HIV Testing and Clinical Management Flashcards Preview

INFECTIOUS DISEASES 303 > HIV Testing and Clinical Management > Flashcards

Flashcards in HIV Testing and Clinical Management Deck (19):
1

What occurs when HIV is diagnosed late?

Death more likely
Transmission to others

2

Most common people with HIV?

White homosexual men 35-49 years old

3

Clinical indicator diseases for adult HIV infection?

Kaposi's sarcoma = severe or recalcitrant seborrhoeic dermatitis, recurrent herpes zoster, oral candidosis, ral hairy leukoplakia
Head and neck cancer
Hodgkin's lymphoma
Castleman's disease
Lymphadenopathy of unknown cause
Chronic parotitis
Lymphoepithelial parotid cysts

4

Signs of HIV primary infection?

Fever
Adenopathy
Malaise
Rash
Arthralgia
Myalgia

5

Signs of advanced HIV (CD4<200)?

Oral candidiasis
Hairy leukopiakia
Herpes simplex
Non-hodgkin's lymphoma
Primary CNS lymphoma

6

What is candida?

Fungal infec - white marks (oral thrush)
Usually in healthy adults

7

Risk factors of candida?

antibiotics, immunocompromised

8

What is shingles?

Reactivation of varicella zoster virus
Dermatomal distribution
Painful blistering rash, malaise

9

Risk factors of shingles?

Age
Immunocompromised

10

How to recommend a HIV test to a pt?

Verbal and documented consent - send clotted blood to lab
If pt says no - explore why

11

How to test for HIV?

4th generation test:
- Antibody/antigen
- Window period 1 month
- Cheap
- Confirmatory test >99.9% PPV
THEN:
Call specialist for advice
Result: given face to face in a confidential environment
Contact tracing done by specialist services

PR antibody and antigen only tests, point of care tests

12

What is Kaposi's sarcoma?

Human herpesvirus-8
Usually linked with HIV
Black/brown marks
Spindle cells on biopsy
Refer to oncology

13

What is oral hairy leukoplakia?

Epstein-Barr virus
White patches that cannot be scraped off - white striations on side of tongue
Linked with HIV, smoking and immunosuppression

14

What presents with herpes simplex virus (HSV)?

Coldsores

15

How does HIV impact HSV?

More severe coldsores
More frequent
Outbreaks last longer
May have genital herpes

16

How to treat HIV?

Highly antiviral retroviral therapy (HAART) - Act on different points of HIV replication cycle = suppresses virus
Consists of 3 antiretroviral drugs

17

Replication cycle of HIV? How the medications work?

CD4 = lymphocyte that HIV can bind to via a co-receptor
Drugs can inhibit this process by binding to the co-receptor to stop HIV entering the cell
HIV RNA gets into cell and uses reverse transcriptase to turn itself into the DNA = NRTI and NNRTI work against reverse transcriptase

18

Why does HIV become resistant to drugs?

1 mutation in every 2 new viruses produced
1 -10 billion new virus particles each day
1-5 billion mutations per day

19

Why are therapeutic drug levels essential to keep HIV suppressed?

1. Non-adherence : missing one or two doses can cause resistance
2. Drug-Drug interactions : Many drugs interact with antiretrovirals, and therefore cause subtherapeutic levels