Podcast
Questions and Answers
What is the role of antiviral therapy in relation to HHV-8 replication?
What is the role of antiviral therapy in relation to HHV-8 replication?
Antiviral therapy, particularly zidovudine and nelfinavir, may inhibit HHV-8 replication.
Which antiretroviral therapies are suggested to inhibit HHV-8 replication?
Which antiretroviral therapies are suggested to inhibit HHV-8 replication?
Zidovudine and nelfinavir are suggested to inhibit HHV-8 replication.
What conditions associated with HHV-8 replication may require antiviral therapy?
What conditions associated with HHV-8 replication may require antiviral therapy?
Antiviral therapy may be more significant in treating MCD (multicentric Castleman disease) and KICS (Kaposi's sarcoma inflammatory cytokine syndrome).
What is the primary type of HIV that is prevalent in the United States?
What is the primary type of HIV that is prevalent in the United States?
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How can HHV-8 associated malignancies be treated?
How can HHV-8 associated malignancies be treated?
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What defines the advanced stage of HIV infection known as AIDS?
What defines the advanced stage of HIV infection known as AIDS?
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What precautions are recommended for hospitalized patients with HHV-8?
What precautions are recommended for hospitalized patients with HHV-8?
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What percentage of adolescents and adults typically develop acute retroviral syndrome shortly after HIV infection?
What percentage of adolescents and adults typically develop acute retroviral syndrome shortly after HIV infection?
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Name two common symptoms of acute retroviral syndrome.
Name two common symptoms of acute retroviral syndrome.
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How does acute retroviral syndrome typically present in terms of symptoms?
How does acute retroviral syndrome typically present in terms of symptoms?
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What is the primary mode of HHV-8 acquisition according to epidemiologic data?
What is the primary mode of HHV-8 acquisition according to epidemiologic data?
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Why do some experts recommend that high-risk individuals avoid contact with saliva?
Why do some experts recommend that high-risk individuals avoid contact with saliva?
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What criticism has been raised regarding the recommendation to avoid saliva in preventing HHV-8 transmission?
What criticism has been raised regarding the recommendation to avoid saliva in preventing HHV-8 transmission?
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What current status is mentioned regarding recommendations for HHV-8 transmission control measures?
What current status is mentioned regarding recommendations for HHV-8 transmission control measures?
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What are the clinical manifestations of HIV infection characterized by?
What are the clinical manifestations of HIV infection characterized by?
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What untested strategies are posed for high-risk individuals concerning HHV-8?
What untested strategies are posed for high-risk individuals concerning HHV-8?
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What has been the approach of experts toward preventing HHV-8 transmission?
What has been the approach of experts toward preventing HHV-8 transmission?
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What is lacking in the current guidelines for HHV-8 transmission prevention?
What is lacking in the current guidelines for HHV-8 transmission prevention?
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What organization provides a complete listing of current policy statements regarding HIV and AIDS?
What organization provides a complete listing of current policy statements regarding HIV and AIDS?
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Where can one find the guidelines for the prevention and treatment of opportunistic infections in HIV-exposed and infected children?
Where can one find the guidelines for the prevention and treatment of opportunistic infections in HIV-exposed and infected children?
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What is the significance of the link provided by the American Academy of Pediatrics?
What is the significance of the link provided by the American Academy of Pediatrics?
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What panel addresses the guidelines specifically for HIV-exposed and infected children?
What panel addresses the guidelines specifically for HIV-exposed and infected children?
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Which two groups are explicitly mentioned in the context of HIV and AIDS in the provided content?
Which two groups are explicitly mentioned in the context of HIV and AIDS in the provided content?
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What were the most common opportunistic infections in children during the pre-cART era?
What were the most common opportunistic infections in children during the pre-cART era?
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What does the acronym PCP stand for in the context of HIV-related opportunistic infections?
What does the acronym PCP stand for in the context of HIV-related opportunistic infections?
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What is immune reconstitution inflammatory syndrome (IRIS)?
What is immune reconstitution inflammatory syndrome (IRIS)?
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Which organisms are commonly associated with inducing IRIS?
Which organisms are commonly associated with inducing IRIS?
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What is the significance of the pre-cART era concerning opportunistic infections?
What is the significance of the pre-cART era concerning opportunistic infections?
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List two less common opportunistic pathogens observed in the pre-cART era.
List two less common opportunistic pathogens observed in the pre-cART era.
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What prior health conditions may predispose individuals to develop IRIS?
What prior health conditions may predispose individuals to develop IRIS?
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How did the frequency of opportunistic infections vary in the pre-cART era?
How did the frequency of opportunistic infections vary in the pre-cART era?
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What types of malignant neoplasms are more commonly seen in children with HIV infection compared to immunocompetent children?
What types of malignant neoplasms are more commonly seen in children with HIV infection compared to immunocompetent children?
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How has the incidence of malignant neoplasms in HIV-infected children changed during the cART era?
How has the incidence of malignant neoplasms in HIV-infected children changed during the cART era?
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What is the prognosis for untreated infants who acquire HIV through mother-to-child transmission and have high viral loads?
What is the prognosis for untreated infants who acquire HIV through mother-to-child transmission and have high viral loads?
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Which neurologic complications are noted in untreated HIV-infected infants and children?
Which neurologic complications are noted in untreated HIV-infected infants and children?
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What is the role of the viral reverse transcriptase enzyme in the HIV lifecycle?
What is the role of the viral reverse transcriptase enzyme in the HIV lifecycle?
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What are the three distinct genetic groups of HIV?
What are the three distinct genetic groups of HIV?
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What are the AIDS-defining conditions during the first 6 months of life for untreated HIV-infected infants?
What are the AIDS-defining conditions during the first 6 months of life for untreated HIV-infected infants?
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What is the significance of CD4+ T-lymphocyte counts in the prognosis of HIV-infected children?
What is the significance of CD4+ T-lymphocyte counts in the prognosis of HIV-infected children?
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Study Notes
Human Immunodeficiency Virus Infection
- HIV-1 is more common in the United States than HIV-2
- AIDS is an advanced stage of HIV infection
- Acute retroviral syndrome occurs in 50-90% of infected adults and adolescents in the first few weeks after infection
- Symptoms include fever, malaise, lymphadenopathy, and skin rash
- Untreated pediatric HIV infection can lead to unexplained fevers, generalized lymphadenopathy, hepatomegaly, splenomegaly, failure to thrive, persistent or recurrent oral and diaper candidiasis, recurrent diarrhea, parotitis, hepatitis, CNS disease (e.g., encephalopathy, hyperreflexia), hypertonia, floppiness, developmental delays, lymphoid interstitial pneumonia, and recurrent invasive bacterial infections, and other opportunistic infections (OIs)
- With timely diagnosis of HIV infection in pregnant women, infants, and children, and appropriate treatment, clinical manifestations of HIV infection, including the occurrence of AIDS-defining illnesses, are now rare in industrialized countries
- In pre-cART era, common OIs in children included infections from encapsulated bacteria, Pneumocystis jirovecii, varicella-zoster virus, cytomegalovirus, herpes simplex virus, Mycobacterium avium complex, and Candida. Less common OIs included EBV, M. tuberculosis, Cryptosporidium, Cystoisospora, other enteric pathogens, Aspergillus, and Toxoplasma gondii
- Immune reconstitution inflammatory syndrome (IRIS) can occur due to an inflammatory response as cell-mediated immunity is restored
- Leiomyosarcomas and non-Hodgkin B-cell lymphomas of the Burkitt type can occur more commonly in children with HIV infections
- HIV-2 is found predominantly in Western Africa
- HIV-2 is resistant to nonnucleoside reverse transcriptase inhibitors (NNRTIs) and at least 1 fusion inhibitor (enfuvirtide)
- Human are the only known reservoir for HIV-1 and HIV-2
- HIV transmission includes sexual contact, percutaneous blood exposure, mucous membrane exposure to contaminated blood or body fluids, MTCT in utero, around the time of labor, and delivery (perinatally), and postnatally through breastfeeding
- In 2014, most HIV infections in 13-24 year olds were attributed to male-to-male sexual contact in males and heterosexual contact in females.
- HIV-infected adolescents and young adults are often asymptomatic initially
- The incubation period for untreated infants and children in the U.S. is usually 12-18 months
- Acute retroviral syndrome in adolescents/adults lasts 5-7 days and presents 7-14 days after infection
- HIV-1/HIV-2 immunoassays and antigen assays are used for diagnosis
- Nucleic Acid Amplification Assays (NAAs) use plasma HIV DNA or RNA testing for diagnosis
- HIV-infection in children is treated with combination antiretroviral therapy (cART) as soon as possible
Clinical Manifestations
- HIV infection results in many clinical manifestations varying by age, co-infections
- Acute retroviral syndrome (ARS). Includes fever, malaise, lymphadenopathy, rash
- Pediatric HIV infections can have varied symptoms.
Other
- cART is critical to reduce morbidity and mortality in HIV-infected individuals
- Prevention and treatment of opportunistic infections is crucial
- Guidelines for prevention and treatment of opportunistic infections in HIV-exposed and infected children are available
- Pediatric HIV infections are treated differently than adult HIV infections, especially regarding age-specific guidance on vaccination and medication dosages.
- Preventing mother-to-child transmission (MTCT) of HIV is crucial in resource-limited settings
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Description
This quiz explores key aspects of Human Immunodeficiency Virus (HIV) infection, including the differences between HIV-1 and HIV-2, the symptoms of acute retroviral syndrome, and the impacts of untreated pediatric HIV. It also discusses the importance of timely diagnosis and treatment in preventing severe manifestations like AIDS in various populations.
