Hiv

Question 1

What type of people usually have Kaposi’s Sarcomas?

Answer 1

• Immuno-compromised people

- Associated with elderly

Question 2

Kaposi’s Sarcomas are the most frequent opportunistic tumours. What percentage of patients with AIDS will have these?

Answer 2

• 20% (mostly homosexuals)

Question 3

What virus is associated with Kaposi’s sarcomas?

Answer 3

• Human Herpes Virus 8

Question 4

What is an example of one of the infections that defines that start of AIDS?

Answer 4

Kaposi’s Sarcoma

Question 5

What are the two types of T-cell?

Answer 5

• T helper and killer cell. (messengers - initiate activity of other immune cells and help to generate your antibodies)

Question 6

Apart from homosexual men. What other groups were affected by HIV before they know what it was? (3 points)

Answer 6

• Women (associated with injecting drug use or sexual contact with men who had AIDS)
• Haitians residing in the US (all young and denied homosexual activity)
• Heterosexual men with haemophilia - all received factor VIII

Question 7

What does AIDS stand for?

Answer 7

• Acquired Immunodeficiency Syndrome

Question 8

Apart from sexual transmission, how else can AIDS be spread?

Answer 8

• Through blood transfusions

- From mother to child

Question 9

The first test for HIV-1 antibodies was very sensitive but what was one downside to this test?

Answer 9

• It had a high false positive rate which would end up giving the wrong diagnosis to someone but would have no way of knowing you had given them the wrong diagnosis

Question 10

What is HIV PrEP? (4 points)

Answer 10

• A pill that can stop the person from taking from getting HIV
• PrEP is for HIV negative people who are at high risk of getting HIV
• It is extremely effective at preventing HIV when taken as directed, with few side effects
• Once the drug reaches protective levels it stops HIV from staying in your body

Question 11

How is HIV Transmitted? (5 points)

Answer 11

• Unprotected sex
• Drug addicts
• Blood transfusions
• Pregnancy
• Non-sterile instruments

Question 12

How is HIV NOT transmitted? (5 points)

Answer 12

• Touching
• Through food
• With a kiss
• Insect bites
• In a pool

Question 13

Where is it though that HIV originated?

Answer 13

• In the democratic republic of Congo in the 1920’s
• Via ingestion and/or exposure to blood
• Recon it came from the chimps - associated with humans hunting - either eating or being exposed to chimp blood

Question 14

How many people globally are living with HIV and what percentage don’t know their status?

Answer 14

• 37.9 million living with HIV

- 21% don’t know their status

Question 15

What are the 2018 90 90 90 targets?

Answer 15

• Wanted to have 90% of people aware of their HIV status, 90% on HIV treatment and 90% of people virally suppressed

Question 16

How does HIV spread in the body?

Answer 16

• One in cd4 cell the virus releases RNA - this is converted into DNA with enzymes and this DNA is incorporated into your own DNA
• Your own body then replicates the virus
• Only a small number of cd4 cells are infected but from this you get billions of infected virus cells very quickly (45 mins)

Question 17

What are the 5 key stages in the HIV cycle?

Answer 17

• HIV releases genetic material into CD4 cell
• Reverse transcriptase copies RNA - DNA
• Viral DNA inserted into DNA cell
• Many copies of the viral RNA and proteins made
• New viral particles assemble and bud from cell

Question 18

What is the HIV viruses half life?

Answer 18

5.7 hours

Question 19

How many HIV virus particles can be replicated per day?

Answer 19

• 10 billion

Question 20

How many HIV virions can be in a ml of blood?

Answer 20

10-100 million

Question 21

How could you define AIDS? (3 points)

Answer 21

• The presence of one of 25 conditions indicative of severe immunosuppression
• OR HIV infection in an individual with a CD4+ cell count of <200 cells per cubic mm of blood
• AIDS is therefore the end point of an infection that is continuous, progressive and pathogenic

Question 22

What are 5 clinical features of AIDS?

Answer 22

• Lymphadenopathy and fever
• Opportunistic infections
• Malignancies
• Wasting
• AIDS-related dementia

Question 23

We don’t just rely on blood tests anymore for testing for HIV, we have other options but the blood tests are the best. What are the other options and what are the positives/negatives of these?

Answer 23

• Rapid tests
• Oral fluid tests - less sensitive
• Dried blood spot - Good for research purposes

Question 24

Home testing kits for HIV are useful but what needs to be confirmed after taking one?

Answer 24

• All positive tests MUST be confirmed

Question 25

What are the dental implications for people with HIV?

Answer 25

- HIV infected individuals have poorer oral health and greater dental care needs than the general population BUT - The experience high levels of HIV-related stigma and discrimination when attending dental services

Question 26

There are 3 groups of oral lesions associated with HIV. Which one should we be especially aware of?

Answer 26

- Group 1 

Question 27

What are group 1 oral lesions associated with HIV?

Answer 27

- Lesions STRONGLY associated with HIV infection | - e.g. Candidosis, Hairy Leukoplakia, Kaposi's sarcoma, Non-Hodgkin's lymphoma and periodontal disease

Question 28

What are group 2 oral lesions associated with HIV?

Answer 28

Lesions LESS COMMONLY associated with HIV infection 

Question 29

What are group 3 oral lesions associated with HIV?

Answer 29

- Lesions SEEN in HIV infection 

Question 30

What are HIV indicator conditions?

Answer 30

- Conditions that would suggest someone may be infected with HIV - IF seen then suggest testing

Question 31

Why would HIV screening in the dental setting be a positive thing? (4 points)

Answer 31

- Key prevention strategy is to improve the availability and access to HIV screening - Early diagnosis improves health outcomes and provides opportunities to prevent further transmission events - Several key HIV indicators that are encountered by the dental professional - Rapid point of care HIV tests could be used to offer chairside HIV screening to patient during dental appointments

Question 32

What does an undetectable viral load mean for the spread of HIV?

Answer 32

- Means risk of transmission is low