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Flashcards in HIV Course Deck (12)
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1
Q

Which gender is more likely to be infected with HIV? There are more _____ infected than _______

A

Females; males, females

2
Q

Which group is more likely to acquire HIV?

A

Male-to-male sexual contact, at least 75% new infections(over heterosexual, injection drug use, MSM and injection drug use combined)

3
Q

In the time course of the HIV infection, when could anti-HIV Abs appear? What happens during the clinical latency period? When can we see constitutional symptoms? Can you make a diagnosis of HIV based on the CD4 count?

A

3-12 weeks; Virus is proliferating in CD4 cells that have been infected, maybe creating syncytia and creating virions; when CD4 cells and immune system lose control and viremia recurs, perhaps at 8 years after primary HIV infection;NOOOOOO

4
Q

What do you begin to see at a certain CD4 count? What is that count?

A

Kaposi’s sarcoma (HIV in conjunction with HHV)1. Pneumocystitis jirovecii pneumonia (classified as fungus and can respond to bactrim, a sulfa drug)2. Non-Hodgkin’s lymphoma (could see lymphadenopathy)3. Esophageal candida (AIDS defining diagnosis!!!: thrush, oral hairy leukoplakia)4. Crypcosporidiosis5. Chronic herpes (face)6. Cerebral toxoplasmosis (mass effect, multiple ring-enhancing lesions on MRI/CT, typically involves basal ganglia)7. Progressive Multifocal Leukoencephalopathy (JC virus)8. CMV retinitis9. Mycobacterium avium complex (straight pink things that fill up the macrophages);around 200

5
Q

At around 500 CD4 T cells, what do you see? What would you try to target?

A

Skin disease (seborrheic dermatitis) and nodular prurigo (papulopruitic eruptions centered around hair follicles);target the HIV

6
Q

At around which CD4 count do you see pulmonary TB? How does the TB typically arise?

A

300-400; typically is reactivated with a low enough CD4 count

7
Q

What are some goals of antiretroviral therapy?

A
  1. Suppress HIV-1 replication (lower viral load and impede HIV spread)2. Prevent/delay destruction of immune system3. Achieve normal survival while maintaining a tolerable life
8
Q

When is it indicated to initiate therapy of chronic infection?

A

If symp, with CD4 T cell count and plasma HIV RNA at any value, TREAT;if asymp with AIDS, CD4 less than 350, TREAT;if asymp, >350 CD4, >100,000 copies of plasma HIV RNA, some clinicians might treat;if asymp, >350, <100,000, DEFER THERAPY

9
Q

Benefits to treating someone with CD4 > 500 cells/ul?

A

At the very least, DISCUSS treatment with the patient

10
Q

List concerns of early therapy?

A
  1. ARV-related toxicities2. Non-adherence to ART3. Drug resistance4. Cost
11
Q

What are the different types of ARV medications (6)?

A
  1. NRTI’s2. NNRTI’s3. PI’s4. II’s5. Fusion inhibitors6. CCR5 antagonist
12
Q

What are the PREFERRED initial regimens?

A
  1. Combination of 2 NRTI’s with NNRTI2. Combo of 2 NRTI’s with PI3. Combo of 2 NRTI’s with II