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67 Cards in this Set
- Front
- Back
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What is the primary receptor for the HIV-1 virus and what are the coreceptors?
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CD4 on T lymphocytes is the primary receptor and the chemokine receptor (CCR5 or CXCR4) is an essential secondary co-receptor
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What viral HIV-1 protein binds to the receptor molecules on the T cell?
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The viral GP120 glycoprotein
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What is the function of the pol gene and what antiviral classes target it's gene product?
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Pol codes for treverse transcriptase which is a major antiviral target of NRTIs and NNRTIs (nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors)
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What are the function of the tat and rev genes?
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They encode proteins involved in RNA synthesis and transport to the cytoplasm; they upregulate virus gene expression
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What is the significance of the Nef protein?
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It is important for the in vivo pathogenicity
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Describe the infectivity ability of HIV in people who have a mutated CCR5 protein
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They are resistant to the infection of most HIV-1 strains
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Is viral load a good predictor of CD4 T-cell depletion in HIV-1 infection?
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No, it does not always predict immune decline and loss of CD4 T-cells
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What is the initial screening test for HIV and what confirmatory test must be done?
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The initial screening test is an antibody-capture ELISA, which may give false positives so the confirmation test is a Western blot
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Describe the results of antibody detection in a newborn of an HIV infected mother and wheather or not this means the child is infected
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Antibody will be present in 100% of infants born to HIV positive mothers, but the infection rate is only ~25%
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What tests need to be done in an infant that is antibody positive?
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PCR to detect proviral DNA in the peripheral blood cells or RT-PCR to dettect virion RNA in the serum/plasma
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What tests are done to detect and quantitate the viral RNA in the plasma?
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RT-PCR and bDNA assays
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What tests are used in HIV patients to monitor the efficacy of therapy and current status of infection?
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RT-PCR and bDNA assays
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Why is a confirmatory Western blot done after a positive ELISA?
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The ELISA may give false positives
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When is a false negative result possible?
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If a person is tested too soon after exosure because anti-HIV antivody is not detectable until 2-12 weeks after infection starts
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Why are ELISA and western blot not used to diagnose infection in newborns or infants less than 12 months?
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The antiviral IgG detected is maternal in origin and only indicates maternal infection
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What is a characteristic of body fluids which are important in the transmission of HIV?
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They are rich in white blood cells
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What aer the body fluids most associated with HIV transmission?
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Blood, semen, vaginal fluid, and colostrum/breast milk
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What is the highest risk of sexual transmission of HIV?
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Receptive anal intercourse with infectced male
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What drug can be given to HIV positive pregnant women to reduce the chances of infecting the baby?
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Nevirapine, a non-nucleoside reverse transcriptase inhibitor
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What are the viral targets for HIV therapy?
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1) RNA dependant DNA polymerase 2) viral protease3) integrase protein 4) CCR5 5) gp41 envelope glycoprotein (fusion)
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What are the classes of drugs used to treat HIV infection?
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1) NRTIs and NNRTIs 2) protease inhibitors 3) fusion inhibitors 4) integrase inhibitors 5) CCR5 antagonists
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From where did the HIV1 and 2 viruses originate?
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From primates with chronic, asymptomatic SIV infections
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What protein is the lentivirus capsid?
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p24 Gag protein
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Describe the CDC's definition of AIDS
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It is a life-long illness caused by HIV infection characterized by 1) HIV encephalopathy 2) wasting syndrome 3) AIDS opportunistic infections 4) AIDS assocaited malignancies ***5) CD4 T-cell count less than 200
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What is the incubation period from HIV infection to the development of AIDS?
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around 10 years
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What is a long term non progressor and how is it believe they are protected?
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Someone chronically infected with HIV who does not develop AIDS in abscence of antiretroviral therapy; they have "protective" HLA alleles such as HLA B57 and strong anti-HIV CTL response
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|
What is the primary receptor for the HIV-1 virus and what are the coreceptors?
|
CD4 on T lymphocytes is the primary receptor and the chemokine receptor (CCR5 or CXCR4) is an essential secondary co-receptor
|
|
|
What viral HIV-1 protein binds to the receptor molecules on the T cell?
|
The viral GP120 glycoprotein
|
|
|
What is the function of the pol gene and what antiviral classes target it's gene product?
|
Pol codes for treverse transcriptase which is a major antiviral target of NRTIs and NNRTIs (nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors)
|
|
|
What are the function of the tat and rev genes?
|
They encode proteins involved in RNA synthesis and transport to the cytoplasm; they upregulate virus gene expression
|
|
|
What is the significance of the Nef protein?
|
It is important for the in vivo pathogenicity
|
|
|
Describe the infectivity ability of HIV in people who have a mutated CCR5 protein
|
They are resistant to the infection of most HIV-1 strains
|
|
|
Is viral load a good predictor of CD4 T-cell depletion in HIV-1 infection?
|
No, it does not always predict immune decline and loss of CD4 T-cells
|
|
|
What is the initial screening test for HIV and what confirmatory test must be done?
|
The initial screening test is an antibody-capture ELISA, which may give false positives so the confirmation test is a Western blot
|
|
|
Describe the results of antibody detection in a newborn of an HIV infected mother and wheather or not this means the child is infected
|
Antibody will be present in 100% of infants born to HIV positive mothers, but the infection rate is only ~25%
|
|
|
What tests need to be done in an infant that is antibody positive?
|
PCR to detect proviral DNA in the peripheral blood cells or RT-PCR to dettect virion RNA in the serum/plasma
|
|
|
What tests are done to detect and quantitate the viral RNA in the plasma?
|
RT-PCR and bDNA assays
|
|
|
What tests are used in HIV patients to monitor the efficacy of therapy and current status of infection?
|
RT-PCR and bDNA assays
|
|
|
Why is a confirmatory Western blot done after a positive ELISA?
|
The ELISA may give false positives
|
|
|
When is a false negative result possible?
|
If a person is tested too soon after exosure because anti-HIV antivody is not detectable until 2-12 weeks after infection starts
|
|
|
Why are ELISA and western blot not used to diagnose infection in newborns or infants less than 12 months?
|
The antiviral IgG detected is maternal in origin and only indicates maternal infection
|
|
|
What is a characteristic of body fluids which are important in the transmission of HIV?
|
They are rich in white blood cells
|
|
|
What aer the body fluids most associated with HIV transmission?
|
Blood, semen, vaginal fluid, and colostrum/breast milk
|
|
|
What is the highest risk of sexual transmission of HIV?
|
Receptive anal intercourse with infectced male
|
|
|
What drug can be given to HIV positive pregnant women to reduce the chances of infecting the baby?
|
Nevirapine, a non-nucleoside reverse transcriptase inhibitor
|
|
|
What are the viral targets for HIV therapy?
|
1) RNA dependant DNA polymerase 2) viral protease3) integrase protein 4) CCR5 5) gp41 envelope glycoprotein (fusion)
|
|
|
What are the classes of drugs used to treat HIV infection?
|
1) NRTIs and NNRTIs 2) protease inhibitors 3) fusion inhibitors 4) integrase inhibitors 5) CCR5 antagonists
|
|
|
From where did the HIV1 and 2 viruses originate?
|
From primates with chronic, asymptomatic SIV infections
|
|
|
What protein is the lentivirus capsid?
|
p24 Gag protein
|
|
|
Describe the CDC's definition of AIDS
|
It is a life-long illness caused by HIV infection characterized by 1) HIV encephalopathy 2) wasting syndrome 3) AIDS opportunistic infections 4) AIDS assocaited malignancies ***5) CD4 T-cell count less than 200
|
|
|
What is the incubation period from HIV infection to the development of AIDS?
|
around 10 years
|
|
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What is a long term non progressor and how is it believe they are protected?
|
Someone chronically infected with HIV who does not develop AIDS in abscence of antiretroviral therapy; they have "protective" HLA alleles such as HLA B57 and strong anti-HIV CTL response
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What is the major opportunistic pathogen causing mobidity and mortality in patients with AIDS?
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Pneumocystis jirocevi (carinii) pneumonia
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What is the most significant hazard to healthcare workers in contact with patients who have AIDS (other than AIDS itself)?
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Mycobacterium tuberculosis infection
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What is idiopathic CD4 T-lymphocytopenia?
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A rare unexplained case of low CD4 T cells with or without accompanying disease which is NOT AIDS
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What are some opportunistic pathogens that affect indiviuals with AIDS?
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pneumocystis carinii (jiroveci), esophageal candidiases, CMV, HHV-8, mycobacterium tuberculosis and mycobacterium avian/intracellulare
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What is Kaposi's sarcoma and what causes it?
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A malignancy seen in AIDS patients caused by human herpes virus 8 (HHV8)
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What causes oral hairy leukoplakia?
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Epstein-Barr virus
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What are the major examples of opportunistic viral infections in AIDS patients?
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Herpes viruses including CMV, Epstein Barr, HHV8, VZV, herpes simplex 1 and 2; JC polyomavirus, molluscum contagiosum pox virus
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What AIDS opportunistic virus causes progressive multifocal leukoencephalopathy?
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JC polyomavirus
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What is given to a healthcare worker post HIV exposure?
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AZT or nevirapine as post-exposure prophylaxis
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What is HAART therapy?
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Highly active antiretroviral therapy; consists of triple combination therapy with two NRTI's and one NNRTI
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What are important considerations with HAART therapy?
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It must be continued for the rest of the patients life, viral load must be monitored with a shift t o a new combination if the viral load increases
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What is GART?
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Genotype antiretroviral resistance testing; used to sequence the pol gene to determine the sensitivity/resistance pattern for inhibitors of the viral reverse transcriptase and viral protease
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What disease is associated with infection of the HTLV-1 virus?
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Adult T-cell leukemia/lymphoma, and HTLV associated myelopathy/tropical spastice paraparesis (HAM/TSP)
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Describe the clinical syndrome of HTLV associated myelopathy/tropical spastic paraparesis
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Progressive, permanent lower extremity weakness, spasticity, hyperreflexia, sensory distrubances, and urinary incontinance
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What cancers are associated with AIDS?
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Kaposi's sarcoma, B-cell lymphomas, and HPV associated cervical cancer
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