HIV

Question 1

What type of virus is HIV?

Answer 1

Retrovirus

Question 2

Which cells (specifically) does HIV infect?

Answer 2

Cell w./ CD4 receptors

• T-helper lymphocytes
• (Monocytes/macrophages)

Question 3

What’s the proportion of men to women with HIV?

Answer 3

69% Men

31% Women

Question 4

What percentage of people don’t know they are infected with HIV?

Answer 4

13%

Question 5

What is the average age of diagnosis for HIV?

Answer 5

40yrs

Question 6

What proportion of people who inject drugs have HIV? (PWID)

Answer 6

3.8/1000

Question 7

How is HIV diagnosed?

Answer 7

• BLOOD TEST:
  
  • Viral protein (antigen Ag)
  • Immunoglobulin (antibody Ab)
  • PCR: detects nucleic acid- v.sensitive BUT expensive and slow results

Question 8

How is HIV transmitted?

Answer 8

Contact with INFECTED BODILY FLUID

eg mucosal tissue/blood/broken skin

Question 9

What factors affect HIV transmission? (4)

Answer 9

1. Type of exposure
   
   1. Type of sexual act
   2. transfusion vs needlestick vs mucous membrane
2. Viral level (viral load) in blood (in person with HIV)
3. Condom use
4. Breaks in skin/mucosa
   
   1. eg Other STI - inflammation of genital tract
   2. Sexual assault

Question 10

What are the aims of treatment of HIV? (6)

Answer 10

1. Detect HIV early
2. Reduce general inflammation
3. Reduce transmission
4. Good quality of life
5. Normalise lifespan
6. Reconstitute CD4 count+immune system

Question 11

What is the outcome for patients with HIV?

Answer 11

• Chronic infection (+/-) disability
• Death= probable if not diagnosed early enough

Question 12

What are the main symptoms of acute HIV infection?

Answer 12

Question 13

What are the conditions associated with severe HIV?

Answer 13

Question 14

What are the ‘rapid tests’ used to diagnose HIV?

Answer 14

Detect HIV antibody (take <1hr)

• Blood test (finger prick)
• Oral (saliva)

In home testing

If negative=accurate

BUT

May get false positve: need to confrim with serology

Question 15

Who should be tested for HIV?

Answer 15

• Everyone if rate >2/1000 in population
• If present with symptoms (see symptoms flashcards)
• If present with any STI

Question 16

What drugs are used to treat HIV?

Answer 16

Anti-retroviral drugs

Question 17

Why must a patient with HIV continue to take retrovirals?

Answer 17

Virus replicates and mutates quickly

Question 18

What strategies can be used to treat and reduce the prevalence of HIV?

Answer 18

1. Increase condom usage
2. Prevention of mother–>child transmission (screening)
3. ARV treatment (as prevention)
4. Medical circumcision
5. PEP
6. PrEP

Question 19

What are some ethical dilemas surrounding HIV?

Answer 19

• Psychological impact of diagnosis
• Stigma
• Patient confidentiality vs:
  
  • Health of mother
  • Health of child
  • Health of sexual contact
  • Risk to other patients/staff at work place

Question 20

In the UK what is the current life expectancy for HIV +ve?

Answer 20

78Years (2 less than general population)

(Provided: healthy living, treatmentm adherence, early detection)

Question 21

Give an example of an ARV.

Answer 21

• Protease inhibitor
• NRTI
• Integrase inhibitor

Question 22

Fill in the missing labels:

Answer 22