HIV/Hepatitis

Question 1

GUM clinic tracking for STIs

Answer 1

Contact Tracing

Question 2

HIV Predominantly prevalence countries

Answer 2

• Asia
• Africa
• Europe

Question 3

Globally HIV prevalence gender
group

Answer 3

Female

Question 4

HIV Mode of Transmission

Answer 4

• Unprotected anal, vaginal or oral sexual activity
• History of drug use and injecting
• Exposure to blood or blood products
• Tattooing
• Occupational risk
• Overseas travel / country of origin
• Vertical transmission

Question 5

Terms used in GUM clinic

Answer 5

Men have sex with Men: MSM

Question 6

Ask men whether top / bottom

Answer 6

to determine areas of high risk

Question 7

why is HIV so difficult to cure

Answer 7

ability to mutate / infects the WBC CD4 Lymphocytes
- once it’s bound 3 enz. infects genome and spread virus
intergrase protease A
Reerse Transcriptase

Answer 8

Protease needed to mature new virus

Question 9

Defining illness from HIV

Answer 9

CD4 < 200 then predispose to infections e.g. pneumocystis jiroveci

Question 10

HIV Exposure timeline

Answer 10

1. 2-8/52 asymptomatic, cold+flu Sx
2. 1-3months: Sero conversion develops HIV Abs responding to HIV viral load
3. HIV viral load then reduce keep at bay for years
4. HIV viral particles will increase and CD4 then will have AIDs
   - Measure HIV viral load and CD4 count: < 400 to give antiviral

Question 11

CD4 & HIV viral load target with ART

Answer 11

Undetectable HIV viral load
CD4 500-1500

Question 12

HIV Tx

Answer 12

NNRTIs NRTIs RTIs

Question 13

Pre-Exposure Prophylaxis / Truvada

Answer 13

Emtricitabine/tenofivir

Question 14

PEP-Post exposure

Answer 14

Truvada+another drug

Question 15

HIV

Answer 15

3 drugs Tx to avoid
U&E
LFTs
FBC

Question 16

Strains of HIV

Answer 16

HIV1: outside africa HIV2: mainly find in africa

Question 18

DNA virus
RNA virus
Treatment options

Answer 18

DNA virus easier to develop vaccine

Answer 19

S Ag - S Ab
C Ag - C Ab
E Ag - E Ab
Carrier? Acute infection? Immunity
Knowing the Ag and Abs

Question 20

The first Ag presenting in blood in Hep B

Answer 20

HBeAg
HBsAg

Question 21

When full immunity determined by

Answer 21

Ab against the surface Ag = full immunity

Question 22

What does the presence of IgM and IgG represents

Answer 22

IgM - recent infection
IgG - past infection, immemory and can fight against this

Question 23

Seroconversion in HIV

Answer 23

the process of producing anti-HIV antibodies during primary infection

Question 24

HIV Ix

Answer 24

4th generation test serum/salivary ELISAs for HIV antibodies and p24 antigen

Question 25

HIV monitoring

Answer 25

- CD4 count - HIV viral load - FBC - U&Es - Urinalysis - ALT, AST and bilirubin

Question 26

HIV exposure prophylaxis Tx

Answer 26

**post-exposure prophylaxis** (PEP)

Question 27

PEP Timeframe

Answer 27

Within **72 hours** of exposure

Question 28

Define HIV

Answer 28

An RNA retrovirus enters and destroys the CD4 T-helper cells of the immune system

Question 29

HIV subtypes

Answer 29

HIV-1: Most common HIV-2: found in West Africa

Question 30

HIV infection phases

Answer 30

1. Seroconversion 2. Latent/Asymptomatic phase 3. Symptomatic 3. Advanced HIV disease = **AIDS**

Question 31

AIDS-Defining Illnesses

Answer 31

- Kaposi’s sarcoma - Pneumocystis jirovecii pneumonia (PCP) - Cytomegalovirus infection - Candidiasis (oesophageal or bronchial) - Lymphomas - Tuberculosis

Question 32

HIV monitoring

Answer 32

1. CD4 count 2. HIV RNA/ml = Viral load

Question 33

Serum CD4 ranges for HIV

Answer 33

- 500-1200 = normal range - < 200 puts the patient at high risk of opportunistic infections

Question 34

HIV viral load range

Answer 34

- < 20copies/ml = undetectable

Question 35

What is the window period for 4th generation ELISA tests for HIV antigens and antibodies

Answer 35

45 days

Question 36

How long should HIV post-exposure patient abstine from sex for?

Answer 36

3 months + negative result

Question 37

PCP pneumocystis pneumonia Tx

Answer 37

Co-trimoxazole

Question 38

Kaposi’s sarcoma causative agent

Answer 38

Human herpesvirus 8 **(HHV-8)**

Question 39

Primary HIV infection/Seroconversion Sx

Answer 39

Fever Muscle aches Malaise Lymphadenopathy **Maculopapular rash** Pharyngitis **Mucosal ulcers**

Question 40

What is the window period Point-of-care tests for **HIV antibodies** be done

Answer 40

90 days

Question 41

Cerebral toxoplasmosis cause

Answer 41

**parasite Toxoplasma gondii**

Question 42

Cerebral toxoplasmosis Tx

Answer 42

Pyrimethamine and sulphadiazine

Question 43

cryptococcal meningitis CSF findings

Answer 43

Normal profile