Flashcards in HIV Treatment and Management Deck (16)
What are the targets of anti-retroviral drugs?
Entry - fusion, CCR5 receptor
What drugs have vitro activity against HIV?
Nucleoside analoguesreverse transcriptase inhibitors (NRTI)
Give an example of a Nucleoside analoguesreverse transcriptase inhibitor?
When did zidovudine not work?
When used as monotherapy against asymptomatic individuals
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
What is the purpose of anti-retroviral therapy?
Reduce viral load to undetectable
Reduce morbidity and mortality
Minimise toxicity (maximise tolerability)
Give an example of an effective anti-retroviral therapy
What is the wish-list for anti-retroviral therapy?
Low pill burden
Low dosing frequency
High barrier to resistence
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)
What are co-infections of HIV?
What are the 3 types of partner notification?
How can you prevent HIV transmission?
STI screening and treatment
Sero-adaptive sex behaviours
Can you transmit HIV by casual/household contact?
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
What is sero-discordance?
When a couple has one person who is HIV -ve and the other is HIV +ve