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HIV II/III
HIV facts from lecture
| Question | Answer |
|---|---|
| How long does it take to go from HIV to AIDS? | 9-10 years |
| If CD4 <400, What Infections do you get? | 1)Oral thrush 2)Tinea Pedis 3) VZV Reactivation 4)TB Reactivation 5)Other bacterial infections (H.Influ, S. pneumoniae, Salmonella) |
| If CD4 <200, What infections do you get? | 1)HSV Reactivation 2) cryptosporidoisis, 4)Isospora, 5)disseminated coccidioidomycosis, 6)PCP |
| If CD4 <100, What infections do you get? | 1)Candida esophagitis, 2)toxoplasmosis, 3)histoplasmosis |
| If CD4 <50, What infections do you get? | 1)CMV retinitis and esophagitis, 2)MAC, 3)Crytococcal Meningoencephalitis |
| What are the neoplasms associated with HIV? | Kaposi's sarcoma (HHV-8), Invasive cervical carcinoma (HPV), Primary CNS lymphoma, non-Hodgkin's Lymphoma |
| At what CD4 level do you get cryptosporidiosis? | CD4 <200 |
| At what CD4 level do you get PCP? | CD4 <200 |
| At what CD4 level do you get MAC? | CD4 <50 |
| How do you get toxo? | Ingestion of raw/undercooked meat with cysts; ingestion of oocysts(cats) |
| What are some of the symptoms of toxo? | Altered mental status, seizures, focal neuro signs |
| Which is the most important virus in AIDS patients? | CMV |
| What are some of the important sypmtoms of CMV? | Retinitis (which is why you'd want to screen them), GI(esophagitis, colitis), CNS, pneumonitis |
| What is the most common malignancy in AIDS patients? | Kaposis |
| Which 2 malignancies occur at a variety of CD4s? | Kaposis and non-hodgkins |
| How do you prevent OIs? | Prevent exposure, Screening tests, chemoprophylaxis, HAART |
| Should ART be started during treatment of OI or until OI treatment is completed? | During treatment obviously. However note that the IRIS rates increased with early treatment. |
| Explain the train analogy of HIV? | Viral load means the speed. The CD4+ markates distance, since t=d/v, since v is high, therefore you'll reach aids in a much shorter time. |
| What are the goals of HIV therapy? | 1)Suppress HIV RNA level 2)Preserve/enhance immune fxn 3)delay progression of HIV disease |
| Would you want to start early or late? | Early of course |
| Name each class of HIV drugs? | Nucleosides/Non-nucleoside reverse 1)transcriptase inhibitor, 2)fusion inhibitor, 3)chemokine receptor antagonist, 4)protein inhibitor, 5)integrase inhibitor |
| How many drugs do you want to give HIV patients? | 3 drugs |
| What are the recommended regimens for HIV? | 1) 2 nucs + NNRTI 2) 2 nucs +PI (+/- RTV) |