Term
| How is HIV person defined? |
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Definition
| Person HIV antibodies with 200 or greater helper T-lymphocytes (CD4/mm3), AND absence of AIDs defining illness |
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Term
| How is someone with AIDs defined? |
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Definition
fewer than 200 helper T-lymphcytes; OR
presence of AIDs defining illness |
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Term
| What is an AIDs defining illness? |
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Definition
| profound immunosuppression produced by chronic infection of HIV |
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Term
| What type of virus is HIV? |
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Definition
| single stranded RNA retrovirus |
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Term
|
Definition
ELISA detects HIV Ab's and Ag's
Positive ELISA confirmed by Western Blot assay -> medical ass. /3-6mths
Western Blot (-) = ELISA false (+)
Western Blot indertermined = patient may have been recently infected --> ELISA every 2 weeks. |
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Term
| What is the normal range of CD4 cells? |
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Definition
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Term
| What does the CD4 count give and indication of? |
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Definition
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Term
|
Definition
Measure of plasma HIV RNA
Higher load = faster disease progression |
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Term
| What are the three modes of AIDs treatment? |
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Definition
HAART
Management of OI & malignancies
Symptom control |
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Term
| What are the categories of antiretroviral drugs? |
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Definition
Nucleoside Reverse Transcriptase Inhibitors
Protease Inhibitors
Non Nucleoside Reverse Transcriptase Inhibitors
Fusion Inhibitors or HIV Entry Inhibitors |
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Term
| What is the MOA of antiretroviral drugs? |
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Definition
| Inhibit viral replication at various points |
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Term
|
Definition
Zidovudine (ZDV)
Didanosine (DdI)
Stavudine (d4T)
Lamivudine (3TC)
Emtricitabine (FTC)
Abacivir
Tenofovir
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Term
| What enzyme do Zidovudine and Stavudine antagonise? |
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Definition
| thymidine kinase for phosphorylation |
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Term
| What are the Protease Inhibitors? |
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Definition
Ritonivir (RTV)
Atazanavir (AZT)
Indinavir (IDV)
all drugs end in "avir" |
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Term
| How do protease inhibitors work to inhibit viral replication? |
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Definition
| act at end of lifecycle when protease cleave HIV polypeptides to give infectious virions |
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Term
| Which protease inhibitor is the least potent inhibitor of CYP450 enzymes? |
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Definition
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Term
|
Definition
Nevirapine (NVP)
Delaviridine (DLV)
Efavirenz (EFV) |
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Term
|
Definition
Inactivating HIV-1RT by non-competitively binding to the enzyme structure.
Has no effect against HIV-2 |
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Term
| What is Efuvirtide? How is it given? |
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Definition
HIV Entry inhibitor; blocks binding of HIV to host cell and prevents entry.
Administered by SC
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Term
| What is the common combination of HAART? Example? |
|
Definition
2 NRTIs + NNRTI and/or PI
eg. Lamivudine + Zidovudine + Efavanir OR Nevirapine; OR
Lamivudine + Zidovudine + lopinavir+ritonavir (ritonavir increase Cs of PIs) |
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Term
| What is given before C section for intrapartum ART in addition to ongoing therapy? |
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Definition
| Zidovudine 2mg/kg over 1-4hours |
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Term
| What is ART in an infant? |
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Definition
| 12 hours after clamping umbilical cord: Zidovudine 2mg/kg orally, Q6h |
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Term
| What are the toxicities/AE associated with ART? |
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Definition
Mitochondrial toxicity (NRTIs)
Rash and Hepatitis (NNRTIs)
Lipoatrophy (NRTIs)
Lipohypertrophy (PIs)
Hyperlipidaemia
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Term
| What are the manifestations of mitochondrial toxicity? |
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Definition
peripheral neuropathy
myopathy
pancreatitis
lactic acidosis |
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Term
| What NRTIs are most likely to cause mitochondrial toxicity? |
|
Definition
stavudine
didanosine
ziduvodine to a lesser extent |
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Term
| In what scenario is rash and hepatitis seen? Caused by what drug most likely? |
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Definition
| High CD4 count and on nevirapine |
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Term
| Which NRTIs are most likely to cause lipoatrophy? |
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Definition
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Term
| How does lipoatrophy present? |
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Definition
| loss of fat from face, upper limbs, and buttocks? |
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Term
| How is facial lipoatrophy treated? |
|
Definition
| Injections of polylactic acid |
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Term
| How does lipohypertrophy present? |
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Definition
| abnormal deposition of fat in abdomen and neck characterised = increased abdominal fat, breast size, buffalo hump |
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Term
| What category of drugs may cause lipohypertrophy? |
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Definition
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Term
| How can hyperlipotrophy be managed? |
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Definition
| Growth hormone releasing hormone; OR Growth hormone |
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Term
| What are the opportunistic infections and their respective treatments associated with HIV/AIDs? |
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Definition
Candida: fluconazole
Cytomegalovirus: gancilovir
Hepatitis: ethambutol + clarithr/azithromycin with or without rifabutin
TB: Rifabutin + PI + nevirapine
Pneumocytosis jiroveci: cotrimoxazole or pentamidine |
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Term
| What is Kaposi's triggered by? |
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Definition
| contraction of human herpes virus-8 |
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Term
| How does Kaposi's sarcoma manifest? |
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Definition
| single or multiple legions that look like purple and raised papules |
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Term
How are indivual kaposi's legions treated?
How are widespread kaposi's sarcoma treated? |
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Definition
Individual: local radiotherapy, intralesional chemo (vincristine)
Widespread: systemic therapy of lipsomal preps of doxorubicin OR daunorubicin |
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