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32 Cards in this Set
- Front
- Back
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How does ELISA work in infants? How can you detect AIDS in infants
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IT DOESN'T because you will detect maternal Ab.
PCR to detect nucleic acids |
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Can you get AIDS from swallowing semen
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Yes
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Prevent AIDS
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condoms, don't share needles, DON'T recap needles, treat HIV pregnant mom during pregnanacy and after child birth, circumcision
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AIDS and sex
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sex-->microtears-->AIDS taken up through tear or dendritic cell periscope-->infect CD4 cells using gp120 and gp41
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How can dendritic cells lead to AIDS?
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dendritic cells take up virus and carry to lymph node to expose CD4 cells
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Primary HIV symptoms. When do they show?
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flulike: fever, lymphadenopathy, sore throat, pharyngitis, rash, mucocutaneous ulcers, myalgias, GI symptoms
2-4 weeks after exposure; last 2 weeks viral load high and very contagious |
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What happens after primary HIV?
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Immune system ramps up and neutralizes it for long period
cytotoxic CD8 cells kill infected CD4 T cells rapidly after 6 weeks HIV Ab start showing up |
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How can HIV escape Immune
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Huge diversity of gp120 cells that easily mutate
gp120 hides gp41 until it binds cell initially subtypes are geographically dispersed |
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Why can't we use Ab against gp41
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until gp120 binds CD4 it shields gp41 and gp41 only exposed short time until it binds CCR5
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How does HIV hide?
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viral cDNA from reverse transcriptase integrates into T cell host DNA
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what causes HIV to reactivate?
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T cell activation-->transcription of integrated virus genes-->RNA transcripts cleaved allowing translation of early genes(tat and rev)-->late proteins produced(gag, pol, env)
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What do early HIV genes tat and rev do?
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tat=amplifies transcription of viral RNA
rev=increased transport of viral RNA to cytoplasm |
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What are the late proteins?
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Gag, Pol, Env
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Why can't we make vaccine to HIV
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forms latent proviral DNA, HIV highly variable, gp120 and gp41 highly camouflaged by glycosylation
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HIV Progression
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Acute retroviral syndrome, seroconversion(Ab's formed), Latent phase, AIDS
eventually virus overpowers immune system |
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HIV and folicular dendritic cells
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hides in lymph nodes and binds follicular DC for long time to hide out
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Why does T cell count drop?
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direct viral killing, infected cells susceptible to apoptosis, CD8 cytoxic T cells kill them, eventually can't make more CD4 T cells(immune exhaustion), fibrosis and loss of lymph architecture
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What paraasites kill AIDS patients?
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Toxoplasma, crytosporidium, Leishmania, Microsporidium
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What intracellular bacteria kill AIDS patients
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TB, Mycobacterium avium intracellulare, salmonella
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What fungi kill AIDS patients
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pneumocystis carinii, cryptococcus neoformans, candida, histoplasma capsulatum, coccidioides immitus
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What viruses kill AIDS patients?
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herpes simplex, cytomegalovirus, varicella zoster
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What is the magic number when a patient needs antiretrovirals
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<200 T cell count
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AIDS associated cancers
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Kaposi's Sarcoma(HHV8)
Non-Hodgkin's Lymphoma(EBV, Burkitt's Lymphoma, Primary Lymphoma of brain |
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How does AIDS cause cancer?
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disregulates immune so uncontrolled cell proliferation, oncogenic viruses no longer stopped, cancer unchecked by immune system
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Common AIDS presentations
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Thrush, weight loss, Kaposi's Sarcoma skin leasions, Pneumocystis Carinii Pneumonia, fever
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Lab test for AIDS
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CD4 cell count
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Late stage clues
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total lymphos <1000
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How long do you have to take retrovirals to clear HIV
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YOU NEVER CLEAR HIV and HIV can become resistant to drugs so then have to change to different drugs
3 or more drugs from 2 different classes at a time works best |
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Main goals of antiretroviral treatment?
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decrease viral load and increase CD4 count by 100/uL per year
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3 factors that predict outcome of AIDS patient
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CD4 cell count, patient adherence, provider experience
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What is HIV commonly comorbid with in Africa
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TB
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How effective are drugs?
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remeber the picture of the African man in a span of a few months drastic improvement.
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