MCPC week 2 HIV

41 Questions

What is the role of the viral envelope in an HIV particle?

Facilitates recognition and binding to host cell receptor CD4

Which protein does NOT play an essential role in HIV entry into the host cell?

GP20

Which of these proteins is the transmembrane envelope glycoprotein?

GP41

Which HIV Drug class stops HIV from being integrated into the cell's DNA?

Integrase inhibitors

Which HIV drug class stops HIV changing from a single strand of RNA to a double strand of DNA?

NRTIs

At What HIV viral load is a patient undetactable and untransmittable?

below 200 copies/mL

What is the primary goal of HIV treatment?

Maximally and durably suppress plasma HIV RNA

Which of the following is NOT a key step in the HIV entry process?

Reverse transcription of HIV RNA into DNA

What is the recommended approach for achieving viral suppression in HIV treatment?

Using a combination of drugs from two or more drug classes

Which of the following drug classes is typically used as an anchor in HIV treatment regimens?

Integrase strand transfer inhibitors (INSTIs)

Which of the following is NOT a goal of HIV treatment?

Eradicate HIV from the body completely

What determines the type of CD4 cell that HIV can infect, known as the virus tropism?

The type of coreceptor recognized by HIV-gp120

What is the mechanism used by entry inhibitors to prevent HIV-1 cellular entry?

Binding to a cellular target

Which HIV entry inhibitor belongs to the attachment inhibitors subclass?

Fostemsavir

When are entry inhibitors typically indicated for use in HIV treatment?

For heavily treatment-experienced adults with resistant HIV infections

What is the brand name of Fostemavir?

Rukobia

What is the generic name of Selzentry?

Maraviroc

What is the mechanism of action of Fostemsavir in the treatment of HIV?

Binds to the HIV gp120 envelope and blocks interaction with CD4 receptor

Which enzyme should be considered when administering Fostemsavir due to potential interactions?

CYP3A4

What is the unique aspect of Selzentry (Maraviroc) among HIV medications?

It interacts with a component of the human immune system rather than HIV itself

What is the primary target of Maraviroc (Selzentry) in the HIV entry process?

CCR5 coreceptor

T/F: Maraviroc is used in combination antiretroviral treatment in HIV patients with only CCR5-tropic HIV1.

True

What is the mechanism of action of ibalizumab-uiyk (TROGARZO) in treating HIV-1 infection?

It is a monoclonal antibody that binds to the CD4 receptor, preventing HIV entry

Which step of the HIV life cycle does reverse transcriptase catalyze?

Conversion of single-stranded HIV RNA to double-stranded DNA

Which class of HIV medications is ibalizumab-uiyk (TROGARZO) classified under?

Entry inhibitors

What is the primary indication for the use of ibalizumab-uiyk (TROGARZO)?

Salvage therapy for heavily treated adults with multidrug-resistant HIV-1 infection

How is ibalizumab-uiyk (TROGARZO) administered?

Intravenously

Which class of HIV reverse transcriptase inhibitors acts as chain terminators?

NRTIs

Which is NOT true about NRTIs?

They are active drugs (not prodrugs)

T/F: TDF-containing regimens can have improved renal and bone safety compared with TAF-containing regimens.

False

Which of the following statements about the mechanism of action of NNRTIs is CORRECT?

NNRTIs bind at an allosteric site of HIV reverse transcriptase

Which of the following is NOT true about Efavirenz?

It is a prodrug

Which of the following is a key advantage of doravirine (PIFELTRO) compared to efavirenz (SUSTIVA)?

All of the above

Which of the following is a common adverse effect associated with all NNRTIs?

Rash

Which NRTI has an increased risk of hypersensitivity reactions in patients with the HLA-B*57:01 allele?

Abacavir

Which HIV drug class ends in -tegravir?

Integrase Inhibitors (INSTIs)

Which of the following is a common adverse effect associated with HIV protease inhibitors?

Dyslipidemia

T/F: elvitegravir and raltegravir are recommened as first line therapy for HIV patients

False

Which is true about HIV Integrase Strand Transfer Inhibitors?

They're tolerable and have demonstrated limited AEs

Which is true about HIV protease inhibitors?

End in -navir

Which of the following statements about cobicistat is true?

It protects the co- administered drug from metabolism by CYP3A4

Study Notes

HIV Structure and Infection

Overview of HIV Structure

Human Immunodeficiency Virus (HIV) is composed of various proteins and genetic material enclosed within a protective shell called a viral particle, or virion. The main components of an HIV particle include:

Viral Envelope (VE): A thin lipid membrane derived from the host cell's plasma membrane during budding. The VE contains transmembrane proteins such as GP120 and GP41.
Capsid: A dense core consisting of the viral protein CA (capsid antigen) formed by self-assembly of CA monomers. Within the capsid lies the viral genome (RNA).
Nucleocapsid: The complex between the RNA genome and the viral protein p24 (also known as regulatory protein p24 or Gag polyprotein p24).
Surface Spikes: On the outermost layer of the viral particle, surface spikes protrude from the envelope, which facilitate recognition and binding to host cell receptor CD4. The spikes are primarily made up of non-glycosylated parts of the GP120 protein, specifically the variable regions with constant domains.

Mechanism of HIV Entry into Cells

The process by which HIV enters a host cell involves several steps:

Binding: HIV uses its external spike proteins, particularly GP120, to attach itself to the CD4 protein on the surface of the host T-cell.
Fusion: After the virus successfully binds to its target cell, it undergoes fusion. The VE merges with the cell membrane, releasing the viral contents into the infected cell.

Infection Cycle

Once inside the host cell, the viral RNA replicates, leading to production of more HIV particles. These newly assembled particles are released from the host cell, initiating the infection cycle once again. The entire lifecycle of an HIV-infected cell involves a balance between viral replication and host defense mechanisms, leading either to the death of the infected cell or the establishment of chronic infection.

Conclusion

Understanding the structure and infection cycle of HIV is crucial for developing novel treatments and vaccines against the virus. Researchers continue to study the details of these processes, aiming to create more effective strategies for preventing and treating HIV infections.

Stopped at cabenuva

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