Term
| Number of people infected with HIV |
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Definition
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Term
| Number of new infections in 2008 |
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Definition
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Term
| Number 1 killer in Africa of all causes |
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Definition
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Term
| Number of people in US infected by HIV |
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Definition
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Term
| % undiagnosed HIV pts in US |
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Definition
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Term
| % undiagnosed HIV pts in US that are MSM |
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Definition
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Term
| globally, percentage of undiagnosed HIV pts |
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Definition
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Term
| globally, % pts who do not know if partner is infected |
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Definition
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Term
| 1 out of every how many black americans is infected w/HIV |
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Definition
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Term
| AIDS is the leading cause of death of what demographic? |
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Definition
| african american women btwn ages of 25-34 and men 35-44 |
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Term
| older blacks are how many times more likely than whites to be HIV (+) |
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Definition
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Term
| % of women not concerned about contracting an STD |
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Definition
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Term
| What demographic is least likely to consider themselves at risk of HIV? |
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Definition
| those at highest risk- women 18 to 24, those w/multiple sexual partners, and those whose current partners have had multiple sex partners |
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Term
| % of high risk women who relied on monogamy for protection against STD's |
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Definition
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Term
| % Transmission to child with current antiretrovirals |
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Definition
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Term
| Estimated number of children born each year to HIV infected women in resource poor settings |
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Definition
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Term
| % HIV/AIDS cases in eastern va |
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Definition
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Term
| % BMSM who aggreed to be tested that were HIV+. % who were unaware they were HIV+. % who perceived themselves to be at low risk of ever becoming infected. |
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Definition
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Term
| In 2006, more new AIDS cases among BMSM were diagnosed in what area than all other census areas combined |
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Definition
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Term
| many of the people interviewed said it mattered a great deal if they thought they might be harmed or rejected because of what factor? |
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Definition
| disclosure. fear and terror often shaped their decisions |
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Term
| what is the epicenter of this (HIV) epidemic? |
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Definition
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Term
| % of those infected with HIV who do not know that they are positive |
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Definition
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Term
| % who first test positive for HIV within 1 yr of an AIDS diagnosis |
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Definition
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Term
| main barriers to care for HIV |
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Definition
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Term
| how many and what percentage of HIV infections in the us in 2008 are undiagnosed? |
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Definition
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Term
| how many HIV infected pts in 2008 were diagnosed but receiving no care |
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Definition
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Term
| What percentage delayed seeking primary care for more than 1 yr after learning they were HIV+ |
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Definition
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Term
| from where was HIV-1 derived? |
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Definition
| HIV-1 was derived from the chimpanzee simian immunodeficiency virus (SIV) as an accidental innoculation during the preparation of "bush meat" |
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Term
| what does RT-polymerase chain rxn assay ms? |
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Definition
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Term
| What does an undetectable viral load mean? |
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Definition
| undetectable means that the amt of virus in the blood is less than the lower limit of detect of the test used. (HIV RNA < 400 or < 50/mmcubed) |
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Term
| Does undetectable mean the patient is uninfected or cured? |
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Definition
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Term
| Does undetectable mean safer sex practices can be forgotten? |
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Definition
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Term
| What occurs in a pt with an undetectable virus load if antiretrovirals are missed? |
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Definition
| the virus will return rapidly |
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Term
| How has the number of new HIV infections progressed since 1988? |
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Definition
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Term
| In what population is HIV screening recommended? |
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Definition
| for pts aged 13-64 yrs in all health-care settings after the pt is notified that testing will be performed unless the pt declines (opt-out screening) |
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Term
| How frequently should high risk pts be screened? |
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Definition
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Term
| according to new guidelines for HIV testing, should separate written consent for HIV testing be required? |
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Definition
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Term
| according to new guidelines for HIV testing, should prevention counseling be required? |
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Definition
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Term
| Up to what percent of initial positive EIA'S may not be confirmed w/a western blot? |
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Definition
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Term
| what is the cdc definition of positive western blot? |
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Definition
| any 2 ands positive of 3: p24, gp41, or gp120/160 |
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Term
| How should testing proceed with EIA negative results? |
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Definition
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Term
| How should testing proceed with EIA positive results? |
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Definition
| 2 of 3 from same sample (+), then western blot performed |
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Term
| How is a western blot with no bands interpreted? |
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Definition
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Term
| 206 pts with indeterminate wb were followed for 6 mos or longer. how many seroconverted? |
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Definition
| 6 (3%) seroconverted, all had recent HIV risk factors |
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Term
| What is the window period? |
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Definition
| time from infection to the development of Ab's, usually 1-3 mos, 95-99% will have positive test by 6 mos |
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Term
| Ab tests are negative, what is 100% sensitive and almost always >50,000? |
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Definition
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Term
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Definition
| western blot confirmation (high risk of false positives in low prevalence population) |
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Term
| unless recent risky behavior, most people with what EIA and what WB are really HIV (-) |
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Definition
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Term
| for pts in the "window period" or with a seroconvertin illness, will HIV RNA generally be positive or negative? |
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Definition
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Term
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Definition
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Term
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Definition
| when CD4<200 or an AIDS defining illness is dx |
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Term
| what type of pneumonia often occurs when CD4 lymphocytes are between 100-250 |
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Definition
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Term
| almost all cases of PCP occur when? |
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Definition
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Term
| What are the clinical signs of PCP? |
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Definition
| fever, non-productive cough. doe. may be subacute w/symptoms for weeks prior to onset. |
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Term
| increased ldh could indicate what disease in an aids pt? |
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Definition
| pcp- non-specific, may be normal in 20% |
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Term
| an aids pt shows a cxr with diffuse bilateral interstitial infiltrates are most common, but may be normal (15-20%) or atypical (20%) |
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Definition
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Term
| what does a cxr show with pcp? |
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Definition
| diffuse bilateral interstitial infiltrates are most common, but may be normal in (15-20%) or atypical (20%) |
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Term
| what might oxygen desaturation with exercise (may be normal at rest) indicate in an aids pt? |
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Definition
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Term
| with what cd4 count is cmv manifested |
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Definition
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Term
| how is pcp tx in aids pts? |
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Definition
| TMP-SMX DS (bactrim, septra) one tab qd for cd4<200, prior pcp or thrush |
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Term
| how is mac tx in aids pts? |
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Definition
| azithromycin 1200mg, once a week or (biaxin 500 mg, bid for cd4<50) |
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Term
| What are 5 screening studies for HIV pts? |
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Definition
| RPR, annual. Pap smear, 6 mos then annual. PPD (no anergy testing), annual, if at risk. screen for hcv, hepb, and hepa. toxoplasma IgG. |
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Term
| what is the most common cause of death in aids pts? |
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Definition
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Term
| what are 4 immunizations for hiv? |
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Definition
| pneumovax: all pts, booster every 5 yrs. hep b, all pts w/neg HBcAb. influenza, all pts, annually. hepA: hep c pts who are not immune to hepA. |
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Term
| what immunizations should be avoided in hiv pts? |
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Definition
| avoid all live virus vaccines (MMR, varicella, yellow fever) |
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Term
| for 1255 pts w/cdr<100, deaths due to aids decreased 70% from jan 1994 to june 1997 (improved survival with haart). what 3 opportunistic infections decreased during the same period? use of haart increased from what percents during the same period? |
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Definition
| PCP, MAC, and CMV decreased by 83% during the same period. use of HAART increased from 2% to 82% during the same period. |
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Term
| what % did excess mortality/1,000 person decrease before and after 1996? |
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Definition
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Term
| by 2004-06 what percent of excess mortality was observed for the *first 5 yrs* following hiv seroconversion for those infected sexually? |
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Definition
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Term
| assuming hiv pts can access and adhere to a std combination antiviral regimen, we can anticipate that most hiv-infected individuals will have their life expectancy decrease by what amount? |
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Definition
| no decrease; normal life-expectancy |
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Term
| what are DHHS preferred ARV'S? |
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Definition
| NNRTI based plus 2 nrtis (truvada); pi based. |
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Term
| How do antiretrovirals work? |
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Definition
| either prevent new infections of cd4 cells by inhibiting *reverse transcriptase* or the development of new viruses by inhibiting the *protease* enzyme |
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Term
| hopkins cohort found risk progression to AIDS or death was what percent in those who started with a cd4 >350 vs. what percent for those who started between 200-350 |
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Definition
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Term
| what are the risk factors for cvd when the baseline cd4<350? |
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Definition
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Term
| what occured with efavirenz in march 2005? |
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Definition
| pregnancy category changed from category c (risk of fetal harm cannot be ruled out) to category d (positive evidence of fetal risk) |
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Term
| what has a boosted pi (protease inhibitor)? |
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Definition
| combining a small dose of ritonavir (potent inhibitor of cyp 3a4) to inhibit the metabolism of the other pi |
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Term
| What are the side affects of the pi atazanavir? |
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Definition
| increased indirect bilirubin; no lipid effects |
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Term
| What are the side effects of the pi kaletra (lopinavir/ritonavir) |
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Definition
| diarrhea, increased lipids |
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Term
| what are the side effects of the pi ritonavir (norvir) |
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Definition
| nausea, diarrhea, drug interactions (potent inhibitor of cyp 3a4) increased lipids, esp triglycerides |
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Term
| lipodystrophy: where is fat depletion located? |
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Definition
| usually subcutaneous. face, buttocks, arms and legs (veins more prominent) |
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Term
| Lipodystrophy: where does fat accumulation occur? |
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Definition
| visceral fat accumulation. buffalo hump. breast enlargement. bilateral symmetrical lipomatosis. |
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Term
| with >95% adherence, what is the virologic sucess? |
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Definition
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Term
| with 80-95% adherence, what is the virologic sucess? |
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Definition
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Term
| with <80% adherence, what is the virologic sucess? |
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Definition
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Term
| what are the problems with structured tx interruption? |
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Definition
| rapid decline in cd4 w/ the return of wild type (improved fitness of wild type). transient benefi in salvage, mutants return quickly. |
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Term
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Definition
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Term
| for GART compared to controlls 11% and 10%, more where undetectable at which months, respectively? |
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Definition
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Term
| HIV RNA was what log less than controls at 3 and 6 mos, respectively? |
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Definition
| 0.27 adn 0.21 log (0.3 log is considered a clinically significant difference) |
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Term
| How can HIV medications and related care be obtained for people who make less than 300% of poverty limit (~$27,000 for a single person)? |
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Definition
| all meds free through the Va AIDS drug assistance progam (ADAP). all outpt HIV related care can be provided for free w/*Ryan White CARE Act* funds, $5 million annually to Norfolk EMA. |
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Term
| what was founded at EVMS in 1994 to provide HIV care throughout SE VA regardless of payor source? |
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Definition
| Center for the Comprehensive Care of Immune Deficiency (C3ID) |
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Term
| what s an anion surfectant developed as a contraceptive spermicide, disrupts viral membrane, but also caused vaginal inflammation/ucleration? |
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Definition
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Term
| what has antiretroviral incorporated in vaginal gel? |
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Definition
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Term
| what is the risk of occupational hiv infection? |
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Definition
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Term
| Efavirenz (sustiva) is not recommended for which populations? |
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Definition
| women w/high pregnancy potential (want to conceive or not using effective contraception) |
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Term
| what is contraindicated with ritonavir? |
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Definition
| simvastatin (zocor) adn fluticasone (advair, flonase) |
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Term
| of 57 documented occupational infections from 1981-2002, how did 41 of these infections occur? |
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Definition
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Term
| what decreased hiv transmission from needlestcks by 79%? |
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Definition
| AZT postexposure prophylaxis |
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Term
| is the following postexposure prophylaxis old or new? basic: azt+3tc and expanded: add a third drug |
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Definition
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Term
| is the following postexposure prophylaxis old or new? basic: azt or viread + either 3tc or emtriva and expanded: kaletra |
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Definition
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Term
| HIV was undetectable in lymph node implants when AZT was initiated within how long after exposure in 10 out of 10 mice? |
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Definition
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