AIDS Policy History Quiz
49 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What was the initial budget announced by George W. Bush for AIDS relief under PEPFAR?

  • $25 billion
  • $10 billion
  • $20 billion
  • $15 billion (correct)

In what year did President Obama sign the Affordable Care Act, which included protections for patients with chronic infections like HIV?

  • 2011
  • 2009
  • 2012
  • 2010 (correct)

What percentage of Americans believed in 2012 that HIV could be contracted by sharing a drinking glass?

  • 20.7
  • 10.5
  • 35.2
  • 25 (correct)

What significant achievement was announced due to PEPFAR since 2003?

<p>1 million babies born HIV-free (B)</p> Signup and view all the answers

What was the finding of the START study regarding HIV-positive patients?

<p>Early ART initiation decreases AIDS-related risks (D)</p> Signup and view all the answers

What percentage of new HIV infections could potentially be prevented according to the CDC in 2015?

<p>90% (D)</p> Signup and view all the answers

What is the estimated overall lifetime risk of an HIV diagnosis in the US as of 2016?

<p>1 in 99 (B)</p> Signup and view all the answers

What was one outcome for 'the Mississippi baby' mentioned in 2014?

<p>Had detectable levels of HIV (C)</p> Signup and view all the answers

How did scientists believe HIV initially made the jump to humans?

<p>Infected blood contact while hunting chimpanzees (A)</p> Signup and view all the answers

As of 2023, what proportion of persons living with HIV are women and girls?

<p>53% (C)</p> Signup and view all the answers

What was the total number of HIV infections globally since 1981 as of 2023?

<p>88.4 million (D)</p> Signup and view all the answers

What is the primary characteristic that differentiates HIV-2 from HIV-1?

<p>HIV-2 is less transmissible than HIV-1. (B)</p> Signup and view all the answers

Which of the following conditions is NOT used to confirm an HIV positive status?

<p>HIV positive status with symptoms of fever (A)</p> Signup and view all the answers

How many people have reportedly died from HIV/AIDS since 1981?

<p>40.4 million (C)</p> Signup and view all the answers

Which cell type is primarily affected by HIV and is critical for immune response?

<p>CD4 cells (B)</p> Signup and view all the answers

What significant event regarding HIV/AIDS occurred in 1981?

<p>CDC published a report on rare infections in gay men. (B)</p> Signup and view all the answers

What distinguishes post-exposure prophylaxis (PEP) from pre-exposure prophylaxis (PrEP)?

<p>PEP is taken only after potential exposure, whereas PrEP is taken beforehand. (C)</p> Signup and view all the answers

Which syndrome is caused by Human Immunodeficiency Virus?

<p>Acquired Immunodeficiency Syndrome (B)</p> Signup and view all the answers

What is a key feature of HIV as a virus?

<p>It is a retrovirus that transcribes RNA to DNA. (C)</p> Signup and view all the answers

In what year was the first drug to treat HIV/AIDS, zidovudine (AZT), approved?

<p>1986 (A)</p> Signup and view all the answers

What event in 1987 highlighted public reaction to HIV-positive individuals returning to school?

<p>A federal judge's ruling (A)</p> Signup and view all the answers

Which year did AIDS become the leading cause of death for all Americans aged 25-44?

<p>1994 (A)</p> Signup and view all the answers

Which significant policy was enacted in 1990 to support those living with AIDS?

<p>Ryan White CARE Act (C)</p> Signup and view all the answers

What was the main focus of the CDC reports in 1983 regarding the population at greatest risk for AIDS?

<p>Homosexual males, IVDAs, Haitians, and hemophiliacs (C)</p> Signup and view all the answers

By which year did the US estimate 792,000 people were living with HIV?

<p>1997 (C)</p> Signup and view all the answers

What was established in 1996 regarding treatment effectiveness for HIV/AIDS?

<p>HAART effectiveness was established (B)</p> Signup and view all the answers

What significant recommendation did the US government make in 1994 regarding pregnant women with HIV?

<p>They should take AZT to reduce transmission (D)</p> Signup and view all the answers

In 1998, what was a notable statistic reported by the CDC regarding mortality in African Americans with AIDS?

<p>Higher mortality than Whites and Hispanics (B)</p> Signup and view all the answers

What viral test was approved in 1996 that contributed to HIV treatment monitoring?

<p>Viral load test (C)</p> Signup and view all the answers

Which medication is absolutely contraindicated when taken with rilpivirine?

<p>Proton Pump Inhibitors (PPIs) (C)</p> Signup and view all the answers

What is the recommended administration condition for doravirine?

<p>With or without food (D)</p> Signup and view all the answers

Which of the following statements about Atazanavir is correct?

<p>It can have decreased concentrations due to H2 blockers. (C)</p> Signup and view all the answers

What is the recommended separation time for taking antacids with rilpivirine?

<p>2 hours before or 4 hours after (B)</p> Signup and view all the answers

What is a common adverse effect associated with protease inhibitors?

<p>Endocrine disturbances (B)</p> Signup and view all the answers

Which integrase strand transfer inhibitor is known for having a lower genetic barrier?

<p>Raltegravir (A)</p> Signup and view all the answers

How do H2 receptor antagonists interact with rilpivirine?

<p>They decrease rilpivirine concentrations. (A)</p> Signup and view all the answers

Which of the following adverse drug events is NOT commonly associated with integrase inhibitors?

<p>Gastrointestinal intolerance (D)</p> Signup and view all the answers

Which of the following factors contraindicates the use of rilpivirine?

<p>Viral load greater than 100,000 copies/mL (D)</p> Signup and view all the answers

What is the primary mechanism of action of protease inhibitors?

<p>Inhibition of the viral maturation process (C)</p> Signup and view all the answers

What is the main function of Lenacapavir in HIV treatment?

<p>Inhibits HIV RNA and enzyme transport into the cell nucleus (A)</p> Signup and view all the answers

Which of the following is a known adverse effect associated with the use of Enfuvirtide?

<p>Injection site reactions (A)</p> Signup and view all the answers

Which statement about Maraviroc is accurate?

<p>It requires a tropism test to determine its effectiveness (D)</p> Signup and view all the answers

What is the route of administration for Ibalizumab?

<p>Intravenous infusion (D)</p> Signup and view all the answers

What role does Fostemsavir play in HIV treatment?

<p>It acts as a prodrug of temsavir (B)</p> Signup and view all the answers

What is a contraindication when using strong 3A4 inducers with Lenacapavir?

<p>Decreased effectiveness of other ARTs (A)</p> Signup and view all the answers

Why is the therapeutic approach of using stem cell transplants considered for HIV patients?

<p>To eliminate HIV by altering immune receptor genetics (A)</p> Signup and view all the answers

Patients taking statins alongside ART should consider which of the following considerations?

<p>Monitoring is essential when using atorvastatin (D)</p> Signup and view all the answers

What is a common adverse effect associated with Ibalizumab?

<p>Nausea and diarrhea (C)</p> Signup and view all the answers

Which patient population is specifically indicated for the use of Fostemsavir?

<p>Heavily treatment-experienced patients failing current therapy (B)</p> Signup and view all the answers

Flashcards

HIV

Human Immunodeficiency Virus, a retrovirus causing AIDS.

AIDS

Acquired Immunodeficiency Syndrome, a disease caused by HIV.

Retrovirus

A type of virus that uses RNA to make DNA.

CD4 cell count

A measure of immune system strength, low count indicates severe HIV.

Signup and view all the flashcards

Epidemiology of HIV

The study of how HIV spreads and affects populations.

Signup and view all the flashcards

PLWHA

People Living With HIV/AIDS

Signup and view all the flashcards

HIV-1 vs HIV-2

HIV-1 is more prevalent and virulent than HIV-2.

Signup and view all the flashcards

HIV Life Cycle

The stages in which HIV replicates and spreads.

Signup and view all the flashcards

AIDS

Acquired Immunodeficiency Syndrome; a condition caused by HIV that weakens the immune system

Signup and view all the flashcards

1982

Year AIDS was officially termed

Signup and view all the flashcards

1986

Year of first HIV/AIDS drug approval; Zidovudine (AZT).

Signup and view all the flashcards

HAART

Highly Active Antiretroviral Therapy; a combination of antiretroviral drugs that effectively treats HIV.

Signup and view all the flashcards

1996

Year HAART's effectiveness was established; decline in new cases

Signup and view all the flashcards

1998

Year of first HAART guidelines. Mortality risk higher in African Americans.

Signup and view all the flashcards

HIV Transmission

Spread of Human Immunodeficiency Virus, often through sexual contact, blood, or from mother to child.

Signup and view all the flashcards

Ryan White CARE Act

Enacted in 1990 to allocate funding for AIDS research

Signup and view all the flashcards

Viral Load Test

A test to measure the amount of HIV in a person's blood

Signup and view all the flashcards

1995

First protease inhibitor approved, affecting the virus's ability to multiply.

Signup and view all the flashcards

PEPFAR (2003)

President's Emergency Plan for AIDS Relief, a $15 billion initiative to combat AIDS in developing countries.

Signup and view all the flashcards

HIV Infections (2008)

CDC reports over 56,000 new HIV infections annually in the US.

Signup and view all the flashcards

Affordable Care Act (2010)

Legislation providing special protections for HIV patients, part of broader healthcare reform.

Signup and view all the flashcards

PrEP (2012)

Truvada approved for use as pre-exposure prophylaxis (PrEP) to reduce HIV risk.

Signup and view all the flashcards

HIV Misconceptions (2012)

A study found that a significant portion of Americans still held inaccurate beliefs about HIV transmission.

Signup and view all the flashcards

PEPFAR's impact on HIV-free births

PEPFAR (President's Emergency Plan for AIDS Relief) has led to 1 million HIV-free babies since 2003.

Signup and view all the flashcards

Potential HIV cure via bone marrow transplants

Two HIV-positive patients with bone marrow transplants showed apparent remission for weeks, but later relapsed.

Signup and view all the flashcards

HIV prevention through diagnosis and treatment

More than 90% of new HIV infections can be avoided by diagnosing people and providing treatment.

Signup and view all the flashcards

HIV transmission prevention strategies

Strategies include diagnosing those infected and ensuring they receive treatment.

Signup and view all the flashcards

Global HIV prevalence (2023)

Globally, 39.9 million people were living with HIV in 2023. 37.5m adults 15+ and 1.4 million children. HIV was infecting globally 1.3 million people/year in 2023.

Signup and view all the flashcards

ART and its impact on HIV progression

Starting antiretroviral therapy (ART) early reduces the risk of AIDS/opportunistic illnesses in HIV-positive patients.

Signup and view all the flashcards

HIV's origin

Scientists believe HIV mutated from SIV in chimpanzees in Central Africa, possibly from infected hunting/contact with blood. First case verified in 1959.

Signup and view all the flashcards

Global HIV-related deaths (2023)

In 2023, 630,000 deaths were globally linked to HIV.

Signup and view all the flashcards

Lenacapavir's Action

Prevents HIV RNA and enzymes from entering the cell nucleus, capsid assembly, and mature virus formation.

Signup and view all the flashcards

Entry Inhibitors

Drugs that prevent HIV from entering host cells.

Signup and view all the flashcards

Fusion Inhibitor (e.g., Enfuvirtide)

Blocks the HIV envelope fusion with the host cell membrane.

Signup and view all the flashcards

CCR5 Antagonist (e.g., Maraviroc)

Blocks HIV from using the CCR5 receptor to enter cells.

Signup and view all the flashcards

Ibalizumab

Monoclonal antibody interfering with HIV-1 entry via binding to CD4 cells.

Signup and view all the flashcards

Fostemsavir

A prodrug that prevents HIV entry by binding near the CD4 receptor.

Signup and view all the flashcards

HIV Life Cycle

The different stages HIV goes through to replicate and spread.

Signup and view all the flashcards

Capsid Assembly

Final stage of HIV maturation; forms a mature virus.

Signup and view all the flashcards

Treatment-experienced Patients

Patients already treated with many different HIV medicines.

Signup and view all the flashcards

HIV Cure Cases

Patients whose HIV is no longer detectable.

Signup and view all the flashcards

Rilpivirine Interactions

PPIs are strictly avoided while H2RAs require a 12/4-hour separation from rilpivirine, and antacids need a 2/4-hour separation.

Signup and view all the flashcards

Doravirine (DOR)

An NNRTI, FDA-approved in 2018, taken daily with or without food, offering fewer side effects and drug interactions.

Signup and view all the flashcards

Protease Inhibitors (PIs)

PIs target HIV's maturation process to stop viral replication, but have challenges with absorption, particularly needing to be taken with food.

Signup and view all the flashcards

PI Booster

Ritonavir or cobicistat; Potent CYP3A4 inhibitors used alongside PIs to increase their effectiveness.

Signup and view all the flashcards

Atazanavir (ATV)

A PI with a crucial note: reversible hyperbilirubinemia, and acid-suppressing medications can lower Atazanavir levels.

Signup and view all the flashcards

Integrase Strand Transfer Inhibitors (INSTIs)

INSTIs block HIV's integration into host DNA. Use with caution in severe liver issues, and note potential side effects like rash, nausea, and weight gain.

Signup and view all the flashcards

DDI with INSTIs

INSTIs, specifically Bictegravir and Dolutegravir, should be separated from polyvalent cations to avoid possible drug interaction issues and virologic failure.

Signup and view all the flashcards

Raltegravir (RAL)

An INSTI with a relatively straightforward administration. Focus on the longest safety experience

Signup and view all the flashcards

HIV Viral Load

The measurement of HIV within a person’s blood, providing crucial information for treatment indication and effectiveness.

Signup and view all the flashcards

NNRTI-Acid Interactions

Doravirine, an NNRTI does not require dietary modifications compared to a few PIs. With PIs, some require food for absorption, and others need to be separated from acid-suppressing medications to prevent lower efficiency.

Signup and view all the flashcards

Study Notes

Human Immunodeficiency Viruses and Acquired Immunodeficiency Syndrome (AIDS)

  • HIV-1 and HIV-2 are causative pathogens for AIDS
  • HIV-2 is less virulent, transmissible, and prevalent than HIV-1
  • HIV is a retrovirus (RNA virus that is transcribed to DNA)

Objectives

  • Define the etiology and epidemiology of HIV
  • Illustrate the life cycle of HIV
  • Describe the pathophysiology of AIDS
  • Compare and apply the pharmacology of antiretroviral therapy
  • Classify the toxicities and adverse effects of antiretroviral therapy
  • Describe the drug-drug interactions of antiretroviral therapy
  • Identify recommended and non-recommended vaccines for patients living with HIV
  • Summarize preferred starting regimens for patients with HIV/AIDS
  • Define prophylactic regimens for post-exposure prophylaxis (PEP) or pre-exposure prophylaxis (PrEP)

Epidemiology

  • Three primary modes of transmission:
    • Sexual transmission (primarily anal and vaginal intercourse; condom use reduces risk by 80%)
    • Parenteral transmission (sharing contaminated needles/syringes, rare with today's screening, healthcare workers from accidental needle sticks)
    • Perinatal transmission (mother to baby, most common cause of pediatric HIV infection, can also be transmitted by breast milk)
  • People Living with HIV/AIDS (PLWHA)
    • Since 1981, 85.6 million people have become infected with HIV
    • 40.4 million have died
  • Diagnosis:
    • Positive HIV status
    • AIDS defining illness
    • CD4 cell count less than 200

HIV/AIDS Timeline

  • 1981: CDC reports 5 previously healthy gay men in Los Angeles with Pneumocystis carinii.
  • 1982: Term "Acquired Immunodeficiency Syndrome (AIDS)" is coined.
  • 1983: First reports of transmission to female sexual partners of males with AIDS.
  • 1986: First drug to treat HIV/AIDS (zidovudine, AZT) approved.
  • 1987: Federal judge ordered 3 HIV-positive brothers back to school.
  • 1990: First report of HIV transmission through dental procedure.
  • 1992: AIDS became the #1 cause of death for US men aged 25-44.
  • 1993: Female condom approved, "Philadelphia" released
  • 1994: AIDS leading cause of death for all Americans aged 25-44, pregnant women given AZT to reduce perinatal transmission.
  • 1995: First protease inhibitor approved.
  • 1996: Highly Active Anti-Retroviral Therapy (HAART) effectiveness established, new cases decline.
  • 1997: HAART becomes standard of care; UN estimates 30 million people worldwide have HIV.
  • 1998: First HAART guidelines published; CDC reports differences in mortality rates among racial groups living with AIDS.
  • 1999: WHO notes AIDS as the 4th leading killer worldwide.
  • 2002: 961,000 people living with HIV in the US.
  • 2003: CDC reports 27,000 new HIV infections from people who don't know they're infected.
  • 2007: CDC reports over 565,000 people have died from AIDS in the US since 1981.
  • 2008: PEPFAR re-authorized.
  • 2009: 100th ART drug released.
  • 2010: Obama signs Affordable Care Act; NIH study shows HIV drug reduces risk of infection in MSM.
  • 2011: CDC announces HIV drug trials reduce heterosexual risk of transmission.
  • 2012-2015: various updates on HIV awareness, testing, treatments, and prevention in these years
  • 2015: CDC reports that more than 90% of new HIV infections could be prevented, lower AIDS risk in patients starting ART earlier.
  • 2016: Overall lifetime risk of HIV diagnosis in the US is 1 in 99.
  • 2018: Various data on perinatal HIV transmission
  • 2022: The South accounted for more than 50% of HIV diagnoses.
  • Data on HIV globally and in the US in 2023 showing 39.9 million people with HIV globally, 30.7 million were accessing antiretroviral therapy.

HIV Origins

  • HIV mutated from Simian Immunodeficiency Virus (SIV) in chimpanzees in Central Africa.
  • Humans contracted SIV from hunted chimpanzees through contact with infected blood.
  • Possibly started in the late 1800s.
  • First verified case was documented in 1959 in the Democratic Republic of Congo.

Prevention

  • Safe sex practices (condoms) greatly reduce risk.
  • Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP)

Vaccine Recommendations

  • Live vaccines contraindicated at low CD4 counts.

Diagnosis

  • All patients ages 13-64 should be screened for HIV risk.
  • Testing recommended using a 3-step process using fourth-generation HIV antigen/antibody test.
  • Confirm HIV 1/2 if positive
  • Viral load measurement if indeterminate.

Typical Course of HIV Infection

  • A graphic demonstrates the decline in CD4+ T-lymphocyte cell count over time with the increase in HIV RNA copies per ml of plasma.

HIV Life Cycle (Diagram)

  • A diagram of HIV structure and components labels HIV Envelope, HIV RNA, HIV capsid, HIV enzymes, and HIV glycoproteins.

Antiretroviral Therapy (ART) Classes

  • Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
  • Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
  • Protease Inhibitors (PIs)
  • Integrase Strand Transfer Inhibitors (INSTIs)
  • Capsid Inhibitors
  • Fusion Inhibitors
  • CCR5 Antagonists
  • Examples and details for each class provided.
  • Importance of medication adherence.

Vaccines for PLWHA

  • Live vaccines are contraindicated for patients with low CD4 counts.
  • Other vaccines are recommended based on individual patient factors and risk.

Therapy Goals for HIV/AIDS

  • Undetectable viral loads is a key goal in treatment as it prevents transmission.
  • CD4 counts should be sustained and increase.

Pregnancy Considerations

  • Pregnant women with HIV should receive ART early in pregnancy.
  • Drug dosing, potential teratogenicity, prevention of vertical transmission, cobicistat regimens, and first trimester initiation of treatment.

Intrapartum Considerations

  • Reduces transmission risk to less than 0.5%
  • Continuing ART, except ZDV, if viral load is below 50 copies/mL
  • If VL is between 50-999 copies/mL, consider IV ZDV.

Adolescent Considerations

  • Adolescents may require additional psychological support during HIV treatment.

HIV/HCV/HBV Co-infections

  • Treatment recommendations for co-infections. Co-infection treatment should address both viral infections.

Treatment as Prevention (TasP)

  • PEP and nPEP for high-risk individuals.
  • Rapid testing and prompt treatment.

Chemoprophylaxis Regimens

  • TDF/FTC + RAL or TDF/FTC + DTG.
  • Start treatment ASAP, ideally within 72 hours if exposed.

PrEP

  • Preferred combinations for PrEP.
  • Important considerations for PrEP regimens and patient monitoring.

PrEP Testing Recommendations

  • Assess baseline CrCl and lipid panels before starting PrEP (especially for TAF/FTC).

PrEP Counseling

  • High-risk subgroups.
  • Considerations for pregnant women.
  • Screen for STIs.

U=U (Undetectable = Untransmittable)

  • The concept of viral suppression as preventing HIV transmission to sexual partners
  • Adherence is a key element in successfully implementing U=U.

Science Behind PrEP Studies

  • iPrEX, PROUD, and Bangkok Tenofovir studies
  • Key findings and results.

Case Studies

  • Detailed case study presentations.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

HIV/AIDS 2024 (PDF)

Description

Test your knowledge on the history of AIDS policy in the U.S. with questions about PEPFAR, the Affordable Care Act, and public perceptions of HIV. Explore key events and statistics that have shaped the fight against HIV/AIDS.

More Like This

AIDS and HIV Infection
6 questions

AIDS and HIV Infection

StupendousNovaculite avatar
StupendousNovaculite
Ramos Act: HIV/AIDS Prevention and Control
29 questions

Ramos Act: HIV/AIDS Prevention and Control

FaithfulLobster avatar
FaithfulLobster
Epidemiology and Progression of AIDS
40 questions

Epidemiology and Progression of AIDS

EffectualArtNouveau avatar
EffectualArtNouveau
Philippine AIDS Prevention Act Quiz
48 questions

Philippine AIDS Prevention Act Quiz

RevolutionaryTsilaisite9508 avatar
RevolutionaryTsilaisite9508
Use Quizgecko on...
Browser
Open
Browser
Browser