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Flashcards in HIV Treatment and Management Deck (16):
1

What are the targets of anti-retroviral drugs?

Reverse transcriptase
Integrase
Protease
Entry - fusion, CCR5 receptor
Maturation

2

What drugs have vitro activity against HIV?

Nucleoside analoguesreverse transcriptase inhibitors (NRTI)

3

Give an example of a Nucleoside analoguesreverse transcriptase inhibitor?

Zidovudine

4

When did zidovudine not work?

When used as monotherapy against asymptomatic individuals

5

What is the definition of highly active anti-retroviral therapy?

A combination of 3 drugs from at least 2 drug classes to which the virus is susceptible

6

What is the purpose of anti-retroviral therapy?

Reduce viral load to undetectable
Restore immunocimpetence
Reduce morbidity and mortality
Minimise toxicity (maximise tolerability)

7

Give an example of an effective anti-retroviral therapy

Tenofovir
Emtricitabine
Efavirenz

8

What is the wish-list for anti-retroviral therapy?

Tolerability
Low toxicity
Low pill burden
Low dosing frequency
Minimal drug-interactions
High barrier to resistence

9

What are the side effects of HAART therapy?

GI - protease inhibitors, transaminitis, fulmient hepatitis (nevirapine + most others)
Skin - rash, hypersensitivity, Stevens-Johnsons (abacavir, nevirapine)
CNS - mood, psychosis (efavirenz)
renal - proximal renal tubulopathies (tenofovir, atazanavir)
Bone - Osteomalacia (tenofovir)
CVS - Increased MI risk (Abacavir, lopinavir, maraviroc)
Haem - anaemia (Zidovudine)

10

What are co-infections of HIV?

Hep B
Hep C
TB

11

What are the 3 types of partner notification?

Partner referral
Provider referral
Conditional referral

12

How can you prevent HIV transmission?

Condom use
HIV treatment
STI screening and treatment
Sero-adaptive sex behaviours
Disclosure
Post-exposure prophylaxis
Pre-exposure prophylaxis

13

Can you transmit HIV by casual/household contact?

No

14

How do you prevent transmission from mother to child?

HAART during pregnancy
Vaginal delivery if undetected viral load
Caesarean section if viral load detected
4/52 PEP for neonate
Exclusive formula feeding

15

What is sero-discordance?

When a couple has one person who is HIV -ve and the other is HIV +ve

16

What ways can sero-discordant couples conceive?

HIV +ve male: - Timed unprotected sex with HAART
HIV +ve female: self insemination
Timed unprotected sex with HAART
Treatment as prevention