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Infectious Disease > Retroviruses and HIV-1 > Flashcards

Retroviruses and HIV-1 Flashcards

1
Q

DNA sequence that can change its relative position within the genome of a single cell

A

transposable element

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2
Q

copy themselves in two stages, from DNA to RNA by transcription then from RNA to DNA by reverse transcription

A

retrotransposons

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3
Q

cut from the genome by a transposase and inserted into another region of the genome

A

DNA transposons

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4
Q

retroviruses are (enveloped/noneveloped) viruses and are the only ______ viruses that contain a ________ enzyme

A

enveloped
diploid
reverse transcriptase

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5
Q

retrovirus replicates through a double stranded DNA intermediate known as _______ that integrates randomly into the host cell chromosome

A

provirus

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6
Q
  • virus transmitted primarily by breastfeeding, sexual, and contaminated blood, solid organ transplants
  • infects CD4 T cells lifelong
  • most infected patients remain asymptomatic
A

HTLV-1

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7
Q

HTLV-1 causes ______ when infected at birth or early in life

A

adult T cell leukemia

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8
Q

the envelope glycoprotein of HIV-1 is responsible for virus binding to the _______ and co-receptor molecules on the surface of susceptible cells

A

CD4 receptor and co-receptor

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9
Q

the transmembrane component is responsible for the _______ of viral and host cell plasma membrane during entry

A

fusion

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10
Q

chemokine receptor used by HIV-1?

A

CCR5

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11
Q

the HIV-1 glycoprotein is a target for what antibodies?

A

gp120, CD4, gp41, CCR5 coreceptor

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12
Q

virus gp120 binds _____ receptor, induces conformational change that allows glycoprotein to bind ______

A

CD4

CCR5

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13
Q

when _____ undergoes conformational change, allows fusion peptide to attach to lipid bilayer and fusion event

A

gp41

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14
Q

converts immature virus particle to mature virus particle? last step of maturation

A

viral protease

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15
Q

early on retrovirus can affect ________, attacking T cells with CCR5 on surface, then migrates to spleen, brain, lung, and kidney

A

GALT

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16
Q

the _______ is the level of viremia at the end of the acute stage of infection, and the higher the number the faster the progression to AIDS

A

set point

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17
Q

mean time from infection to AIDS is approximately ______

A

10 years

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18
Q

clinical findings of primary or acute stage oh HIV infection?

A

headache, muscle aches, sore throat, fever, swollen lymph nods, CNS disorders, pneumonitis, diarrhea or GI complaints

19
Q

course of primary or acute stage of HIV infection?

A

lasts for weeks, get lymphadenopathy/lethargy/malaise for months

20
Q

lab findings in acute stage of HIV infection?

A

lymphopenia, thrombocytopenia, CD4/CD8 ratio decreases due to active depletion of CD4 and expansion of CD8, p24 antigenemia, virus may be present in CNS

21
Q

HIV asymptomatic period is a period of __________, however there is _______ virus replication during this period

A

clinical latency, constant

22
Q

during asymptomatic period there is constant turnover of? toward end there is an increase in due to deterioration of immune system?

A

infected T cells, viral loads

23
Q

immune evasion: external protein _______ of HIV is covered with glycosyl groups, which are identical to host proteins

A

gp120

24
Q

_____ protein downregulates MHCI

A

nef

25
Q

AIDS is defined as being HIV-1 positive and CD4 T cells below? or being HIV positive and?

A

200 cells/uL, AIDS defining condition

26
Q

common opportunistic infections of AIDS?

A

protozoa-toxoplasmosis cryptosporidosis

fungal: pneumocystis jiroveci, candidiasis, histoplasmosis, coccidiomycosis
bacterial: mycobacterium, salmonella
viral: CMV, HSV, VZV, JC virus

27
Q

time periods:
rapid progressor?
typical progressor?
long term non progressor?

A

2-3 years
10 years
7-25 years (viremic controller or elite controller)

28
Q

HIV rapid progressors have a high ________, represent about 10% of individuals, develop AIDS in about _____ years without CART, have an absent or weak CTL and antibody response

A

viral set point

2-3 years

29
Q

HIV long term non-progressors maintain elevated CD4 T cell counts in absence of cART for _________ years, represent 2-5% of HIV patients, and maintain low levels of ______

A

7-25 years

viremia

30
Q

HIV viremic controllers achieve virologic control is range of ________ copies, maintain elevated CD4 T cell counts typically above ______, but with time will likely lose T cells

A

200-2000 copies

less than 500 cells

31
Q

elite suppressors or controllers maintain ________ viral loads without cART, represent less than 0.5% of patients, virus can be _______, generally have strong CTL responses

A

undetectable

isolated

32
Q

lab diagnosis of HIV: antibody antigen test to look for _____ and _____ antigen, confirmed with a _______ assay

A

HIV1/HIV2 antibodies, p24 antigen

multispot assay

33
Q

obstacles in HAART:

  • virus persists in ________ CD4 T cells
  • virus replication _______ in almost all patients after discontinuation
  • unlikely that pool of ______ virus can be completely eliminated
A

resting memory

rebounds

latent

34
Q

mycobacterial disease:

  • transmitted by ______
  • taken up by alveolar _______ and form _______ in lungs where bacteria can go dormant
  • reactivated to form?
A

aerosols

macrophages, granulomas

M tuberculosis, M avium complex (MAC) into disseminated, lymphadenitis, or pulmonary disease

35
Q
  • fungus, colonizes normal host, can cause severe pneumonia in immunocompromised
  • prophylactic trimethoprim sulfamethoxozole
A

pneumocytis jiroveci

36
Q
  • most common fungal infection in HIV infected patients
  • white stuck on plaques on tongue, buccal mucosa, palate
  • esophagitis and skin
A

candida albicans

37
Q
  • dsDNA enveloped virus
  • enters latent state in monocytes and can be reactivated
  • causes retinitis, GI tract, pulmonary, CNS, myelopathy, bone marrow suppression
A

cytomegalovirus

38
Q
  • enveloped DNA virus
  • infects B lymphocytes and epithelial cells of throat
  • 90% of adults in US have antibody to virus
A

EBV hairy leukoplakia

39
Q

opprotunistic malignancies?

A

Kaposi sarcoma HHV8, CNS lymphoma due to EBV, Hodgkin lymphoma, HPV cervical and anal squamous cell carcinoma

40
Q
  • parasite transmitted through undercooked meat and cat feces
  • CNS disease via reactivation
  • headache, confusion, motor weakness, fever
  • ring enhancing lesions on MRI, cysts
A

toxoplasmosis

41
Q
  • causes meningoencephalitis
  • fever, malaise, headache with neck stiffness, photophobia, vomiting
  • abnormal CSF
A

cryptococcus neoformans

42
Q
  • caused by papovavirus JCV
  • reactivation –> cognitive impairment, focal motor deficits, seizures
  • ARV to re-establish host immune system
A

PML

43
Q

AIDS virus in CNS evolves to become largely _______ tropic that targets ______ cells

A

macrophage, microglial

44
Q
  • white matter pallor, microglial nodules, multinucleated giant cells
  • 40% reduction in frontal and temporal neurons
  • memory deficits, impaired executive function, poor attention, mental slowing, apathy
A

AIDS related dementia complex

Infectious Disease (22 decks)

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