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Pathology ICSM COPY > Immunology 4 - HIV infection > Flashcards

Immunology 4 - HIV infection Flashcards

(54 cards)

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1
Q

What is more common - primary or secondary immune deficiencies?

A

secondary

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2
Q

What is Good’s syndrome?

A

thymoma and Ab def

combined T and B cell defect

CMV PJP and mucocutaneous candida

autoimmune disease (pure red cell aplasia, myasthenia gravis, lichen planus)

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3
Q

Which cancers may immunodeficiency syndromes predispose to?

A

viral EBV, HHV8

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4
Q

What does ↓IgG and IgM suggest?

A

monitor for B cell neoplasm

Hx exposure to rituximab

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5
Q

What does an isolated ↓IgG suggest?

A

protein losing enteropathy

prednisolone >10mg/day

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6
Q

What does ↓IgG and IgA suggest?

A

? primary Ab deficiency

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7
Q

How many genes are inside the HIV genome?

A

9

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8
Q

Recall the receptor and co-receptors for HIV on CD4+ T cells

A

CD4 receptors
CCR5 CXCR4 coreceptors

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9
Q

How does HIV bind to CD4 cells?

A

gp 120 (initial binding)

gp41 (conformational change)

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10
Q

Using which enzyme does HIV replicate inside cells?

A

Reverse Transcriptase

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11
Q

What is the role of reverse transcriptase in HIV?

A

HIV is dsRNA virus

RNA -> DNA which can be incorporated into host cells’ genes

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12
Q

What are the two key glycoproteins encoded by the HIV virus?

A

gp120
gp41

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13
Q

Which cell of the immune system is particularly affected by HIV?

A

CD4+ T cells

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14
Q

In people who have natural immunity to HIV, what antibodies may be present in serum?

A

Anti-gp120 and anti-gp41 (Nt) antibodies

initally gp41 → gp120

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15
Q

How does HIV infection affect CD8+ T cells?

A

Interferes with activation, as CD4+ T cell and antigen-presenting cell help are not present due to the virus

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16
Q

What is the adaptive immune response to HIV infection?

A
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17
Q

How does HIV infection affect monocytes and dendritic cells?

A

Not activated by CD4+ T cells and so cannot prime naive CD8+ T cells

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18
Q

How does HIV affect immunological memory?

A

CD4+ T cell memory is lost

CD8 memory cell not activated by antigen-presenting cell

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19
Q

Why is there so much variation/mutation in HIV infection?

A

HIV lacks same checking mechanisms in DNA transcription

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20
Q

Why is HIV mutation within the host problematic?

A

Escape from neutralising antibodies.

Escape from HIV-1-specific T cells.

Resistance and escape from antiretroviral drugs.

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21
Q

Recall the 7 steps of the HIV life cycle

A
  1. Attachment/Entry
  2. Reverse Transcription and DNA Synthesis
  3. Integration
  4. Viral Transcription
  5. Viral Protein Synthesis
  6. Assembly of Virus and Release of Virus
  7. Maturation
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22
Q

How does HIV damage the immune response?

23
Q

What is the median time of infection with HIV to AIDS development?

24
Q

What is the screening test for HIV?

Study These Flashcards
A

anti-HIV antibodies (ELISA)

25
How would you confirm HIV infection after screening?
detect Ab via Western Blod Positive test rquired pt to have SEROCONVERTED (i.e. started to prod Abs) around 10wks incubation period
26
What are the 3 major markers used to monitor HIV?
CD8 CD4 Plasma viral load
27
What diagnstic test is now used for HIV?
4th gen combined HIV1 Ag/Ab tests - detect 1 month post infection identify both HIV-specific antigen p24 and HIV antibodies with a blood sample
28
How are CD4+ T cell levels measured in HIV infection?
Flow cytometry
29
What are the two methods of testing for ARV resistance?
Phenotypic (viral replication meausred in cell cultures under selective pressure of increasing concentrations of antiretrovirals) Genotypic (involves directly sequencing the amplified genome)
30
What CD4 count defines AIDS?
\<200 cells/ nanolitre
31
At what CD4 count would you see bacterial skin infections, HSV, HZV, fungal infections
500
32
At what CD4 count would you see Kaposi'a sarcoma
400
33
At what CD4 count would you see Hairy leukoplakia, TB
300
34
At what CD4 would you see PCP, cryptococcis, toxoplasmosis?
200
35
At what CD4 count would you see CMV, lymphoma
120
36
At what CD4 count would you see Mycobacterium avium complex MAC disease?
75
37
WHen should you avoid abacavir (RTI) in HIV?
HLAB\*5701 (systemic hypersensitivity syndrome)
38
What classes of drugs would you use in HIV triple therapy?
2 NRTI and 1NNRRI or integrase inhibitor
39
what happens if individual stops ART?
HIV replication re commences and detectable by 2-3wks
40
Which drugs are capable of inhibiting the action of reverse transcriptase in HIV infection?
1. Nucleoside analogues 2. Non-nucleotide reverse transcriptases
41
Which HIV drugs can prevent modification of translated viral proteins?
Protease inhibitors
42
Which class of HIV drugs can prevent integration of viral DNA?
Integrase inhibitors
43
What does it mean if someone is an HIV exposed seronegative individual?
Partner of individual with HIV who remains uninfected
44
What is long-term nonprogression of HIV?
Individual who is asymptomatic 10 years after infection
45
Which drugs make up a HAART regimen?
Three or more drugs + one or more binding agents
46
Give 2 examples of NRTI HIV drugs
Zidovudine Lamivudine
47
When should HAART treatment be initiated?
Immediately
48
Recall 2 examples of protease inhibitor HIV drugs
Tenofovir Truvada
49
What class of drug is raltegravir?
Integrase inhibitor
50
Which drugs make up the HAART regimen initially?
2 NRTIs + PI
51
Which ARV is best to use in pregnancy?
Zidovudine
52
How can CD8+ T cells provide HIV entry into cells?
Producing chemokines MIP-1A, MIP-1b and RANTES
53
when is IgG replacement therapy indicated?
54
REcall 5 classess of ART drugs
* reverse transcriptase inhibitors * boosted protease inhibitors * integrase inhibitors * CCR5 antagonist * fusion inhibitos

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