Biology Of Aids

Front 1

(True/False)
Although the agent responsible for AIDS was probably in the united states during the 1970s, the "official" beginning of the AIDS epidemic in the united states occurred in 1991.

Back 1

Fales, The beginning of the aids Epidemic in the united states occurred in 1981

Front 2

(True/False)
Two diseases that physicians commonly observe in AIDS patients are Pneumocystis pneumonia and a form of skin cancer known as adenocarcinoma.

Back 2

False, The form of skin cancer was known as Kaposi Syndrome.

Front 3

(True/False)
It is now generally recognized that AIDS is caused by a virus.

Back 3

True

Front 4

(True/False)
One of the important modes of transmission for the human immunodeficiency virus (HIV) is contaminated food

Back 4

False, The more important modes of transmission for HIV is contaminated Blood.

Front 5

(True/False)
AIDS is a disease that occurs in homosexual men as well as in injection drug users.

Back 5

True, but not exclusively.

Front 6

(True/False)
In France, the research team that confirmed the identity of the AIDS virus was led by Bernard Schwartlander.

Back 6

False, It was led by Luc Montagnier.

Front 7

(True/False)
The AIDS virus, originally designated HTLV-III/LAV, is now know by the acronym HIV.

Back 7

True

Front 8

(True/False)
Since the introduction of blood tests for AIDS, the number of transfusion-linked cases of AIDS has increased sharply.

Back 8

False, The number of transfusion-linked cases of AIDS has decreased sharply.

Front 9

(True/False)
Because of its global involvement, the AIDS epidemic is more properly termed an AIDS endemic.

Back 9

False, The proper term is an AIDS Pandemic

Front 10

(True/False)
By 1989, the number of cases of AIDS diagnosed in the United states had passed 1 million.

Back 10

False, by 1989 the number of cases of AIDS diagnosed in the U.S had passed 100,00

Front 11

(True/False)
A global program to combat the spread of the AIDS has been established by the World Health Organization

Back 11

True

Front 12

(True/False)
One theory relating to the origin of the AIDS virus suggests that it may have existed in the African birds before being transmitted to humans.

Back 12

False, It was believed it may have existed in African monkeys.

Front 13

(True/False)
The form of AIDS caused by HIV-2 appears to be deadlier than the form caused by HIV-1

Back 13

False, HIV-2 is milder

Front 14

(True/False)
The current research thinking is that epidemics of AIDS due to HIV-2 originated from SIV in the sooty mangabey monkey

Back 14

True

Front 15

(True/False)
At the beginning of the 21st century, the AIDS pandemic was particularly severe on the continent of Africa

Back 15

True

Front 16

_____________is the name of the brain disorder occurring in roughly one third of persons with AIDS

Back 16

AIDS-dementia complex

Front 17

_____________is the hospital whose physicians devised a six-stage classification system of the stages leading to AIDS

Back 17

Walter Reed

Front 18

_____________is the cancer of the skin often observed in persons with AIDS.

Back 18

Kaposi's sarcoma

Front 19

_____________is the virus that forms giant cells in the laboratory and that invades many cells of many organs as an opportunist

Back 19

cytomegalovirus

Front 20

_____________is the name of the protozoan that causes lung disease as an opportunistic disease accompanying AIDS

Back 20

Pneumocystis carinii

Front 21

_____________Is the approximate incubation period for AIDS

Back 21

10 years

Front 22

_____________is the name assigned to the condition where a patient harbors HIV but shows no symptoms of disease.

Back 22

HIV infection

Front 23

_____________ is the term given to the swollen lymph nodes commonly associated with HIV infection, ARC, and AIDS.

Back 23

lymphadenopathy

Front 24

_____________is the approximate number of cases of pediatric AIDS reported through 2000

Back 24

6000

Front 25

_____________is the normal count of T-lymphocytes per micro liter of blood.

Back 25

800

Front 26

_____________is the yeast-like fungus that causes the infection of the mouth called thrush, an early sign of impending AIDS.

Back 26

candida albicans

Front 27

_____________is the system of the body attacked by the opportunistic microorganism Cryptosporidium

Back 27

gastrointestinal system

Front 28

_____________is the name given to the chronic diarrhea and dramatic weight loss that can fulfill the definition for AIDS

Back 28

HIV wasting syndrome

Front 29

_____________is the drug used to treat patients who experience Pneumocystis pneumonia

Back 29

Pentamidine isethionate

Front 30

_____________are the animals that harbor Toxoplasma and that should be avoided by a person infected by HIV

Back 30

cats

Front 31

What are some jobs of an epidemiologist?

Back 31

Discovering that an epidemic is in progress, defining circumstances under which a disease spreads, studying the pattern of distribution of a disease.

Front 32

In a male, the presence of a sexually transmitted disease (STD) such as gonorrhea or chlamydia can contribute to HIV transmissions because

Back 32

STDs can cause erosion of the urethra and provide an entry path for HIV

Front 33

HIV could conceivably pass through the lining of a woman's uterus if she is exposed to the virus during.....

Back 33

during the menstrual period

Front 34

Methods by which HIV is known to be transmitted

Back 34

Placental transfer from mother to fetus, contact with contaminated blood in syringes, anal intercourse.

Front 35

As of 2006, the total number of cases of HIV/AIDS in the united states stood at

Back 35

approximately 1 million cases of HIV/AIDS

Front 36

Whereas the percentage of AIDS cases involving homosexual men is dropping, the percentage continues to rise in

Back 36

doctors and surgeons

Front 37

direct blood-to-blood or semen-to-blood transfer of HIV is necessary for the transmission of AIDS because

Back 37

The AIDS virus is a very fragile virus.

Front 38

The transmission of HIV can be limited by some of these methods...

Back 38

Using a condom during sexual encounters, disinfecting needles used to inject drugs, limiting the number of sexual partners.

Front 39

In the Western Hemisphere, confirmed cases of AIDS have been reported in what countries?

Back 39

in nearly every country

Front 40

The typical AIDS patient in Africa exhibits symptoms that typify

Back 40

The HIV wasting syndrome

Front 41

Research evidence has shown that mosquitoes

Back 41

do not transmit HIV

Front 42

The HIV antibodies detected in a newborn's blood most likely have come from

Back 42

the mothers blood system

Front 43

During vaginal intercourse, the risk of HIV infection increases if....

Back 43

the woman has vaginal lesions

Front 44

If mosquitoes were capable of transmitting HIV...

Back 44

many more adults would have AIDS

Front 45

In Africa, the most predominant method for HIV transmission appears to be

Back 45

heterosexual vaginal intercourse

Front 46

(True/False)
A lighted match is an excellent way for injection drug users to sterilize their needles.

Back 46

False, the needles should be decontaminated with household bleach and hot water.

Front 47

(True/False)
One method by which health care workers can be exposed to HIV-contaminated blood is through needlestick injuries.

Back 47

True

Front 48

(True/False)
The universal precautions promulgated by the CDC are recommendations for all health care workers.

Back 48

True

Front 49

(True/False)
A condom prevents the passage of bacteria from the semen to the man's sex partner but does not prevent the passage of viruses.

Back 49

False, condoms do prevent the passage of viruses

Front 50

(True/False)
The agents of STDs, including AIDS, are generally unable to withstand exposures to the outside environment that other microorganisms can tolerate.

Back 50

True

Front 51

(True/False)
In controlled laboratory studies, natural lambskin condoms were found to be more effective for preventing HIV passage than latex condoms.

Back 51

False, Lambskin condoms are porous and inconsistent.

Front 52

(True/False)
Law enforcement officers may be exposed to HIV-contaminated blood when they suffer needlestick injury while conducting a search.

Back 52

True

Front 53

(True/False)
Aids education in the lower school grades should begin with descriptions of HIV and include a thorough grounding in sex education, including condom use.

Back 53

False, emphasis should be placed on the facts that AIDS is hard to get, that AIDS primarily effects adults, and that researchers are actively seeking a cure for the disease.

Front 54

(True/False)
One of the most effective germicides for destroying the AIDS virus is a solution of bleach in water at a concentration of 1% to 10%

Back 54

True

Front 55

(True/False)
Health care workers should assume that all patients are infected with HIV in their blood and other body fluids.

Back 55

True

Front 56

(True/False)
Disposable gloves need not to be carried in emergency response equipment because technicians rarely encounter accident victims who are infected with HIV.

Back 56

False, Disposable gloves should be a standard component of emergency response equipment and should be put on by all personnel prior to initiating any emergency care tasks involving exposure to blood or other body fluids to which universal precautions apply

Front 57

(True/False)
One widely adopted way of interrupting the spread of AIDS among prison inmates is to distribute clean, sterile needs to drug addicts.

Back 57

False

Front 58

(True/False)
Medical Laboratory technicians should pipet liquids by mouth because the probability of dealing with HIV-contaminated fluids is very low.

Back 58

False, Mechanical pipetting devices should be used for manipulating all liquids.

Front 59

(True/False)
(True/False)
Funeral directors and embalmers should be concerned about exposure to HIV because the virus may be present in the blood, other body fluids, and organs of the deceased.

Back 59

True

Front 60

(True/False)
Abstinence from sexual intercourse and avoiding injection drug use are effective methods for avoiding exposure to HIV

Back 60

True

Front 61

__________________ is the acronym used for the laboratory test most widely used to detect HIV antibodies.

Back 61

ELISA

Front 62

__________________Characterizes the result of an HIV antibody test when the person is infected but does not have sufficient antibodies to give a positive test.

Back 62

False-Negative

Front 63

__________________is the technique in which an electric current is used to separate HIV proteins (antigens) used in the Western blot analysis.

Back 63

Electrophoresis

Front 64

__________________are the cells that must be obtained from a patient to perform a gene probe

Back 64

T-Lymphocytes

Front 65

__________________is the amount of HIV in the body when a test for HIV RNA is performed.

Back 65

Viral Load

Front 66

__________________is the name given to any test that determines the presence of antibodies in a patient.

Back 66

Serological

Front 67

__________________is the validation test most frequently used when the ELISA test is positive.

Back 67

Western Blot

Front 68

__________________is the result that can occur if an uninfected person has antibodies that react with HIV antigens in a laboratory test.

Back 68

false-positive

Front 69

__________________are the main targets of HIV fragment tests

Back 69

antigens

Front 70

__________________is the reaction used to amplify the amount of DNA in an HIV test using a gene probe

Back 70

PCR

Front 71

__________________is the agency of the united states government that licenses HIV diagnostic tests

Back 71

FDA

Front 72

__________________is the process wherein blood banks combine samples of donor bloods for HIV testing

Back 72

radioimmunoprecipitation

Front 73

__________________is the material obtained from a patient to perform an ELISA test

Back 73

serum

Front 74

__________________is the source of the antibodies in a newborn's blood that makes an HIV antibody test inefficient

Back 74

Mother

Front 75

__________________is a fragment of DNA that seeks out and binds with a complementary DNA fragment such as that from an HIV provirus.

Back 75

gene probe

Front 76

__________________is the approximate time after exposure to HIV required for a person's immune system to make enough antibodies to give a positive ELISA test.

Back 76

6-10 weeks

Front 77

__________________is the level of specificity and sensitivity exceeded by both the ELISA test and Western blot analysis

Back 77

99%

Front 78

__________________is the material other than polymerase enzymes and nucleotides that must be added to DNA to carry out the PCR

Back 78

Primer DNA

Front 79

__________________is the serologic test in which a color change signals that HIV antibodies are present in the serum of the patient.

Back 79

ELISA

Front 80

__________________is one group for which HIV testing is mandatory in the United States.

Back 80

military

Front 81

(drug/therapeutic agent)
Preferred drug for treating herpes simplex infections

Back 81

Acyclovir

Front 82

(drug/therapeutic agent)
Combined with sulfamethoxazole for treating pneumocystis carinii pneumonia

Back 82

Pentamidine isethionate

Front 83

(drug/therapeutic agent)
Approved by the FDA in 1987 but causes suppression of bone marrow and anemia

Back 83

AZT

Front 84

(drug/therapeutic agent)
Used with AZT; also know as lamivudine

Back 84

3TC

Front 85

(drug/therapeutic agent)
Binds to gp120 and gp41 proteins of HIV

Back 85

trojan horse virus

Front 86

(drug/therapeutic agent)
Inhibits tumor necrosis factor

Back 86

Thalidomide

Front 87

(drug/therapeutic agent)
Primary drug for treating Pneumocystis carinii pneumonia

Back 87

pentamidine isethionate

Front 88

(drug/therapeutic agent)
Acts on reverse transcriptase, but unlike AZT

Back 88

NRTI

Front 89

(drug/therapeutic agent)
Approved for treating HIV infected persons to forestall profression to AIDS

Back 89

AZT

Front 90

(drug/therapeutic agent)
Possible alternative to AZT with fewer side effects; also called didanosine

Back 90

ddI

Front 91

(drug/therapeutic agent)
Commonly used to treat tuberculosis

Back 91

isoniazid

Front 92

(drug/therapeutic agent)
Aerosolized form used to prevent Pneumocystis carinii pneumonia

Back 92

Pentamidine isethionate

Front 93

(drug/therapeutic agent)
Induces T-lymphocytes to mature

Back 93

IL-2

Front 94

(drug/therapeutic agent)
Synthetic antiviral substance used against Kaposi's sarcoma

Back 94

Alpha interferon

Front 95

(drug/therapeutic agent)
Marketed as Videx and used in rotation with AZT; a similar nucleoside

Back 95

ddI

Front 96

(drug/therapeutic agent)
Synthetic molecule that combines with HIV-specific mRNA during viral replication

Back 96

antisense molecule

Front 97

(drug/therapeutic agent)
Also known as zidovudine and Retrovir

Back 97

AZT

Front 98

(drug/therapeutic agent)
Structured to react with a protein-processing enzyme in viral reproduction

Back 98

protease inhibitor

Front 99

(drug/therapeutic agent)
Has synergistic effect when used with AZT

Back 99

NRTI

Front 100

(drug/therapeutic agent)
Recommended for CMV-induced retinitis

Back 100

Ganciclovir

Front 101

(drug/therapeutic agent)
Protease inhibitor; also known as Norvir

Back 101

Ritonavir

Front 102

(drug/therapeutic agent)
Commercially available as roferon and intron-A

Back 102

Alpha interferon

Front 103

(drug/therapeutic agent)
Complementary to RNA molecule produced during viral replication

Back 103

Antisense molecule

Front 104

(drug/therapeutic agent)
Fusion inhibitor

Back 104

T-120

Front 105

(drug/therapeutic agent)
Category that includes nevirapine

Back 105

NRTI

Front 106

Among the major subunits being considered for use in an AIDS vaccine are

Back 106

gp120 and gp41

Front 107

In subunit vaccines, the immune-stimulating agents are made more attractive to macrophages by

Back 107

binding the agents to adjuvant

Front 108

A viable-vector vaccine uses HIV genes linked to

Back 108

canarypox viruses cultivated in the laboratory

Front 109

A therapeutic vaccine is one that

Back 109

prevents an infected person from progressing to disease

Front 110

Possible solutions to the problem of the lack of a suitable animal model for vaccine testing may involve the following

Back 110

Developing a mouse with a human immune system, using rhesus macaque monkeys, using test tube cultures of human cells.

Front 111

Liposomes have found value in vaccine technology as

Back 111

adjuvants to enhance immune system stimulation

Front 112

The whole-virus vaccine developed by Salk's group contains

Back 112

HIV particles without envelopes

Front 113

The propagation of viruses for vaccine use depends heavily on the

Back 113

ability to cultivate viruses in tissue culture

Front 114

Among those who would probably be candidates for an AIDS vaccine are

Back 114

Persons who use injection drugs, individuals who practice anal intercourse, allied health science professionals.

Front 115

A vaccine containing subunits is considered safer than one containing whole viruses because

Back 115

subunits do not infect cells or replicate in the body

Front 116

A vaccine composed of attenuated viruses

Back 116

has viruses that multiply in the body

Front 117

Aluminum sulfate and mineral oil have both been used in vaccines to

Back 117

make subunits more attractive to macrophages

Front 118

Mutations that occur in a virus tend to

Back 118

limit the usefulness of a vaccine

Front 119

(True/False)
An ethical or social concern that may surface during vaccine trials is multiplying viruses will be used in the AIDS vaccine.

Back 119

False, some ethical or social concerns are; Volunteers can only participate in a single trial, counseling must be given to all recipients of the vaccine, participating in a vaccine trial will prompt a positive test for HIV antibodies

Front 120

(True/False)
It is generally advantageous for a business to have an unstated policy regarding AIDS.

Back 120

False, An AIDS-specific policy should seek to inform all employees about AIDS and recognize that persons with HIV infection and AIDS pose significant and sensitive issues in the work place.

Front 121

(True/False)
According to decisions by the U.S Supreme Court, a person suffering from AIDS is considered to be handicapped.

Back 121

True

Front 122

(True/False)
The guidelines issued by the CDC are rarely used by laboratory or hospital facilities in the development of safety policies

Back 122

At the ends of the 1990s a survey indicated that over half of work sites had AIDS policies in place and nearly 20% were offering AIDS education programs

Front 123

(True/False)
The 2001 federal expenditure for AIDS research and care of patients was less than $10,000 per year, and it is becoming less each year.

Back 123

False, $15,000 a year

Front 124

(True/False)
(True/False)
Federal law requires that employers make reasonable accommodations for AIDS patients, including time off for doctor's appointments and rest periods during the work day.

Back 124

True

Front 125

(True/False)
Observing universal precautions is one of the multiple burdens imposed on members of the health care system by the AIDS epidemic.

Back 125

True

Front 126

(True/False)
An AIDS-specific policy developed by businesses for use in the workplace projects the idea that AIDS is no different from other major illnesses such as cancer or heart disease

Back 126

False

Front 127

(True/False)
In future years, it is very likely that all persons infected with HIV will develop AIDS and can expect to die

Back 127

False

Front 128

(True/False)
HIV infection and AIDS are generally not a problem in the workplace because most people affected are not in their economically productive years

Back 128

False

Front 129

(True/False)
By 1996, the AIDS epidemic was virtually over.

Back 129

False

Front 130

(True/False)
One of the ethical dilemmas that medical professionals must consider is whether to perform surgery on a patient whose HIV status is uncertain.

Back 130

True

Front 131

(True/False)
The knowledge generated from AIDS research has no application in any other field of medicine

Back 131

False

Front 132

(True/False)
It is illegal to inform others of a patient's HIV status without the patient's consent.

Back 132

True

Front 133

(True/False)
The development of new drugs for treating HIV infection and AIDS will require that diagnosis be performed as soon as possible because early intervention can preclude disease development.

Back 133

True

Front 134

(True/False)
One of the lessons of the AIDS epidemic is that scientists do not have a ready answer for every medical problem that may face society

Back 134

True

Front 135

Approximately what percent of the individuals infected in Sub-Saharan Africa are women?

Back 135

60

Front 136

(True/False)
The distribution of opportunistic infections characteristic to AIDS across the world is uniform.

Back 136

False

Front 137

If you made Black America a separate nation, what rank would it have among the world for worst HIV/AIDS rate?

Back 137

16th

Front 138

In the U.S. as of 2011, which group had the greatest number of new HIV/AIDS cases reported because of high risk heterosexual sex?

Back 138

Black/African American

Front 139

In the U.S., the second greatest number of HIV infections is currently seen among which group?

Back 139

Heterosexual men and women

Front 140

In 2010, approximately what percentage of the new HIV infections in women in the U.S. are Black/African American?

Back 140

60%

Front 141

As of the latest data available, which region had the greatest number of new HIV infections (incidence)?

Back 141

Sub-Saharan Africa

Front 142

Who is considered to be the 'father of epidemiology' and what disease did he study?

Back 142

John Snow, cholera

Front 143

Name characteristics part of the criteria for a viral zoonotic disease?

Back 143

Phylogenetic relatedness of viruses
Prevalence in the natural host
Geographic coincidence of hosts
Plausible routes of transmission

Front 144

In the ELISA test what endpoint is actually detected/measured (assayed) for?

Back 144

Color

Front 145

Why would a PCR-based HIV test provide a different result relative to an antibody test?

Back 145

PCR does not require an abundance of circulating antibodies.
PCR can detect the presence of the proviral DNA

Front 146

If the first screening test shows a positive result for HIV twice, which is the second test used before one is declared positive for HIV?

Back 146

Western blot

Front 147

What is the acronym used for the laboratory test most widely used to detect antibodies to HIV?

Back 147

ELISA

Front 148

What does the PCR test detect in a patient's sample?

Back 148

HIV proviral DNA levels

Front 149

In the ELISA test, what endpoint is actually detected/measured?

Back 149

Color

Front 150

A ____ characterizes the result of an HIV antibody test when the person is infected but does not have sufficient antibodies to be detected.

Back 150

false negative

Front 151

Why is testing important?

Back 151

Means if positive, can start getting treatment and if not you can continue to be safe. Lower risk of transmission

Front 152

What ages range should be tested?

Back 152

ages 13-64

Front 153

Who are at higher risk of being infected by HIV?

Back 153

homosexuals, methamphetamine (cause cells to be more penetrable), injetion drugs, unprotected anal sex with multiple partners, use of drugs during sex

Front 154

Explain HIV antibodies test

Back 154

Indirect test of infection, must be past "window periods" (ELISA, Western blot), rapid "point of care"
Most common test

Front 155

Explain HIV antigen test

Back 155

Looks for viral components, variation on ELISA, uncommon in US and EU

Front 156

Explain Nucleic Aid Test

Back 156

Viral RNA or DNA, reverse transcriptase-PCR, bDNA probes (amplify signal)

Front 157

Explain EIA: Enzyme-linked immunosorbent Assay (ELISA)

Back 157

Most Widely used
Antibody-based test
sensitivity and specificity greater than 99%
"non-reactive"free of HIV antibodies, therefore free of HIV
"reactive" means initially reactive

Front 158

What type of tests can differentiate between HIV1/HIV2?

Back 158

multispot tests

Front 159

How do Home and point of care tests work?

Back 159

Confide: collect 3 drops of blood onto test card, mailed in coded card, call 800# for result, positive results routed to counselor.

Front 160

What is Orasure?

Back 160

HIV test (that we used on campus): requires no blood, uses tissue sample from check or gums, minimal skill required to administer and read.

Front 161

What is an example of a multispot test?

Back 161

Clinical laboratory improvement amendments (CLIA) if two of three are reactive, individual is positive.

Front 162

How does Western Blotting work?

Back 162

HIV antigens loaded onto gel
Quantifies which HIV antigens they are
Patient serum + solid media incubated
Enzyme-linked antibodies + solid media incubated
Developer solution ( enzyme substrate) added, bands appear.

Front 163

What antigens are used in a western blot?

Back 163

Gag Proteins p17, p24, p55
Pol Protein components p31, p51, p64
ENV protens gp41, gp120, gp160

Front 164

(Criteria for ELISA Testing)
Association of state and territorial Public, Health laboratory Directors/CDC

Back 164

Any two of:
p24
gp41
gp120/gp160

Front 165

(Criteria for ELISA Testing)
FDA-licensed DuPont test

Back 165

p24 and p31 and gp41 or gp120/gp160

Front 166

(Criteria for ELISA Testing)
American Red Cross

Back 166

3 bands; 1 from each gene-product group:
gag, pol, env

Front 167

(Criteria for ELISA Testing)
Consortium for retrovirus serology standardization

Back 167

2 bands: p24 or p31
gp41 or gp120/gp160

Front 168

How can you test seronegative yet still be HIV+?

Back 168

Time gap between infection & antibody production (window period 2-10 weeks)
Heterogeneity of HIV- mutations in HIV cause numerous, different antibodies not detected by the ELISA

Front 169

What causes False positive?

Back 169

HIV for a test cultivated in human cells, remaining human proteins can bind beads, horse antihuman antibodies then detect these
Mono, virulent flue-cross reactivity

Front 170

What are Gene Probes

Back 170

A gene probe is a single-stranded segment of DNA that can recognize and bind to a complementary segment of DNA on a large DNA molecule. To perform gene probe,
-infected T cells are isolated and lysed
-cellular DNA is isolated and 2 strands melted apart
-Radioactive single-stranded gene probe is added

Front 171

What is PCR

Back 171

Polymerase chain reaction used to make more dna, can be used with RNA if reverse transcriptase is used.

Front 172

What is Epidemiology?

Back 172

Epidemiology is the study of the distribution and determinants of health-related states and events in populations and control of health problems.

Front 173

What is an epidemic?

Back 173

"in one place among the people"

Front 174

What is the epidemiologic triad?

Back 174

Host-Agent-Environment

Front 175

What is the cycle of disease transmission?

Back 175

Host -> mode of escape -> reservoir -> mode of transmission

Front 176

Who is Dr. John Snow?

Back 176

Dr. Snow tried to prove the cholera outbreak in London of 1853 was through a water source. He searched house by house and came to conclusion the downstream of industrial meat plant was infected, upstream was fine

Front 177

What is the most common group of HIV-1

Back 177

With 'M' for "major", this is by far the most common type of HIV, with more than 90% of HIV/AIDS cases deriving from infection with HIV-1 group M.
It is subdivided
A is common in West Africa.
B is the dominant form in Europe, the Americas, Japan, Thailand, and Australia.
C is the dominant form in Southern Africa, India, and Nepal
D is limited to East and Central Africa

Front 178

How do we determine infection rates and percentages of populations?

Back 178

Prevalence: number of people that are infected ("state")
Incidence: number of new infections "rate"
Total # = Prevalence + incidence - deaths

Front 179

Why are females more susceptible in heterosexual sex?

Back 179

Because of the surface area of genital region

Front 180

When was the CDC 1st recorded case of HIV

Back 180

NYC 1979

Front 181

What is zoonotic and name 5 criteria

Back 181

Zoonosis is the ability of cross- species transmission
1. Simulates in viral genome organization
2. Phylogenetic relatedness
3. Prevalence in natural host high
4. Geographic coincidence of both types
5. Plausible rates of transmission

Front 182

Origin of HIV-2

Back 182

Sooty mangeby, the first evience of HIV ever came from this

Front 183

What is AIDS

Back 183

Acquired immunodeficiency Syndrome (AIDS)

there's not 1 specific disease, constellation of disease that form in absence of immune function. It is regionally different and individually different

Front 184

How was AIDS defined in 1981?

Back 184

Kaposi's sarcoma or infectious disease that occurs only when immune system is impaired.

Front 185

Helper T cells are needed to activate immune system, decreased T cells - immune system fails immediate surge in helper T-cell numbers early; attempt to fight infection. When does AIDS develop?

Back 185

Aids develops only after the helper t-cell count falls below 200

Front 186

What is clinical incubation?

Back 186

Period after infection through window period (time until anti-HIV antibodies are measurable) 2 weeks- 6 months

Front 187

What is clinical latency?

Back 187

Period from antibody detection through asymptomatic phase (prior to OI onset) 1-25 years ( average 11 years)

Front 188

Stages of HIV disease: AI (acute infection) (or PHI) 2-8 weeks after primary infection

Back 188

Acute retroviral syndrome: greatest HIV production
Fever, muscle soreness, rash, headache, sore throat

Front 189

Asymptomatic HIV disease (clinical latent infection)

Back 189

CD4 cells drop over time to less than 200 per microliter

Front 190

Early symptomatic HIV disease (late infection)

Back 190

cd4 counts below 200
30% develop "AIDS" within 5 years with treatment
OI onset, dendritic network breakdown and release of HIV into bloodstream

Front 191

Chronic symptoms

Back 191

weight loss, diarrhea, fever, fatigue

Front 192

Advance HIV Disease (AIDS) symptoms

Back 192

Soaking night sweats, chronic diarrhea, weight loss, blurred/distorted vision, persistent unexplained fatigue, spots/lesions on tongue.

Front 193

2008 case definition of stages

Back 193

stage 1 -normal T cells-Early infection
stage 2 -T cells drop below normal-chronic infection
stage 3 -under 200 T cells - AIDS

Front 194

Most important opportunistic infections

Back 194

Histoplasmosis
candidiasis
pneumocystis carinii pneumonia
cytomegalovirus
taxoplasmosis
mycrobacterium avium intracellulare
Cryptococcus

Front 195

What does Taxoplamosis gondii do?

Back 195

attacks brain tissue

Front 196

Where does Canidiasis occur?

Back 196

Happens in the mouth of AIDS patients, yeast infection. Growth in mouth of white curd-like material with painful inflamed tissue

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What is Histoplasmosis?

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caused by inhaled histoplasma fungal spores, causes flu-like symptoms

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Describe Cryptococcosis

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Its found in skin, kidneys, prostate, CNS and bone. causes piercing headaches, pneumonia, paralysis. there is no cure and it recurs frequently

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Describe Mycobacteriosis

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Its causes by mycobacterium aviam intracellulare or turberculosis. Causes chest pains, shortness of breath, HIV wasting syndrome

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Describe Cytomegalovirus

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most common infection causing mental retardation and congenital deafness. Causes pneumonia, prolonged fever, anemia, leukemia, severe diarrhea, blindness. 30-80% of population has this.

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Describe hepatitis

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7 times greater risk of death from HIV,

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What is AIDS encephalopathy and dementia complex?

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Astrocytes can be the targets of HIV, and the result can be AIDS-related dementia
Clinical Diagnosis: in absence of illnesses other than HIV infection, disabling cognitive and/or motor dysfunction that interferes with daily living; loss of behavioral and developmental milestones in a child

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What is AIDS- Associated Wasting System?

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Diagnostic criteria for HIV Wasting Syndrome : in absence of illnesses other than HIV infection – involuntary loss of more than 10% of body weight and either chronic diarrhea or chronic weakness plus fever lasting more than 30 days

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What is nephropathy?

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Kidney disease where you get glomerular nephritis

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What is HAART? And what are challenges of the treatment

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Highly Active Anti-Retroviral Therapy.
Purpose of Treatment: keep pathogen in check by interfering with some essential biochemical process (keep T cell count high, and HIV propagation low)
The challenges are the virus doesnt live independently, must not be toxic to host, when is it best to trat, addressing unique features of HIV

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What do protease inhibitors do?

Back 206

prevents maturing and interferes with processing of viral proteins

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What are Viral Fusion inhibitors?

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They stop gp41 or gp120

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What are NRTIs?

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Nucleoside reverse transcriptase inhibitors (AZT or Tenofir).
They provide faulty DNA building blocks. They must be able to enter cell, be incorporated into growing chain, preferred by reverse transcriptase, escape decomposition

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What are Virucidal agents?

Back 209

microbicides, products that women can apply vaginally or rectally before sex to protect themselves from being infected by HIV

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What is UC-781?

Back 210

chemical barrier for heterosexual transmission

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What are Prophylactic drugs?

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Gilead combination of Viread and Emtrivia (NRTIs)

Front 212

What does Vitamin C do? What human hormone is good for treatment?

Back 212

suppression of HIV viral replication, testosterone

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Whats a Immunotherapeutics treatment?

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Immunotherapeutics.
Cells engineered to overproduce HIV antigens to stimulate immune response.
Mutated HIV genes
Genes coding for Anti-HIV antibodies

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Gene Therapy...

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Alteration of gene in T-lymphocytes
zinc-finger nuclease
Directed CCR5 mutation (deletion)
T-cell transfusion

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(Theories about Zoonosis)
Hunter theory

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SIVcpz transferred during hunting of chimpanzees

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(Theories about Zoonosis)
Oral Polio Vaccine Theory

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February 2000, samples of original vaccine found negative for both HIV and SIVcpz

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(Theories about Zoonosis)
Contaminated Needles Theory

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disposable single-used needles are a luxury

Front 218

(Theories about Zoonosis)
Colonial Theory

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African labor camps in earth 20th century were poor health, starvation conditions, unsterile needles, prostitutes

Front 219

(Theories about Zoonosis)
Conspiracy Theory

Back 219

Man made

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What is the UFO conspiracy theory

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UFO crashes and releases new organism to wipe out humanity
Soviet press links AIDS with biological weapons made in U.S.
Israel and South Africa created HIV as an ethnic weapon designed to attack blacks

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(Conspiracy)
Harlem AIDS forum meet to discuss what

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1. Failed CIA backed weapon aimed at Cuba by hitting Haiti
2. Farrakhan says its to decimate Africans in areas with natural resources
3. Intentionally transmitted by WHO via immunization programs
4. Actually African Swine Fever – hushed up by pork industry

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What are Koch's postulates?

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In order to establish that an organism is the cause of a disease you must:
1. Find the same pathogen in each diseased individual investigated
2. Isolate the pathogen from the diseased subject and be able to grow it in pure form from culture
3. Be able to induce the disease in experimental animals by transferring the pure pathogen
4. Be able to isolate the identical pathogen from the animals after the disease develops

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Duesberg claimed Koch's postulates are not fulfilled by HIV because:

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1. There is no detected free virus in >90% of cases of AIDS
2. The virus in isolated only by a “reactivation” in vitro of 1 in 10,000 lymphocytes
3. Pure HIV does not cause the death of chimpanzees
4. Papers identifying HIV as the cause of AIDS came out before there was ‘proof’

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(Most recent arguments against HIV as the cause)
Hemophiliacs get sick because of ‘contaminants’ that are in the factor eight and HIV is only a “harmless passenger”

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If correct, those who got larger doses of factor eight should be more likely to get sick or get sicker faster. However, there has never been any demonstration of this

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(Most recent arguments against HIV as the cause)
Koch’s Postulates are not fulfilled, particularly #3, induce disease by transferring the isolated virus.

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There are at least three instances of hospital and/or lab workers who were accidentally injected with purified HIV and they have all developed the characteristic infections
associated with AIDS

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(Most recent arguments against HIV as the cause)
Predicted AIDS outbreak in Thailand, following rapid increase of HIV infection, has not happened.

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This prediction was made in the 1980’s, but by the mid 1990’s AIDS cases began to increase dramatically, paralleling the infection rate of the ‘80

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(Most recent arguments against HIV as the cause)
AIDS is merely a result of lowered immune function due to narcotic use.

Back 227

T-cell counts are normal in HIV negative drug users and the immune system abnormalities that do exist are not the same type as in the HIV positive drug users

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Three types of Vaccination

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Preventative: teach immune system, provide memory attenuated virus- prevents from infection
Therapeutic: lessen the severity
Perinatal: prevention of mother to fetus transmission

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What are the 3 phases of clinical trails?

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Phase 1: looks at safety in a small group of low risk HIV negative volunteers
Phase 2: looks at safety and immunogenicity in a larger group and helps determine the number of doses needed
Phase 3: looks at efficacy (how well vaccine works) in large groups of high-risk HIV negative individuals

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Vaccines – Neutralizing Antibodies – “First line of defense”

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Bind free viral particles, prevent entry into host
Bind to infected host cell, trigger elimination via effector mechanism

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VaxGen and AIDSVAX – Don Francis and Phil Berman

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Bi-valent vaccine – gp120 from both B and E strains
Reduction in infection rate – 3.8% among entire volunteer group, 78% among black volunteers
Why? Strain particularly sensitive, glitch in data

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Vaccines – Cellular Response (CTL) – “Second line of Defense”

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Cytotoxic T cells bind infected cells; HLA-viral protein complex is signal cell for elimination
Release of antiviral ctyokines; Limit new virus activity

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Merck and the STEP trials:

Back 233

Participants “no less likely” to become infected
Different immune response in those already immune to adenovirus (cold virus)[this is the delivery system..stimulate cytotoxic T cells]

Uncircumcised men 4x more likely to become infected if receiving vaccine
Try different virus??
Coordination of CTL and Neutralizing Antibody responses require induction of virus-specific T helper (CD4) cells

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ALVAC/AIDSVAX combination trial: RV144

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ALVAC is canarypox virus carrying select HIV genes
AIDSVAX is still B and E strains
**26-31% efficacy
No effect on viremia or CD4+ T cell count in people who became infected

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What is the cycle of transmission of infectious disease?

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Agent <----- Host ----> Environment; time is in the inside of the triangle

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Who are the players involved in the health triangle?

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agent: microbe that causes the disease (what); host: organism harboring the disease (who); environment: external factors that cause or allow disease transmission (where)

Front 237

What needs to happen in order to break the cycle of an epidemic?

Back 237

Stay healthy, use safety precautions, practice safe sex

Front 238

What are the three major routes of transmission of HIV?

Back 238

Unsafe sex (MSM and heterosexual), contaminated needles, breast milk or perinatal transmission

Front 239

What are the two major strains of HIV and where are they primarily found?

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HIV-1 and HIV-2; HIV-1 is found everywhere, and HIV-2 is found in West Africa

Front 240

What are the most common issues that dictate areas or countries where HIV is most prevalent?

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preventive or education programs are lacking, malnutrition, high mobility of men, poverty and sexual mores

Front 241

Which country holds 70% of worldwide HIV infections?

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Sub-Saharan Africa

Front 242

Where are the incidence and prevalence highest?

Back 242

Prevalence: Africa; Incidence: the United States

Front 243

What is the evidence for HIV-1 and HIV-2 being a zoonotic?

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HIV-1: 1. Identical genome structure, only SIV with Vpx, 2. Phylogenetically close, 3. Animals are numerous and have a high infection rate, 22%, 4. Geographic coincidence of monkey habitat and endemic HIV-2, 5. Hunted for food and orphans kept as pets;
HIV-2: 1. Most closely related to Pan troglodytes SIV (chimpanzee), 3 of 4 viruses found (P.t.t. chimps) 70-90% identical, 4th virus found (P.t. schweinfurthii) is very different in far East Africa

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What is early HIV disease?

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No AIDS-defining condition and CD4+ T-cells below 500 or CD4+ T-cells below 29% of total; early infection; 30% develop "AIDS" within 5 years without treatment, OI onset, dendritic network breakdown and release of HIV into bloodstream

Front 245

What arguments could you come up with to counter this person's claims about HIV?

Back 245

Is it found consistently? Is the "cause" closely correlated with the effect? Is the "cause" scientifically plausible? Is the "cause" biologically consistent with the proposed biology and natural history of the disease?
Koch's Postulates Fulfilled: 1. causative agent must be found in all cases of the disease, 2. must be isolated from the host and grown in pure culture, 3. must reproduce the original disease when introduced into a susceptible host, 4. must be found in the experimental host that was infected

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What is the advanced HIV disease?

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No AIDS-defining condition and CD4+ T-cells 200-499 or CD4+ T-cells 14-28% of total; chronic infection; symptoms include: fever, fatigue, swollen lymph nodes, diarrhea, weight loss, cough and shortness of breath

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What is the acute infection stage for HIV?

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2 to 8 weeks after primary infection, acute retroviral syndrome; greatest HIV production; fever, muscle soreness, rash, headache, sore throat, mouth ulcers, joint pain, night sweats, diarrhea, swollen lymph glands; mono-nucleosis-like, aseptic meningitis, or primary HIV infection

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What is the asymptomatic phase for HIV?

Back 248

6 months --- 11 years ---- 25 years; typically 8 to 10 years, CD4 cells drop over time to <200 per UI; healthy carrier

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What is the primary goal of viral drug therapies?

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Maximal and durable suppression of viral load, restoration and/or preservation of immunologic function, improvement of quality of life, and reduction of HIV-related morbidity and mortality

Front 250

What are the requirements of an efficient drug treatment of HIV?

Back 250

Maximize adherence, rational sequencing of therapy, preservation of future treatment options, and use of resistance testing in selected clinical settings

Front 251

What would constitute a cure for HIV/AIDS?

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HAART (highly active anti-retroviral therapy) allows the stabilization of the patient's symptoms, partial recovery of CD4+ T-cell levels, and reduction in viremia to low or near-undetectable levels

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What are the current types of antiviral drugs? How do they work in the process of viral infection?

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Nucleoside/Nucleotide Reverse Transcriptase Inhibitors: NRTIs interfere with the action of an HIV protein called reverse transcriptase, which the virus needs to make new copies of itself; Non-Nucleoside Reverse Transcriptase Inhibitors: NNRTIs also stop HIV from replicating within cells by inhibiting the reverse transcriptase protein; Protease Inhibitors: PIs inhibit protease, which is another protein involved in the HIV replication process; Fusion or Entry Inhibitors: Fusion or entry inhibitors prevent HIV from binding to or entering human immune cells; Integrase Inhibitors: Integrase inhibitors interfere with the integrase enzyme, which HIV needs to insert its genetic material into human cells.

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What is the danger involved in single drug therapy?

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If only one drug was taken, HIV would quickly become resistant to it and the drug would stop working

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Why is combination drug therapy more effective?

Back 254

Taking two or more antiretrovirals at the same time vastly reduces the rate at which resistance would develop, making treatment more effective in the long term.

Front 255

Where are the sites of drug actions in viral life cycle?

Back 255

The receptor molecule on the surface of the host cell, the helper-T cells (CCR5 and CD4) and CD4+ analog

Front 256

What are unique problems with vaccine against HIV?

Back 256

it must depress initial rates of HIV replication and lower the set point of infection maintaining a low viral load and therefore a state of long term non-progression. Patients who naturally have a low viral load either do not progress to disease or progress more slowly. By decreasing the viremia, there should be a lower virus load in blood and semen and therefore a reduced chance of transmission

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How is the epidemic different for African Americans and Hispanic/Latino populations in the U.S?

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It is relevant in heterosexual African American women and dominant in MSM in Hispanic/Latino populations; The total of African Americans diagnosed is 50% and 20% in hispanic/latino populations

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What are the unique aspects of the epidemic with respect to women?

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Women transmit HIV through heterosexual contact and injection drug use, but are able to transmit it to their children through perinatal transmission or breast fluid; HIV/AIDS is the leading cause of death globally for women

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Are trends in the U.S the same as those seen worldwide?

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Worldwide, women account for half of the AIDS epidemic, but in the U.S. men are still the leading percentage. Women in the U.S are less susceptible to transmission through heterosexual contact because they are able to refuse sex or prefer safe sex