HIV Basics Flashcards
Healthy immune system CD4 count
500 - 1600 cells/mm3
Body fluids that can spread HIV
- Blood
- Semen and pre-seminal fluid
- Rectal fluids
- Vaginal fluids
- Breast milk
Acute HIV symptoms
2-3 weeks after infection, ⅔rds will have flu-like illness for a few days to weeks
- Fever
- Chills
- Rash
- Night sweats
- Muscle aches
- Sore throat
- Fatigue
- Swollen lymph nodes
- Mouth ulcers
Symptoms of AIDS
- Rapid weight loss
- Recurring fever or profuse night sweats
- Extreme and unexplained tiredness
- Prolonged swelling of the lymph glands in the armpits, groin, or neck
- Diarrhea that lasts for more than a week
- Sores of the mouth, anus, or genitals
- Pneumonia
- Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
- Memory loss, depression, and other neurologic disorders
7 Stages of the HIV Lifecycle
- Binding
- Fusion
- Reverse transcription
- Integration
- Replication
- Assembly
- Budding
7 Stages of the HIV Lifecycle
1) Binding (describe process and drug class that inhibits)
- Process: HIV virus binds/attaches to receptor on CD4 cell surface
- Blocked by:
- CCR5 antagonist
- Post-attachment inhibitors
7 Stages of the HIV Lifecycle
2) Fusion (describe process and drug class that inhibits)
- Process: HIV envelope fuses with CD4 cell membrane allowing virus to enter cell
- Blocked by:
- Fusion inhibitors
7 Stages of the HIV Lifecycle
3) Reverse Transcription (describe process and drug class that inhibits)
- Process: HIV releases its enzyme reverse transcriptase and uses it to convert HIV RNA into HIV DNA, allowing DNA to enter CD4 cell’s nucleus
- Blocked by:
- Nucleoside reverse transcriptase inhibitors (NRTI’s)
- Non-nucleoside reverse transcriptase inhibitors (NNRTI’s)
7 Stages of the HIV Lifecycle
4) Integration (describe process and drug class that inhibits)
- Process: HIV releases its enzyme integrase inside CD4 cell nucleus and uses it to insert HIV DNA into the CD4 cell DNA
- Blocked by:
- Integrase inhibitors
7 Stages of the HIV Lifecycle
5) Replication (describe process and drug class that inhibits)
- Process: HIV uses CD4 machinery to make long chains of HIV proteins (building blocks for more HIV)
- Blocked by:
- No drug classes for this step
7 Stages of the HIV Lifecycle
6) Assembly (describe process and drug class that inhibits)
- Process: New HIV RNA and proteins move to surface of cell and make immature/non-infectious HIV
- Blocked by:
- No drug classes for this step
7 Stages of the HIV Lifecycle
7) Budding (describe process and drug class that inhibits)
- Process: New HIV pushes itself out of the CD4 cell and releases its enzyme called protease which breaks up the long proteins of the immature virus, making it now infectious
- Blocked by:
- Protease inhibitors
Nucleoside reverse transcriptase inhibitors (NRTIs)
Name the drugs
- Abacavir (abacavir sulfate/ABC/ziagen)
- Emtricitabine (FTC, Emtriva)
- Lamivudine (3TC, Epivir)
- Tenofovir disoproxil fumarate (tenofovir DF, TDF, viread)
- Zidovudine (azidothymadine, AZT, ZDV, retrovir)
Non-nucleoside reverse transcriptase inhibitors (NRTIs)
Name the drugs
- Doravirine (DOR, pifeltro)
- Efavirenz (EFV, sustiva)
- Etravirine (ETR, intelence)
- Nevirapine (NVP, viramune, viramune XR)
- Rilpivirine (RPV, endurant)
Protease Inhibitors
Name the drugs
- Atazanavir (ATV, reyataz)
- Darunavir (DRV, prezista)
- Fosamprevanir (FOS-APV, FPV, lexiva)
- Ritonavir (RTV, norvir) *also used as a pharmacologic enhancer
- Saquinavir (SQV, invirase)
- Tipranavir (TPV, aptivus)
Fusion Inhibitors
Name the drugs
- Enfuvirtide (T-20, fuzeon)
CCR5 Antagonist
Name the drugs
- Maraviroc (MVC, selzentry)
Integrase Strand Transfer Inhibitors (INSTIs)
Name the drugs
- cabotegravir (CAB, vocabria)
- dolutegravir (DTG, Tivicay, Tivicay PD)
- raltegravir (RAL, isentress)
Attachment Inhibitors
Name the drugs
- Fostemsavir (FTR, rukobia)
Binds to gp120 protein on outer surface of HIV, preventing it to enter CD4 cell
Post-Attachment Inhibitors
Name the drugs
- ibalizumab-uiyk (trogarzo)
Block CD4 receptors on the surface of certain immune cells that HIV needs to enter the cells.
Pharmacokinetic enhancers
Name the drug
- cobisistat (COBI, tybost)
What are the 2 tenofovirs and what is the difference
- Tenofovir disoproxil fumarate (TDF, viread) - older
- found in Truvada, Atripla, Complera, Delstrigo, Stribild, Symfi/Symfi Lo
- Tenofovir alafenamide (TAF, vemlidy) - newer, prodrug of TDF, so lower doses can be given → less exposure for organs (brain, bones, kidney). Patent until 2022
- found in Descovy, Biktarvy, Genvoya, Odefsey, Symtuza
