NAPLEX 2021: HIV Exam Questions And Answers

NAPLEX 2021: HIV Exam Questions And Answers HIV is an ____ retrovirus that uses machinery in ______ cells to replicate - ANS RNA retrovirus; uses CD4+ T helper cells AIDS is diagnosed when: __________ or _________ - ANS CD4 count <200 OR presence of an AIDS-defining condition (i.e. opportunistic infections or Kaposi's sarcoma) HIV can be transmitted through (5) - ANS blood, semen, vaginal secretions, anal secretions, breast milk CDC recommends HIV screening for ________ (who and how often). - ANS everyone aged 13-64 at least once High risk: annually Who is considered high risk for HIV (4) - ANS IV drug users High risk sexual activity Hx of STI Hx of hepatitis or TB When is the HIV viral load high enough to test? - ANS 2 weeks post-infection for antigens 4-6 weeks for antibodies Initial screening for HIV is done with what test and what does it test for? - ANS H1H2AA screening test (HIV1/HIV2 antigen/antibody) Tests for HIV p24 antigens and HIV2/HIV2 antibodies If the initial test is positive for HIV, what is the next step? - ANS Confirm positive test with H1H2ADI (HIV1/HIV2 antibody differentiation immunoassay) Differentiates between HIV1 (most common in US) and HIV2) First test for HIV positive, then second test done: Results negative--> Results positive--> - ANS Results negative--> Nucleic acid test (NAT) Results positive--> Diagnosis and subtype confirmed OTC HIV test: Name: What it tests: When can you use it: - ANS OraQuick --> Detects HIV Ab Use ≥ 3 months from exposure Stages of HIV replication: (7) - ANS 1. Binding/Attachment 2. Fusion 3. Reverse Transcription 4. Integration 5. Transcription/Translation 6. Assembly 7. Budding/Maturation Maraviroc works on stage ___ of HIV replication - ANS Stage 1: Binding/Attachment Trogarzo works on stage ___ of HIV replication - ANS Stage 1: Binding/Attachment Fuzeon works on stage ___ of HIV replication - ANS Stage 2: Fusion NNRTIs/NRTIs work on stage ___ of HIV replication - ANS Stage 3: Reverse transcription INSTIs work on stage ___ of HIV replication - ANS Stage 4: Integration PIs work on stage ___ of HIV replication - ANS Stage 7: Budding and Maturation Normal CD4+ cell count - ANS 800-1200 CD4 count is a marker of _______ HIV viral load is a marker of _______ - ANS CD4-->immune function viral load --> response to ART ART treatment goal - ANS undetectable viral load What should be tested before initiation of ART (6) - ANS CD4 HIV viral load Hep B/C Pregnancy HLA-B*5701 allele (if considering abacavir) Tropism assay (is considering maraviroc) Acceptable adherence to prevent HIV resistance: - ANS 95% adherence i.e. no more than 1 dose/month with a once daily regimen