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Flashcards in T4-HIV Deck (39):
1

HIV causes a weakened immune system by killing what type of cells?

CD4 T cells

2

T/F: HIV puts patients at increased risk for certain cancers

TRUE

3

What is the technical definition of AIDS?

A syndrome in which the individual is HIV+ and has either
1. CD4 T count below 200 cell/mL OR
2. Has 2 AIDS defining illnesses

(Pheumocytosis pneumonia, TB, Kaposi Sarcome, discemminated histoplasmosis, cytomegalovirus retinitus)

4

What is ART?

Standard antiretroviral therapy

5

How many drugs does ART consist of?

3-4

6

What is another name for ART therapy?

HAART (highly active antiretroviral therapy)

7

T/F: Current drug therapy (HAART) can decrease plasma HIV to levels that are undetectable with current technology?

TRUE

8

ART has reduced age related deaths by ___%

72%

9

T/F: Patients compliant with ART can become noncontagious.

FALSE; ART does NOT eliminate HIV

10

HIV is a retrovirus. What do retroviruses lack?

The machinery needed for SELF-REPLICATION--and thus are OBLIGATE INTRACELLULAR PARASITES

11

How many types of HIV are there?

2
HIV1 and HIV2

12

What type of HIV is most common is the US?

HIV1

13

What are 2 reasons why HIV replication is massive during the initial phase of infection?

1. Population of CD4 T cells is large! (large breeding ground)
2. Host has not yet mounted immune system against HIV, so replication can proceed unopposed

14

What is the name for the stage of initially high viral load?

Acute retroviral syndrome

15

Why is it essential that clients be treated with a combination of antiretroviral drugs?

To minimize the emergence of resistance (same strategy fro treating TB)

16

T/F: Male circumsion can decrease the risk of acquiring HIV sexually?

TRUE

17

What are the S&S of acute retroviral syndrome?

Flu-like:
-Fever
-Lymphadenopathy
-Pharyogitis
-Rash
-Myalgia
-Headache

18

The average duration that people with HIV are symptomatic is ___.

10 years

19

How many antiretroviral drugs do we have at this time?

5

20

What are the 5 types of antiretroviral drugs?

Reverse Transcriptase Inhibitors
Integrase Strand Transfer Inhibitors (INSTIs)
Protease Inhibitors (PIs)
Fusion Inhibitors
Chemokine Receptor 5 Antagonists (CCR5)

21

Which type of drug is this: Interfere with HIV DNA replication. These do this by either binding to the DNA strand and causing premature termination, or binding to the enzyme that is building the DNA strand.

Reverse transcriptase inhibitors (NRTIs and NNRTIs)

22

What type of drug is this: Inhibits the enzyme that initially integrates HIVs DNA into human DNA

Integrase strand transfer inhibitors (INSTIs)

23

What type of drug is this: Prevent the maturing of new HIV into its active form

Protease Inhibitors

24

What type of drug is this: Block HIV from entering CD4T cells

Fusion inhibitors and CCR5 antagonists

25

Which 3 drugs work by inhibiting enzymes needed for HIV to replicate?

Reverse transcriptase inhibitors (NRTIs NNRTIs)
INSTIs
PIs

26

Which 2 drugs work by inhibiting HIV entry into cells?

Fusion inhibitors
CCR5 antagonists

27

Which antiretroviral were the first used and remain the backbone of therapy today?

NRTIs (reverse transcriptase inhibitors)

28

**What are the 5 major adverse effects of the protease inhibitors?

1. Hyperglycemia/diabetes
2. Increased bleeding i people with hemophilia
3. Increases serum transaminase (indicates liver injury) and increase lipids (hyperlipidemia)
4. Fat redistribution
5. Reduced bone mineral density

29

Most patients take 2 ___ combined with either a __ or __.

Take 2 NRTIs combined with a PI or NNRTI

30

Which lab test is a major factor in deciding when to initiate retroviral therapy and when to change the drug regiment?

CD4 T cell counts

31

Which lab test is the best measurement available for predicting clinical outcomes?

Plasma HIV RNA (viral load)

32

**The goal of therapy is to decrease HIV RNA plasma levels to below what value?

An undetectable level--below 20-75 copies/mL of plasma

33

T/F: When a clients plasma HIV RNA is undetectable, they can still transmit HIV to other people.

TRUE

34

**The current recommendation is to begin antiretroviral therapy when the CD4 count drops below ___.

500cells/mm^3

35

This recommendation of 500cells/mm^3 is ___ that what was recommended in the past.

HIGHER- it used to have to drop to 350 cells/mm^3 in the past

36

Oral preexposure prophylaxis can reduce infection risk by ___.

44-73%

37

When should post exposure prophylaxis be initiated?

ASAP after HIV exposure--preferably 1-2 hours and NO more than 72 hours and should be continued 28 days

38

In the absence of antiretroviral drugs, the rate of perinatal transmission of HIV in the US is ___%

25%

39

When zidovudine is given IV to the mother during labor and delivery, and then IV or PO to the infant, the rate of HIV transmission is ______.

Essentially zero