Term
| HIV Virus was Isolated in... |
|
Definition
|
|
Term
HIV went from acute disease to chronic disease in...
Why? |
|
Definition
1996
Introduction of Protease Inhibitors |
|
|
Term
| The most prevelant mode of transmission globally is _____________ contact, at 75%. |
|
Definition
heterosexual
This is due to the problem in Sub-Saharan Africa |
|
|
Term
| Name two reasons HIV infection rates have increased. |
|
Definition
1) Decrease in perceived threat (decrease in condom use)
2) Drug in the South - Meth abuse |
|
|
Term
| Rank states regarding incidence of HIV: |
|
Definition
1. D.C.
30. Kentucky
Last: North/South Dakota or Montanna |
|
|
Term
Who said this:
"If it doesn't make sense, it is probably not true." |
|
Definition
Judge Judy
haha - :) I bet you liked that! |
|
|
Term
Rank the three main methods of transmission in the U.S. |
|
Definition
1. MSM 35%
2. Heterosexual Contact 31%
3. Injection drug use 12%
IDU decreased because of clean needles!!!!!!!!!! |
|
|
Term
Someone told you they got HIV from giving oral sex.
That is ........... |
|
Definition
|
|
Term
Which version of the virus is most common in the US?
Which is most common in Africa?
Which is most Virulent? |
|
Definition
|
|
Term
| HIV's ability to mutate frequently and replicate at a high rate is a recipe for... |
|
Definition
|
|
Term
Name the 5 drug targets in HIV infection.
What is the next target going to be? |
|
Definition
1. CD4 receptor
2. R5 co-receptor
3. Reverse Transcriptase
4. Integrase
5. Protease
Next target: X4 co-receptor |
|
|
Term
True or False:
A doubtful risk body fluid (e.g. sweat, tears, saliva, vomitus, urine, stool) becomes high risk if it is bloody. |
|
Definition
|
|
Term
Post Exposure Prophylaxis is intended for what population?
What is the drug therapy used to treat these patients? |
|
Definition
PEP is for: ocupational needle sticks, or sexual assault
Combivir 1 PO BID
Kaletra 2 caps BID
both for 1 month |
|
|
Term
| A woman is pregnant, what precautions should you take for the fetus? |
|
Definition
Put her on 3 drug therapy.
If she refuses she should AT LEAST be on AZT
AZT protects the baby, NOT MOM. |
|
|
Term
| Does AZT get into the breast milk? |
|
Definition
It doesn't matter because that is ridiculous!
Why are you asking? The baby should not be breast fed! |
|
|
Term
Routine HIV testing should be done how often?
What age range of people? |
|
Definition
Every Year
13-64
It doesn't matter if you are gay, bi, tri, married, or single. |
|
|
Term
| HIV ELISA test leads to a lot of False Positives because... |
|
Definition
It is highly sensitive but not specific.
Therefore if someone tests positive you should tell them they were reactive and you need to do additiaonl testing. |
|
|
Term
| Once you have a reactive HIV ELISA test you should... |
|
Definition
| Do a Western Blot to confirm HIV positive. |
|
|
Term
| The patient is said to have "AIDS" when the patient's CD4 counts are... |
|
Definition
1. <200: this is if the counts are or ever have been <200
2. OR is HIV positive and has or ever had an AIDS-defining illness such as TB, PCP, toxoplasmosis, MAC |
|
|
Term
True or False:
All patients who have AIDS have HIV. |
|
Definition
|
|
Term
TRUE or False:
All patients who have HIV have AIDS. |
|
Definition
|
|
Term
| When should you initiate HIV therapy? |
|
Definition
When Symptomatic OR CD4 cell count is <350cells/mm3
therapy is considered when CD4 count is <500. |
|
|
Term
| Why don't we start HIV therapy when they are diagnosed? |
|
Definition
1. Cost
2. Resistance
3. Quality of Life (SE are bad) |
|
|
Term
| What are the 2 goals of therapy when treating HIV? |
|
Definition
1. Reduce and maintain HIV RNA levels at an undetectable level (<48 copies/ml)
2. Preserve or increase the CD4 count. |
|
|
Term
| Standard of Care for HIV therapy is.... |
|
Definition
3 antiretrovirals
Most potent combo: 2 NRTI and a PI
Alternative: 2 NRTI and 2 NNRTI (preferably efavirenz)
Salvage therapy: 2 PI, integrase inhibitor, enfurvitide, co-receptor blocker. |
|
|
Term
| Define Ritonavir Boosting. |
|
Definition
Producing a favorable drug interaction by combining low dose of ritonavir with another PI, thus enabling the PI to be dosed at a reduced pill burden.
Ex: Kaletra. (Combo: Lopinavir/Ritonavir)
For low dose boosting ritonavir does not "count" as an antiretroviral when considering therapy |
|
|
Term
| Ritonavir is a potent _____ inhibitor. |
|
Definition
CYP450
This is the most potent CYP450 inhibitor in the pharmacy.
Long list of DI
Can cause cushings in a person with a corticosteriod inhaler. |
|
|
Term
| When using this drug, the patient's next stop is Hospice. |
|
Definition
CD4 receptor inhibitor
The drug is: Enfurvitide. |
|
|
Term
| Treatment failure is when.... |
|
Definition
The viral burden is detectable.
Thus it is NOT UNDETECTABLE!
|
|
|
Term
| Patient JP is on drugs ABC and has failed treatment. What is your next step without doing resistance testing? |
|
Definition
D/C drugs ABC
Start drugs DEF |
|
|
Term
| You should use this resistance testing early in the disease. |
|
Definition
|
|
Term
| You should use this resistance testing late in the disease. |
|
Definition
Phenotypic
This is more costly because you have to culture the virus in cells.
More like antibiotic suceptability.
More accurate than genotypic. |
|
|
Term
| Innate immunity is when someone has 2 bad copies of this receptor. |
|
Definition
R5
This is important because almost all of the HIV (95%) in the US use R5 to enter the cell. |
|
|
Term
| When an individual has one bad copy and one good copy of R5 they are considered to be a.... |
|
Definition
Slow progressor.
This person will live for years with HIV or without showing symptoms. |
|
|
Term
| The only effective HIV vaccine is what type? |
|
Definition
Live attenuated.
Who wants to be in this Phase 3 trial and sign a consent form that says you may be infected with HIV?
The proof of concept is hard to prove because of the high variability in the high-risk populations.
|
|
|
Term
| What is the problem of testing for Antibody generation after giving the vaccine? |
|
Definition
| Antibodies toward HIV do NOT neutralize the virus! |
|
|
Term
| What is the time frame for the window of opportunity for HIV intervention in a patient with an accidental needle stick? |
|
Definition
24-48 hours / 1-2 days
After this time you are past the point of no return. This means that the HIV virus has invaded the CD4--> MEMORY CELLS |
|
|
Term
| We have drugs to stop viral replication in 5 different places, why is it that we still cannot irradicate the virus? |
|
Definition
Because the virus sits in CD4 memory cells in a latent phase.
Because the memory cells are there for a long time, they are permant seeds of the virus
Time extrapolation: Patient would have to be on antivirals for 100 years to kill out the virus in the latent CD4 cells....ridiculous. |
|
|
