HIV and PrEP Concepts Quiz
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Questions and Answers

What does TasP stand for?

  • Therapeutic Suppressive Prophylaxis
  • Treatment as Prevention (correct)
  • Therapy and Supportive Prevention
  • Treating for the Prevention of AIDS

What is the recommended method of feeding for infants born to mothers living with HIV?

  • Formula feeding (correct)
  • Breastfeeding exclusively
  • Breastfeeding with ART supplementation
  • A combination of breastfeeding and formula feeding

What is the main objective of TasP?

  • To increase the lifespan of people living with HIV
  • To cure HIV infection
  • To prevent HIV transmission from an infected person to an uninfected person (correct)
  • To improve the overall health of people living with HIV

What is the effectiveness of PrEP when taken at least 4 times per week?

<p>99% effective (A)</p> Signup and view all the answers

What are the two main medications typically included in PrEP?

<p>Tenofovir Disoproxil Fumarate (TDF) and Emtricitabine (FTC) (B)</p> Signup and view all the answers

What is the main mechanism of action of PrEP?

<p>It prevents HIV from copying itself after exposure (B)</p> Signup and view all the answers

What is the main consequence of remaining undiagnosed or untreated for HIV?

<p>Increased risk of progressing to AIDS (C)</p> Signup and view all the answers

How often should people taking TasP get viral load testing?

<p>Every 3 months (C)</p> Signup and view all the answers

What is the primary goal of antiretroviral therapy (ART)?

<p>To suppress the HIV viral load (B)</p> Signup and view all the answers

Which of the following is a key benefit of combination therapy in HIV treatment?

<p>Reduces the risk of drug resistance (D)</p> Signup and view all the answers

What is the primary indicator for diagnosing AIDS?

<p>A CD4+ T-cell count falling below 200 cells/µL (C)</p> Signup and view all the answers

Which antiviral medication is used for the treatment of Herpes simplex virus in opportunistic infections?

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

What does U=U stand for in the context of HIV treatment?

<p>Undetectable equals untransmittable (B)</p> Signup and view all the answers

Why is adherence to ART critical for patients?

<p>To maintain a stable viral load (C)</p> Signup and view all the answers

What preventive measure is recommended for Hepatitis B in individuals at risk?

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

What is the mechanism of action for Nucleoside Reverse Transcriptase Inhibitors (NRTIs)?

<p>Mimics natural nucleotides to stop HIV DNA synthesis (D)</p> Signup and view all the answers

Which of the following conditions can be identified as AIDS-defining?

<p>Oral candidiasis (B)</p> Signup and view all the answers

Which prophylaxis treatment is suggested for Pneumocystis jiroveci pneumonia (PJP)?

<p>Trimethoprim-Sulfamethoxazole (TMP-SMX) (C)</p> Signup and view all the answers

Which of the following is NOT a goal of ART?

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

What is a standard regimen for ART typically composed of?

<p>Three active drugs from at least two classes (B)</p> Signup and view all the answers

Which class of drugs is used to block integrase in HIV treatment?

<p>Integrase Strand Transfer Inhibitors (INSTIs) (A)</p> Signup and view all the answers

What must be monitored when prescribing protease inhibitors due to their potential interactions with anticoagulants?

<p>INR levels (D)</p> Signup and view all the answers

Why is strict adherence to ART crucial in the management of HIV?

<p>It prevents the development of viral resistance. (B)</p> Signup and view all the answers

Which laboratory values should be monitored to assess for nephrotoxicity in patients on ART?

<p>Creatinine and BUN levels (B)</p> Signup and view all the answers

What is a common side effect of medication that patients should be prepared for during ART?

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

Why is it important to monitor serum cholesterol and triglycerides in patients on ART?

<p>Due to risk of increased levels and insulin intolerance (A)</p> Signup and view all the answers

What is the significance of monitoring CD4 counts in individuals receiving ART?

<p>It indicates the effectiveness of the treatment. (A)</p> Signup and view all the answers

What should be done to accommodate patients who may face adherence challenges due to stigma?

<p>Assess and address stigma and mental health issues. (D)</p> Signup and view all the answers

When considering ART, which of the following should be discussed regarding specific drug requirements?

<p>Some drugs require certain timing and food considerations. (D)</p> Signup and view all the answers

What is the primary function of Protease Inhibitors (PIs) in HIV treatment?

<p>Inhibit the protease enzyme, preventing maturation of infectious viral particles (A)</p> Signup and view all the answers

Which of the following is a combination that can be used as the NRTI backbone in the preferred regimen for adults and adolescents?

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

What is a common adverse effect associated with NRTIs, particularly with Tenofovir Disoproxil Fumarate?

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

What is the role of Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) in HIV treatment?

<p>Bind directly to reverse transcriptase, inhibiting its activity (D)</p> Signup and view all the answers

What is an important aspect of adherence to ART for individuals with HIV?

<p>Daily adherence is essential to achieve and maintain viral suppression (C)</p> Signup and view all the answers

Which drug class is associated with causing respiratory adverse effects, such as pneumonia?

<p>Integrase Inhibitors (INSTIs) (C)</p> Signup and view all the answers

Which of the following statements regarding HIV treatment is accurate?

<p>Drug therapy suppresses the virus but does not eliminate it. (B)</p> Signup and view all the answers

Which of the following is a potential allergic reaction associated with Integrase Inhibitors?

<p>Rash and flu-like symptoms (D)</p> Signup and view all the answers

What are the potential Central Nervous System (CNS) side effects associated with Efavirenz, a type of NNRTI?

<p>Mood changes, depression, vivid dreams (A)</p> Signup and view all the answers

Which drug class is known for minimal drug interactions due to its lack of metabolism by CYP450 enzymes?

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

What are the potential interactions between INSTIs and antacids, calcium, magnesium, or iron supplements?

<p>Decreased absorption of INSTIs (C)</p> Signup and view all the answers

What is the recommended approach for managing the potential interaction between INSTIs and antacids, calcium, magnesium, or iron supplements?

<p>Administer INSTIs 2-6 hours after supplements (A)</p> Signup and view all the answers

Which of the following side effects is specifically associated with Atazanavir, a type of PI?

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

What is a potential long-term side effect of prolonged Antiretroviral Therapy (ART)?

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

Which drug class might interact with rifampin and anticonvulsants, potentially reducing its effectiveness?

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

What is the recommended approach to managing the potential interaction between NNRTIs and PPIs (Proton Pump Inhibitors)?

<p>Avoid using PPIs with NNRTIs (B)</p> Signup and view all the answers

Flashcards

What is ART?

Antiretroviral therapy (ART) is a combination of medications used to suppress HIV replication and prevent AIDS progression.

What is the main goal of ART?

ART aims to achieve viral suppression, meaning reducing the amount of HIV in the blood to undetectable levels.

What is Combination Therapy?

Combination therapy involves using at least two different classes of antiretroviral drugs (ARVs) to combat HIV.

Why is Combination Therapy crucial for HIV treatment?

Combining ARVs reduces the risk of drug resistance, as HIV is less likely to develop immunity to multiple medications.

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How do NRTIs work?

Nucleoside Reverse Transcriptase Inhibitors (NRTIs) block the enzyme reverse transcriptase, preventing HIV from replicating.

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What is the mechanism of action of INSTIs?

Integrase Strand Transfer Inhibitors (INSTIs) prevent the integration of HIV DNA into the host's genetic material.

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Is ART a cure for HIV?

ART requires lifelong adherence for long-term success, meaning taking the medications consistently as prescribed.

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What does "U=U" stand for?

Undetectable = Untransmittable (U=U) demonstrates that individuals with undetectable viral loads cannot transmit HIV through sexual contact.

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Protease Inhibitors (PIs)

A type of HIV medication that blocks the enzyme protease, preventing the maturation of new virus particles.

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Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

A type of HIV medication that binds to the reverse transcriptase enzyme and inhibits its activity, stopping the conversion of viral RNA into DNA.

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First-Line Regimen

A combination of drugs used as the initial treatment for HIV infection.

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Dolutegravir (DTG) + NRTI Backbone

The current preferred first-line regimen for adults and adolescents with HIV, consisting of Dolutegravir (DTG) combined with two NRTIs.

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HIV Treatment is NOT Curative

HIV treatment does not cure the virus; it suppresses its activity. Consistent adherence to medication is crucial for maintaining viral suppression.

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Integrase Inhibitors (INSTIs)

A class of antiretroviral drugs that work by preventing the integration of viral DNA into the host's DNA.

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Adverse Effects of HIV Drugs

Side effects can vary depending on the specific drug class. Common adverse effects include nausea, headache, allergic reactions, and metabolic changes.

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Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

A class of antiretroviral drugs that resemble the natural building blocks of DNA, preventing the virus from creating new copies of itself.

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What are NNRTIs?

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) are a class of antiretroviral drugs that work by blocking the enzyme reverse transcriptase, preventing HIV from replicating.

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What are INSTIs?

Integrase Strand Transfer Inhibitors (INSTIs) are a class of antiretroviral drugs that work by preventing the integration of HIV DNA into the host's genetic material. This stops the virus from taking over the host cell.

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What are PIs?

Protease Inhibitors (PIs) are a class of antiretroviral drugs that work by blocking the enzyme protease, preventing HIV from maturing and becoming infectious.

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Why do NRTIs have fewer drug interactions?

NRTIs have minimal drug interactions because they don't rely on CYP450 enzymes for metabolism.

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What drugs can interact with INSTIs?

INSTIs can interact with antacids, calcium, magnesium, and iron supplements, potentially reducing their absorption.

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What drugs interact with NNRTIs?

NNRTIs can interact with CYP3A4 inducers and inhibitors, affecting their effectiveness.

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How do acid-reducing agents affect RPV?

Acid-reducing agents like PPIs can interfere with the effectiveness of RPV (a type of NNRTI) as it needs an acidic environment in the stomach for absorption.

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What drugs reduce the effectiveness of NNRTIs?

Rifampin and some anticonvulsants can reduce the effectiveness of NNRTIs.

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PI drug interactions

Protease inhibitors (PIs) can interact with other medications, particularly statins, anticoagulants, anticonvulsants, and boosters. These interactions can increase the levels of statins and may require dose adjustments.

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Why are lab tests important?

Regular blood tests are important to monitor the effectiveness of ART, as well as any potential side effects it may cause.

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What is the goal of ART?

ART is not a cure for HIV, but it can effectively suppress viral replication and improve immune function.

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Why is adherence so critical?

It's essential to emphasize the importance of strict adherence to ART to prevent viral resistance and maintain viral suppression. Explain how adherence can impact the effectiveness of treatment.

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How is treatment effectiveness monitored?

Regular monitoring of viral load and CD4 counts helps assess the effectiveness of ART and make any necessary adjustments to the treatment plan.

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Managing potential side effects

Discuss potential side effects of ART, such as nausea, headache, or diarrhea, and how to manage them. Be aware of potential serious side effects like hepatotoxicity (liver damage) and nephrotoxicity (kidney damage).

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How to support adherence

Assess lifestyle integration, use of pill organizers, alarms, or reminders to help patients adhere to their ART medication regimen.

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Drug interactions and timing

Check for interactions with other prescribed medications, over-the-counter drugs, and herbal supplements. This includes educating patients about specific timing and food requirements for certain medications.

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What is Treatment as Prevention (TasP)?

Antiretroviral therapy (ART) helps reduce the amount of HIV in a person's blood to undetectable levels, preventing the transmission of HIV to others.

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How does TasP work?

This approach focuses on using antiretroviral therapy (ART) consistently to lower the viral load to an undetectable level.

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What is Pre-Exposure Prophylaxis (PrEP)?

Taking PrEP medicine before potential exposure to HIV can significantly reduce the risk of getting infected.

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How does PrEP work?

PrEP helps prevent HIV infection by preventing the virus from copying itself and establishing a permanent infection in the body.

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Why is consistent ART important?

Consistent use of ART is crucial to maintain an undetectable viral load, ensuring the effectiveness of Treatment as Prevention (TasP).

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What happens to people living with HIV who are not diagnosed or treated?

If someone living with HIV is undiagnosed or untreated their condition may worsen, leading to AIDS.

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What is recommended for feeding infants of mothers living with HIV?

Formula feeding is advised for mothers living with HIV due to the risk of transmission through breastfeeding.

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What is the recommendation for ART during pregnancy?

ART is recommended for all pregnant women living with HIV to reduce the risk of transmission to their infant.

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What is AIDS?

AIDS is the most advanced stage of HIV infection, occurring when the immune system is severely compromised due to untreated HIV infection, with a CD4+ T-cell count below 200 cells/µL or the development of one or more AIDS-defining conditions.

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What are Opportunistic Infections?

Opportunistic infections are infections caused by microorganisms that usually do not make people sick but can cause illness in individuals with weakened immune systems, like those with AIDS.

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What is Prophylaxis in HIV treatment?

Prophylaxis is a preventative measure taken to prevent a specific disease or infection, such as the use of medications to prevent the development of opportunistic infections in people with weakened immune systems.

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How is HIV treated?

Treatment for HIV infection is lifelong and focuses on suppressing HIV replication, slowing its progression, and preventing opportunistic infections.

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What is 'U=U'?

Individuals with undetectable viral loads due to effective antiretroviral treatment cannot transmit HIV through sexual contact, demonstrating the importance of adherence to medication.

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Study Notes

HIV Treatment and Prevention

  • Antiretroviral drugs (ART) are specifically used to treat infections caused by HIV.
  • Goals of ART include:
    • Viral suppression (the main purpose is to reduce the HIV viral load, protect the immune system, and prevent AIDS).
    • Immune restoration (helps restore CD4 cell counts).
    • Prevention of resistance (through combination therapy).
    • Improved quality of life (reducing HIV-related morbidity and mortality).
    • Prevention of transmission (undetectable = untransmittable).

Antiretroviral Therapy (ART)

  • Combination therapy involves using multiple ARVs from different drug classes.
  • This is done to effectively suppress HIV replication.
  • Drug combinations reduce the risk of drug resistance.
  • Synergistic effects make viral suppression more effective.
  • ART is a lifelong treatment, adherence is key to long-term success.
  • Standard regimens typically involve a combination of three active drugs.

Drug Classes in ART

  • Nucleoside Reverse Transcriptase Inhibitors (NRTIs): Mimic natural nucleotides to block reverse transcriptase, halting HIV DNA synthesis. Examples include Tenofovir, Emtricitabine, Abacavir, Lamivudine.
  • Integrase Strand Transfer Inhibitors (INSTIS): Block integrase, which prevents viral DNA from integrating into the host genome. Examples include Dolutegravir, Bictegravir, Raltegravir.
  • Protease Inhibitors (Pls): Inhibit protease, preventing the maturation of infectious viral particles. Examples include Atazanavir, Darunavir
  • Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs): Bind directly to reverse transcriptase, inhibiting enzyme activity. Examples include Efavirenz, Rilpivirine, Doravirine.

First-Line Regimen

  • Preferred regimen for adults and adolescents typically involves Dolutegravir combined with a nucleoside reverse transcriptase inhibitor backbone (tenofovir/lamivudine or abacavir/lamivudine).
  • HIV treatment does not cure the virus, only suppresses the virus.
  • Adherence to ART is critical for viral suppression.

Adverse Effects

  • Potential side effects depend on the specific drug class.
  • Some common systemic effects include allergic reactions, liver dysfunction, and metabolic issues (e.g., changes in lipids, glucose, bone density).
  • Long-term ART can lead to bone demineralization.
  • Regular monitoring of lab values (CBC, kidney function, liver function) is needed to detect potential issues relating to treatments.

Drug Interactions

  • Interactions among medications exist, so physicians should note possible complications.
  • Minimal drug interactions can be expected with some ART regimens.
  • Some drugs (antacids, calcium, magnesium, iron supplements) interact with ART.
  • Careful monitoring of drug interactions is necessary to avoid potential issues.

Prevention: Treatment as Prevention (TasP)

  • TasP involves using antiretroviral therapy (ART) to reduce the viral load of HIV to an undetectable level to prevent transmission to others in practice Undetectable =Untransmittable
  • Consistent use of ART and regular viral load testing are crucial to achieving undetectable viral load, preventing transmission.

Prevention: Pre-Exposure Prophylaxis (PrEP)

  • PrEP involves taking HIV medications by HIV-negative individuals to prevent HIV infection before exposure.
  • Daily use of PrEP is highly effective in preventing HIV infection.
  • PrEP typically involves a combination of Tenofovir Disoproxil Fumarate (TDF) and Emtricitabine (FTC).
  • Consistent use of PrEP is critical for most cases of efficacy

Risks of Untreated or Late-Stage HIV

  • Untreated or late-stage HIV infection can lead to the development of AIDS, a serious stage of HIV.
  • The CDC criteria for diagnosing AIDS include a low CD4+ T-cell count and the presence of opportunistic infections.

Opportunistic Infections

  • Opportunistic infections commonly present in late-stage or untreated HIV are mentioned, along with their treatment and prophylaxis strategies.

Resources

  • Various resources for HIV/Hepatitis C Information are provided, including websites.

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HIV Treatment and Prevention PDF

Description

Test your knowledge on key concepts related to HIV treatment and prevention, including TasP, PrEP, and ART. This quiz covers essential information about medications, feeding recommendations for infants of HIV-positive mothers, and the importance of viral load testing. Challenge yourself and enhance your understanding of these critical healthcare topics.

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