Human Immunodeficiency Virus (HIV)

HIV has two main types - which is the one known for the global pandemic starting in the 1980s?

Which of the subtypes of HIV-1 was responsible for the global pandemic that started in the 1980s?

[blank_start]CD4+[blank_end] receptors are the target site for the HIV virus

HIV-2 is worse than HIV-1 and unfortunately no known treatment or cure is available for it.

CD4+ lymphocytes are [blank_start]Helper T cells[blank_end]

CD4+ T Helper Cells recognise [blank_start]MHC-2[blank_end] antigen presenting cells

HIV causes a [blank_start]reduction[blank_end] in CD4+ cells and an [blank_start]increase[blank_end] in CD8+ cells

Psoriasis is a CD8+ cell mediated condition. Therefore, a person with Psoriasis who contracts HIV will likely experience an exacerbation of their Psoriasis.

The normal CD4+ Cell number is between [blank_start]500[blank_end]-1600 cells/mm3

An individual with HIV is considered to be at significant risk of opportunistic infection when their CD4+ cell count falls below [blank_start]200[blank_end] cells/mm3

Between exposure to the virus and its establishment within the body, there is a [blank_start]3[blank_end] day period whereby post-exposure prophylaxis (PEP) can be given to completely eradicate the virus and prevent chronic infection.

Primary HIV infection typically presents [blank_start]2-4 weeks[blank_end] after exposure to the virus.

Which three of the following symptoms are typically found in those suffering from Primary HIV Infection?

Which of the following opportunistic infections is most common in HIV patients?

A HIV positive patient presents with a dry cough and shortness of breath. The clinician decides to run an exercise tolerance test and this shows exercise desaturation. Which opportunistic infection has likely caused these symptoms? [blank_start]Pneumocystis Pneumonia[blank_end]

Pneumocystis Pneumonia in HIV patients occurs due to which pathogen? Pneumocystis [blank_start]Jiroveci[blank_end]

The treatment for Pneumocystis Pneumonia in HIV patients is high dose [blank_start]Co-Trimoxazole[blank_end]

Which medication is given in low doses to HIV patients with CD4+ count under 200 in order to act as prophylaxis against opportunistic infections?

Tuberculosis infection is made less probable due to HIV infection.

Cytomegalovirus is a common organism to infect HIV patients when their CD4+ count is very low (<50). How, and in which system, does this infection most typically present?

A HIV patient suffering from recurrent headaches and seizures, fever and reduced consciousness is likely to be suffering from which opportunistic infection? See picture for clue. [blank_start]Cerebral Toxoplasmosis[blank_end]

Cerebral Toxoplasmosis is caused by the pathogen Toxoplasma [blank_start]Gondii[blank_end] which is typically found in [blank_start]cats[blank_end] and lives latent in the human body (in most cases never causing any problems) unless that person is to become immunosuppressed.

An individual with HIV who rapidly develops confusion, personality change and focal neurology is likely to be suffering from which condition?

Progressive multifocal leukoencephalopathy is caused by the [blank_start]John Cunningham (JC)[blank_end] virus

A HIV patient presents with multiple lesions on his arm as is shown in the picture. This type of tumour, which can also occur in the oral mucosa, pulmonary system and GI system, is called ... [blank_start]Kaposi's Sarcoma[blank_end]

Non-Hodgkins Lymphoma is an AIDS-related cancer caused by the [blank_start]epstein barr[blank_end] virus

HIV patients are also increasingly susceptible to HPV infection. This predisposes women diagnosed with HIV to a higher risk of [blank_start]cervical[blank_end] cancer.

HIV is also known to cause Anaemia.

What mode of transmission accounts for 94% of all HIV infections in the UK?

Which type of sex leaves an individual more susceptible to contracting HIV?

An individual is less likely to contract HIV if they have a concurrent STI

As of 2015, the approximate total number of people living with HIV in the UK is [blank_start]100,000[blank_end]

There are 3 types of markers for HIV that the labs use to test for the virus: [blank_start]Viral RNA[blank_end]: First marker to indicate positive HIV test [blank_start]Antigen[blank_end]: Second marker to indicate positive HIV test (typically at 4 weeks) [blank_start]Antibody[blank_end]: Third marker to indicate positive HIV test (typically at 12 weeks)

Typically, scientists use which antigen as a marker for HIV?

4th generation HIV tests now exist that test for HIV antigens and antibodies in conjunction, therefore allowing HIV to be diagnosed after around [blank_start]4[blank_end] weeks

Which three enzymes are typically targeted in the treatment of HIV? (name in alphabetical order) [blank_start]Integrase[blank_end] [blank_start]Protease[blank_end] [blank_start]Reverse Transcriptase[blank_end]

Life cycle of HIV Virus: Virus attaches to [blank_start]CD4+[blank_end] receptor on host cell. This receptor brings the virus in and the virus then unloads its [blank_start]RNA[blank_end] into the host cell. The RNA then copies itself using the enzyme called [blank_start]reverse transcriptase[blank_end] to create the virus's own double stranded DNA. The viral DNA is then integrated into the host DNA using an enzyme called [blank_start]integrase[blank_end]. After viral proteins are made using the integrated viral DNA, an enzyme called [blank_start]protease[blank_end] then cleaves these proteins into 'buds' which are then released to infect other host cells.

NRTIs are drugs used to combat the action of [blank_start]reverse transcriptase[blank_end] in the life cycle of the HIV virus.

Highly active antiretroviral therapy is the mainstay of treatment for HIV. This consists of a combination of [blank_start]3[blank_end] drugs from at least [blank_start]2[blank_end] different drug classes to which the HIV virus is susceptible.

Tenofovir is a commonly utilised [blank_start]NRTI[blank_end]

Compliance is unimportant in the case of HIV treatment as long as the medications are taken at least 75% of the time.

Diarrhoea is a very common side effect of HIV medications, but especially common in those who take [blank_start]protease inhibitors[blank_end]

[blank_start]Atazanavir[blank_end] is a protease inhibitor which is safe for use in pregnancy

If a woman with HIV refuses to tell her long term male partner of her diagnosis and plans to keep on having unprotected sex with him, are there any laws that prevent this from occurring?

If a man with HIV refuses to tell his long term partner (who you do not know) of his diagnosis and plans to keep on having unprotected sex with them, you as a medical professional are obliged to inform the partner themselves to prevent them from coming to harm.

What is the biggest preventer of onwards transmission of HIV?

If a patient who is HIV positive has an undetectable viral load, they are able to have unprotected sex with their partner with no risk of transmission.

A man informs his female partner of 15 years that he has been diagnosed with HIV. after testing, the woman is HIV negative. Despite this, she wishes to start HIV treatment anyway to protect herself from the condition. Is this possible?

HIV Pre-Exposure Prophylaxis (PrEP) can be given to partners of HIV positive patients in order to protect them from contracting the condition. If they forget to take this after they are worried about infection, emergency post-exposure prophylaxis (PEP) can be taken up to 3 days following sex in order to prevent chronic infection.

When their viral load is undetectable, HIV patients are able to have condomless sex in order to attempt to conceive a baby with no risk of transmission.

Irrelevant of whether a mother's viral load is undetectable or not, baby's with HIV positive mothers must always be delivered via C-section.

Following the birth of a child to a HIV positive mother, the neonate is given Post-Exposure Prophylactic (PEP) treatment for [blank_start]4 weeks[blank_end] following their birth.

In terms of the PEP treatment of a neonate following birth to a HIV positive mother, if at the time of the birth the mother's viral load is 0 the baby is only given [blank_start]1 antiretroviral drug[blank_end] however if the mother has a detectable viral load they are given [blank_start]2 antiretroviral drugs[blank_end]

In order to qualify for PrEP in Scotland: The individual must be over the age of [blank_start]16[blank_end], HIV [blank_start]negative[blank_end] and be able to commit to [blank_start]3[blank_end] monthly follow ups. They must also be either ... - A partner to someone who is HIV positive - A gay man or transwoman who has had >[blank_start]2[blank_end] sexual encounters in the last year and is likely to have another within 3 months or has had a confirmed bacterial [blank_start]rectal[blank_end] STI in the past year