HIV

Question 1

What happens when HIV is not treated?

Answer 1

Acquired immunodeficiency syndrome (AIDS)

Question 2

What kind of virus is HIV?

Answer 2

An RNA retrovirus

Question 3

Where is HIV-2 most commonly found?

Answer 3

West Africa

Question 4

HIV enters and destroys which cells of the immune system?

Answer 4

CD4 T-helper cells

Question 5

How is HIV transmitted?

Answer 5

Unprotected anal, vaginal or oral sexual activity
Mother to child at any stage of pregnancy or breastfeeding
Mucous membrane, blood or open wound exposure to infected blood or bodily fluids (eg sharing needles)

Question 6

When does AIDs occur?

Answer 6

When the CD4 count has dropped to a level that allows for unusual opportunistic infections and malignancies to appear.

Question 7

What are some examples of AIDS-defining illnesses?

Answer 7

Kaposi’s sarcoma
Pneumocystis jirovecii pneumonia (PCP)
Cytomegalovirus infection
Candidiasis
Lymphomas
TB

Question 8

All patients accessing which services are offered HIV testing?

Answer 8

Sexual health
Antenatal
Substance misuse services

Question 9

The fourth generations lab tests for HIV checks for antibodies to HIV and the ____ antigen

Answer 9

p24

Question 10

How long may the lab test take from exposure to the virus for the test turn positive? (window period)

Answer 10

45 days

Question 11

What is the normal range for CD4 cells in the blood?

Answer 11

500-1200 cells/ mm3

Question 12

What does treatment for HIV involve?

Answer 12

Combination of ART (antiretroviral therapy) medications.

Question 13

What type of testing is used to help guide which medications are effective for the strain of HIV?

Answer 13

Genotypic resistance testing

Question 14

Name some classes of antiretroviral therapy medications for HIV treatment

Answer 14

Protease inhibitors (PI)
Integrase inhibitors (II)
Nucleoside reverse transcriptase inhibitors (NRTI)
Non-nucleoside reverse transcriptase inhibitors (NNRTI)
Entry inhibitors (EI)

Question 15

Treatment for HIV aims to achieve a normal CD4 count and ______ viral load

Answer 15

undetectable

Question 16

What is given to all HIV positive patients with CD4 under 200/mm3 to protect against PCP?

Answer 16

Prophylactic co-trimoxazole

Question 17

Why are yearly cervical smears recommended in HIV?

Answer 17

Increased risk of HPV and cervical cancer

Question 18

Which vaccines are avoided in HIV?

Answer 18

Live vaccines like BCG and typhoid

Question 19

Is it ever safe to have unprotected sex with a diagnosis of HIV?

Answer 19

If there has been effective treatment with an undetectable viral load then HIV should not be spread.

Question 20

The mother’s viral load will determine the mode of delivery with a high viral load indicating… and a lower viral load indicating….

Answer 20

Over 400 copies/ml = pre-labour C-section

Over 50 copies/ml then consider a pre-labour C-section

Under 50 copies/ml = normal vaginal delivery

Question 21

What infusion is given during labour and delivery if the viral load is unknown in the mother or over 1000 copies/ml?

Answer 21

IV zidovudine

Question 22

Should a mother breast-feed if they have an undetectable viral load of HIV?

Answer 22

No, should still avoid to be safe. Occasionally attempted with close monitoring.

Question 23

When is post-exposure prophylaxis for HIV effective?

Answer 23

Within 72 hours of exposure.
Is not 100% effective but the sooner started, the better.