Microbio -9- HIV

Question Answer
What type of virus is HIV-1 and where is it most common HIV-1 is a retrovirus that causes AIDS most common in USA and most other parts of the world
Is HIV an enveloped or naked virus enveloped
How is HIV-2 different from HIV-1 and where is it most commonly found structurally similiar to HIV-1 but HIV-2 has a significantly different GENOME most commonly found in west africa and India. AIDS progresses slowly
What is the surface glycoprotein gp120 on the surface of HIV used for recognizes target cell allowing attachment to host cells
What is the transmembrane protein gp41 in HIV used for this is the protein that helps the virus penetrate cell to infect them
What is the matrix protein p17 for helps maintain the viral structure helps transport viral genome to host cell nucleus and assemble new virions
what is Capsid antigen protein p24 for encapsulates the genome, reverse transcriptase, protease, and integrase proteins
What HIV viral genese are major targets for anti-HIV drugs PR and RT
about how many people world wide suffer from aids 33.2million
what percent of people suffering from HIV/AIDS are female 50%
HOw many new cases of aids are there each year 2.5 million
What racial/ethnic groups are highest group for new HIV or AIDS cases Black and hispanic
What is the annual risk of transmitting HIV of a person who doesn't know they are infected vs someone who knows they are infected unknown annual risk of 6-10% chance of transmission
Know annual risk of 1-2% chance of transmission
Because the annual risk of transmission is so much lower for those who know they are infected what is the guideline from the CDC that routine HIV testing be done from 13-64 years of ages unless patient specifically opts out
What are the high risks for HIV homosexual men, multiple partners, anal sex, traumatic sex, other STD present increase risk or transmission
What are the principal cells infected by HIV CD4 + T Cells and antigen present cells (APCs) but it can infect many different types of cells GI cells leads to chronic diarrhea and brain cells leads to lethargy and dementia
What is the initial receptor that HIV recognizes on host cells and what viral receptor recognizes it HIV initially recognizes the CD4 on host cells with its gp120 but also needs a coreceptor to allow entry of the virus
What viral protein recognizes the coreceptor allowing for PENETRATION OF HOST CELL gp41 recognizes coreceptor for CD4 it is cxcr4 and for macrophages it is ccr5
what is CXCR4 the coreceptor that CD4 cells that HIV gp41 recognizes to allow penetration into the cell
what is CCR5 coreceptor on macrophages that HIV gp41 recognizes allowing penetration into host cell
What is the difference for a TH cell getting infected with HIV and a macrophage getting infected with HIV Th cell will be lysed to allow HIV virions to escape. Macrophage HIV virions are released over time and cell doesn't die
Why is HIV genome highly variable high error rate during reverse transcription
What is ARS acute retroviral syndrome that has symptoms of sore throat, fever, muscle and headaches, enlarged lymph nodes and a rash that disappear in 1-4 weeks
Why do the symptoms of ARS clear up in 1-4 weeks body can still replenish fresh CD4 cells and CTLs
How does HIV infection typically manifest itself as a slow progression as the body slowly looses ground until CD4+ cells fall below normal reaching low levels of around ~300cells/ul
What are you most likely to see when HIV infection reaches point where CD4+ cell counts are ~300cells/ul usually start to see malignant neoplasms such as kaposis sarcoma, lymphomas most B cell lymphomas, cervical and anal carcinoma and opportunistic infections such as fungi
What is the deffinition of AIDS patient that is HIV antibody positive and has CD4+ T cell count below 200/mm3 or less than 14% of total T cells have the disease
What are the common protozoan opportunistic infections in AIDS toxoplasmosis
isospora belli infection
what are the common fungal opportunistic infections in AIDS pneumocystosis
mycobacterial- TB, Myco Avium
What are the common viral opportunistic infections in AIDS persistent mucocutaneous herpes simplex
varicella zoster
multifocal leukoencephalopathy
How do you dx HIV demonstrate presence of HIV antibody by EIA testing or PCR detection fro viral RNA or DNA in the serum
Would it be effective to test someone for aids using an EIA if they had an accidental needle stick the day before no because it take about 4 weeks to develop antibodies that EIA is testing for
which test would allow detection of HIV infection after recent exposure in the last 4 weeks PCR or EIA PCR would be more reliable because EIA tests for antibodies that are generally not present in the first 4 weeks
What is the confirmatory test for a positive EIA test for HIV western blot test that uses antibodies specific to viral proteins
What is the most effective way to stop the spread of HIV education
When should you begin treatment for HIV as soon as infection is detected or accidental blood exposure to infected individual
What does HAART stand for highly active antiretroviral treatment
What are the guidelines for starting HAART symptomatic HIV infection or AIDS related condition regardless of CD4+ T cell count
CD4+ T cell count falls below 200/mm3
When should you consider starting HAART therapy CD4+ T cell count is between 200 and 350/mm3 or HIV RNA is above 100,00 copies/ml
What are the anti-HIV drugs in current use NRTIs (nucleoside reverse transcriptase inhibitors) such as AZT, D4T, lamivudin, DDL and ddC
-Non-nucleoside reverse transcriptase inhibitors
-protease inhibitors
Does HAART cure AIDS no in controls viremia and increases CD4 cell counts discountinuing therapy can cause return of viremia and complications of AIDS
What are fusion inhibitors in HIV therapy such as Enfuvirtide interfer with HIV-1 entry into cell by inhibiting fusion of viral and cellular membranes by binding GP41 subunit on viral envelope
In addition to antiviral treatment what should you also start for patients with T Cells below 200/mm3 prophylaxis treatment for opportunistic infections such as P. Carinii or mycobacterium and other fungal infection
Your CD4 T cell count is below 200 what would you wnat to start prophylaxis against pneumocystis jiroveci
When your T Cell count is below 50 what prophylaxis would you start start prophylaxis against Mycobacterium avium complex
What Prophylaxis treatment would you start with T cell count below 100 and positive anti toxoplasma IgG assay prophylaxis against toxoplasmosis
causitve agent of this tumor of blood and lymph vessels is herpesvirus HHV-8 kaposi's sarcoma
What 2 changes does HHV-8 cause in blood and lymph cells to cause the tumors to form 1. the cells become spinle shaped and proliferate
2 extensive formation of new blood vessels occurs
Which type of lymphoma is more common in HIV patients B cell lymphoma or T cell lymphoma B Cell lymphoma
What virus likely plays and indirect role in causing lymphomas in aids Epstein Barr Virus EBV
What is the oportunistic virus that causes cervical and anal carcinomas in aids patients HPV types 16 & 18
What is Toxoplasma Gondii obligate intracellular sporozoan causes toxoplasmosis
What is the definitive host for toxoplasma gondii GI Tract of Felines- CATS
What type of cell does the parasite toxoplasma gondii infect and what problems can it cause it infects macrophages and multiplies inside of them until they rupture.
What is the problem with congenital toxoplasmosis can cause abortion and stillbirth when infected mother passes parasite to unborn child
If a child that gets congenital toxoplasmosis doesn't die in utero what other complication can they have from the parasitic infection CNS and Visceral problmes such as microcephaly, hydrocephaly, convulsion, hepatitis, pneumonia
What is the main s/sx of asymptomatic toxoplasmosis lymphadenopathy
what other s/sx can accompany the typical lymphadenopathy of toxoplasmosis fever, sore throat, rash, hepatosplenomegaly, atypical lymphocytosis
What percent of aids patients or immunosuppresed individuals develop toxoplasmosis encephalitis 50% with 90% of cases being fatal
How do you dx toxoplasmosis serologic testing detecting IgG antibodies by indirect hemaglutination test or indirect fluorescence test
How can you prevent toxoplasmosis proper hand washing after handling uncooked meat, cooking meat properly, avoid cat feces, cats shouldn't be allowed to hunt birds, rodents or eat undercooked meat
how do you treat toxoplasmosis pyrimethamine and sulfonamides (doesn't treat cyst form) Pregnant women gets spriamycin or there is a new drug that treats cysts too called atovaquone
What virus family does cytomegalovirus belong herpesviridae family enveloped double stranded DNA virus
What is characteristic cytologically of a cytomegalovirus infection infected cells are 2 or more time larger than normal unifected cells
What is it called when cytomegalovirus enters a non replicating non infectious form and why is this significant to aids patients latent cytomegalovirus which can reactivate in immunosuppressed and AIDS patients
What are some of the manifestations of cytomegalovirus infection in AIDS patients pneumonia
neurological disorders
How do you dx cytomegalovirus Detect CMV cytopathology, antigen or DNA in infected tissue. Isolate virus from tissue or secretions, presence of IgM antibody
What is the tx for CMV Gancyclovir, Foscarnet, Cidofovir
Especially Gancyclovir with immune globulin reduces high mortality of CMV pneumonia
What vaccines are not advised for AIDS patients oral poliomyelitis
Oral Typhoid
BCG (TB vaccine)
Varicella Zoster vaccine
Yellow Fever Vaccine
What vaccines should AIDS patients get MMR

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