HIV/AIDS Flashcards Preview

B - Gynaecology > HIV/AIDS > Flashcards

Flashcards in HIV/AIDS Deck (90)
1

What is HIV?

A single stranded RNA retrovirus

2

How dos HIV infect humans?

Infects and replicates within the human immune system using host CD4 cells

3

What can HIV lead to without treatment?

Destruction of the immune system and AIDS

4

What was the prevalence of HIV in the UK in 2015?

~101,000

5

What % of the population of the UK had HIV in 2015?

0.16%

6

What % of people infected with HIV were unaware of their status?

13%

7

What % of people with HIV were men?

69%

8

What proportion of people with HIV are MSM?

Just under half

9

What cells does HIV replicate within?

CD4

10

What are CD4 cells also known as?

T helper cells

11

How does HIV infect a host CD4 cell?

Penetrates cell and empties the contents. The viral RNA is converted to DNA and combines with the host DNA

12

What enzyme causes HIV RNA to become DNA?

Reverse transcriptase

13

What enzyme integrates viral DNA into the host DNA in HIV?

Integrase

14

What happens when the CD4 cell divides in HIV?

Viral DNA is read and viral protein chains are created and push out of the cell retaining some cell membrane to form an immature virus

15

How does the immature HIV virus develop?

Viral protein chains are cut and assemble to create a working virus

16

What enzyme cuts the viral proteins in an immature HIV virus?

Protease

17

What happens to the host CD4 cell when HIV replicates?

It is destroyed

18

What is seroconversion in HIV?

The process pf producing anti-HIV antibodies during primary infection

19

What happens to the levels of CD4 cells during seroconversion?

Fall due to initial rapid replication of HIV

20

How dos HIV infect humans?

Infects and replicates within the human immune system using host CD4 cells

21

What can HIV lead to without treatment?

Destruction of the immune system and AIDS

22

How can the clinical features of HIV be divided?

Into stages of infection

23

What symptoms can be experienced during HIV seroconversion?

Flu-like symptoms

24

What happens to the levels of CD4 cells during seroconversion?

Fall due to initial rapid replication of HIV

25

How infectious is the patient during seroconversion?

Highly infectious

26

What can happen to HIV over the months-years following seroconversion?

Can enter a latent phase

27

What symptoms do many patients with HIV display after seroconversion?

None

28

What happens to CD4 levels after seroconversion?

Continue to fall

29

What happens to HIV viral load after seroconversion?

Increases

30

What happens to the patient as CD4 levels fall and viral load rises in HIV?

- Become more susceptible to infections
- Increasingly infectious
- Increasingly symptomatic

31

Over what period does HIV generally develop into AIDS?

10 years

32

How can HIV be transmitted?

- Unprotected sexual contact
- Sharing needles
- Medical procedures
- Vertical transmission

33

What types of sexual contact can spread HIV?

- Vaginal
- Anal
- Oral

34

What medical procedures can transmit HIV?

- Blood products
- Skin grafts
- Organ donation
- Artificial insemination

35

How can HIV be spread by vertical transmission?

- In-utero
- Childbirth
- Breast feeding

36

What factors can increase likelihood of contracting HIV when in contact with infectious components?

- Higher viral level
- Concurrent STI's causing anogenital inflammation
- Breaks in the skin or mucosa

37

Is HIV preventable?

Yeah

38

What should practitioners be able to advise patients regarding HIV?

- Transmission reduction
- Safe sex

39

What are the risk factors for HIV?

- MSM
- IVDU
- High prevalence areas
- Unprotected sex with a partner who has lived or been to Africa

40

What are the stages of HIV infection?

- Seroconversion
- Asymptomatic infection
- Persistent generalised lymphadenopathy (PGL)
- Symptomatic HIV
- AIDS

41

How long after exposure do fourth generation HIV tests give reliable results?

4-6 weeks

42

What alternatives are available to fourth generation HIV testing?

- Rapid test kits
- Home sampling kits

43

What are the features of HIV seroconversion?

- Fever
- Muscle aches
- Malaise
- Lymphadenopathy
- Maculopapular rash
- Pharyngitis

44

What % of patients with HIV present at seroconversion stage?

20-60% (this is a massive range lol)

45

What is the viral load of HIV in asymptomatic infection stage?

Low - but continuing slow replication

46

Can HIV be cured?

No

47

How long can the asymptomatic infection stage of HIV last?

Many years

48

What is persistent generalised lymphadenopathy (PGL) in HIV?

Nodes >1cm in diameter at 2-extra inguinal sites for 3 months or longer (not due to any other cause)

49

What happens after the latent (asymptomatic) phase of HIV?

Becomes symptomatic

50

What symptoms may a patient have in symptomatic HIV infection?

- Weight loss
- High temperatures
- Diarrhoea
- Frequent minor opportunistic infections

51

What minor opportunistic infections can be present in the symptomatic phase of HIV?

- Candidiasis
- Herpes zoster

52

What is the symptomatic phase of HIV known as?

AIDS-related complex

53

What is AIDS-related complex regarded as?

An AIDS prodrome

54

What can happen to HIV infection if left untreated?

Can develop into AIDS

55

What happens in AIDS?

The immune system is significantly weakened and patient develops some defining illnesses

56

What are some AIDS-defining illnesses?

- Pneumocystis jiroveci pneumonia
- Non-hodgkin's lymphoma
- TB
- Kaposi's sarcoma

57

What are the first line investigations for HIV?

Fourth generation tests

58

What are fourth generation tests for HIV?

ELISAs that test for serum (or salivary) HIV antibodies and p24 antigen

59

How long after infection do fourth generation HIV tests give reliable results?

4-6 weeks

60

How long can rapid testing kits take to give a result on HIV infection?

30 minutes

61

What are the disadvantages to fourth generation HIV test alternatives?

- Less reliable
- Require confirmation by ELISA

62

What public health management is important when managing HIV?

Contact tracing

63

What treatment is given to manage HIV?

HAART (highly active anti-retroviral therapy)

64

What are the regular tests required to monitor HIV?

- CD4 count
- HIV viral load
- FBC
- U&E
- Urinalysis
- ALT, AST and bilirubin

65

What is the prognosis of HIV when using HAART?

Excellent

66

What is the risk of HIV transmission from a person complying fully with HAART?

Low risk

67

What can treatment of HIV with HAART reduce?

AIDS-related and non-AIDS-related mortality

68

What classes of drugs can be used to treat HIV?

- Nucleoside reverse transcriptase inhibitors (NRTIs)
- Protease inhibitors (PIs)
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
- Integrase strand transfer inhibitors (InSTIs)

69

How are are anti-HIV drugs used?

In combination

70

How do anti-HIV drugs reduce viral load?

Target enzymes involved in replication and maturation of HIV

71

How are anti-HIV drugs combined?

Often into a once-daily single tablet

72

What are some examples of single tablet HIV treatments?

- Atripla
- Stribild
- Eviplera
- Ttriumeq

73

What is Atriplas?

Tenofovir + emtricitabine + efavirenz

74

What is Stribild?

Elvitegravir + cobicistat + tenofovir + emtrictabine

75

What is Eviplera?

Tenofovir + emtricitabine + reilpivirine

76

What is Triumeq?

Abacavir + lamivudine + dolutegravir

77

What is key to successful management of HIV?

Good compliance for the rest of their lives

78

What can non-adherence to HARRT result in?

Resistance mutations making treatment difficult or impossible

79

What other factors must be considered when managing HIV?

Psychological impact of living with or being diagnosed with HIV

80

What additional tests may HIV patients require in the future?

- Pregnancy testing
- Resistance testing

81

What can people who believe they have been exposed to HIV be treated with?

Post-exposure prophylaxis (PEP)

82

Within what period from HIV exposure can someone commence PEP?

72 hours

83

What is the aim of PEP for HIV?

Reduce the risk of being infected

84

How long does a HIV PEP course last?

1 month

85

What is a HIV PEP regime?

Truvada OD + Raltegravir BD

86

How can HIV be transmitted vertically?

- In-utero
- Delivery
- Breast feeding

87

How can vertical transmission of HIV be reduced?

- Antenatal antiretroviral therapy during pregnancy and delivery
- Avoidance of breastfeeding
- Neonatal post-exposure preophylaxis

88

What do the collective interventions reduce the risk of HIV vertical transmission to?

<1%

89

What is the risk of vertical transmission of HIV with no interventions?

1 in 4

90

Are caesarean section births indicated in HIV?

Not if the viral load is undetectable at delivery