HIV history, pathogenesis, and presentation Flashcards
What is R0?
Ability of dz to transmit to other people. An R0 < 1 is a self-limited dz. HIV has an R0 of 2-5 (NOT that transmissible)!
What are the risks of transmission of HIV from greatest to lowest?
- Receptive anal intercourse
- IV drug use
- Insertive anal intercourse
- Receptive vaginal
- fellatio
- cunnilingus
What is the risk of HIV per sex act overall?
1/900
How does HIV cause AIDS?
- Productive infection: Cells activated and undergo apoptosis through caspase 3
- Abortive infection: Cell recognizes it’s infected. Undergoes pyroptosis of infected cells (caspase-1)
- ->This is the major cause of AIDs
How do you diagnose HIV?
- Serology then confirm with western blot
2. If recently infected, get an RT PCR
How do nRTIs work?
Inhibits viral RNA to viral DNA by inhibiting RT
What are the side effects of nRTI?
- deadly hypersensitivity (8% if you have HLA B5701)
- fat redistribution
- lactic acidosis
How do nnRTIs work?
They are a NONcompetitive inhibitor of RT
How do protease inhibitors work?
They block the catalytic site of protease so that you can’t cleave them into functional proteins
What other therapies for HIV are there beside the “BIG THREE”?
CCR5 antagonists for resistant HIV
Integrase inhibitors
How does acute HIV present?
Like Mono–fever, headache, fatigue, and rash
CNS changes–can attack the brain
What are HIV pts with a CD4 < 200 at risk for?
Pneumonia from PCP
What are CD4<100 at risk for?
toxoplasmosis
What are CD4<50 at risk for?
MAC
What are CD4<50-100 at risk for?
cryptococcal meningitis
