is going on during the Asymptomatic phase?

Answer 34

Little to no symptoms

Question 35

What is going on during the AIDS phase?

Answer 35

Helper T-cells count >200 ⇒ Death from cancer or opportunistic infections

Question 36

Typical cases during the AIDS phase?

Answer 36

Slow progression over a period of about 10 years

Question 37

Atypical cases during AIDS phase?

Answer 37

Fast progressors to slow progressors

Question 38

What are fast progressors?

Answer 38

The virus progresses quickly over a period of about two years

Question 39

What are long-term non-progressors?

Answer 39

HIV progresses over a longer than typical period of time Elite controllers

Question 40

Are you able to tell if a person has HIV by looking at them?

Answer 40

No, the person must be tested/screened for diagnosis CDC has new screening guidelines

Question 41

What is good about the latest fourth generation testing?

Answer 41

ELISA like testing looks for both antibodies and antigens Earlier detection ⇒ sometimes as early as two weeks (14 days)

Question 42

Does treatment only require the use of only one drug?

Answer 42

No - give a "cocktail" of drugs for better effectiveness known as HAART Highly Active Anti-retro viral Therapy (combination of drug therapy)

Question 43

What type of drugs do we have to fight infection of HIV and are they for a cure?

Answer 43

Drugs do not cure HIV ⇒ the goal is to make the patient a long term or non-progressor AZT - target reverse transcriptase (stops production of DNA from RNA) Types of drugs include: ⇒Protease inhibitors - prevent the cutting of enzymes ⇒Integrase inhibitors ⇒ Receptor binders - binds CCR5 receptors ⇒ Fusion inhibitors

Question 44

Why do we use a combination drug therapy when treating a patient?

Answer 44

Because if one drug becomes resistant then you have some backup

Question 45

What are some downsides of HAART?

Answer 45

It is a kitchen sink approach that encourages resistance by putting the drugs out there Can have tonic side-effects and resistance Can be very costly

Question 46

What is the good side of HAART?

Answer 46

Decrease in death rate Decreases the amount of virus in the body which are sometimes at undetectable levels

Question 47

How do we monitor HIV patients?

Answer 47

Viral load testing

Question 48

What is Post-Exposure Prophylaxis (PEP) for HCP?

Answer 48

Immediate post exposure drug treatment (within 72 hours) consisting of 3 or more drugs for 4 weeks

Question 49

When is a patient tested for HIV after beginning PEP?

Answer 49

6 weeks 12 weeks 6 months

Question 50

What are the chances of becoming infected with HIV after PEP?

Answer 50

0. 3% | 0. 9% if in the eye

Question 51

How is HIV prevented?

Answer 51

* Treat all blood as potentially infectious * Blood/organ screening * needle exchanges * C-section * Bottle feeding * Male circumcision * Vaginal gel * Vaccines (not yet approved)

Question 52

Which trial prevention in Africa has shown a 50% reduction rate?

Answer 52

Vaginal gel | Vaccines (not yet approved)