Rapid Antibody Testing Procedures

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Questions and Answers

What is a method used for sample collection in rapid antibody tests?

Urine sample

Saliva sample

Sweat sample

Venipuncture (correct)

What is the purpose of pre-test counseling in testing procedures?

To help individuals understand the implications of testing (correct)

To provide medication after testing

To analyze laboratory results

To collect biological samples

Which type of test allows for results to be interpreted on-site?

Urine tests

Rapid Antigen/Antibody Tests (correct)

Rapid Antibody Tests

Blood tests sent to a laboratory

What happens during post-test counseling?

Results are discussed, regardless of their outcome Signup and view all the answers

Which sample collection method is NOT mentioned for rapid tests?

Urine collection Signup and view all the answers

Which cells are primarily targeted by HIV in the immune system?

CD4 cells Signup and view all the answers

What is the first stage of infection after HIV enters the body?

Viral Replication Signup and view all the answers

What condition occurs when the CD4 cell count falls below 200 cells/mm²?

Acquired Immunodeficiency Syndrome (AIDS) Signup and view all the answers

What encourages the progression of HIV to AIDS?

Destruction of CD4 cells Signup and view all the answers

Which method is NOT a common way for HIV to enter the body?

Ingestion of contaminated food Signup and view all the answers

What is the average survival time for untreated individuals with AIDS?

3 years Signup and view all the answers

Which of the following is a consequence of AIDS?

Increased vulnerability to infections Signup and view all the answers

What is the primary mode of HIV transmission from mother to child?

Through breast milk Signup and view all the answers

What is the primary method of administration for Tenofovir?

Oral tablets once daily Signup and view all the answers

What should be monitored regularly while a patient is on Tenofovir?

Kidney function Signup and view all the answers

What is a primary side effect associated with Tenofovir usage?

Nausea Signup and view all the answers

Why is consistency in taking Tenofovir important?

To avoid flare-ups in co-infected patients Signup and view all the answers

What is a recommended dietary consideration when taking Tenofovir?

It should be taken with food to aid absorption Signup and view all the answers

What type of patients require a dose adjustment when taking Tenofovir?

Patients with moderate to severe renal impairment Signup and view all the answers

What are users of Tenofovir advised to take to counteract side effects?

Calcium and vitamin D Signup and view all the answers

Which of the following conditions makes Tenofovir less suitable?

Severe kidney disease Signup and view all the answers

What is the primary method by which Nevirapine (NVP) lowers HIV levels in the blood?

By inhibiting viral replication Signup and view all the answers

What is the recommended dosing schedule for Nevirapine (NVP) during the first 14 days of treatment?

200 mg once daily Signup and view all the answers

Which of the following is considered a common side effect of Nevirapine (NVP)?

Nausea Signup and view all the answers

How is Nevirapine (NVP) primarily excreted from the body?

In feces Signup and view all the answers

What should a patient do if they experience severe skin or hypersensitivity reactions while taking Nevirapine (NVP)?

Immediately stop the medication Signup and view all the answers

What is the pregnancy category classification of Nevirapine (NVP)?

Category B Signup and view all the answers

Which adverse effect is associated with increased liver function tests when taking Nevirapine (NVP)?

Increased liver function tests (LFTs) Signup and view all the answers

What is a critical consideration when treating patients with Nevirapine (NVP)?

It must be taken daily as part of a lifelong regimen Signup and view all the answers

What is the primary purpose of the CDC staging system?

To assess the severity of HIV disease Signup and view all the answers

Which system is particularly helpful in settings with limited access to CD4+ cell measurements?

WHO system Signup and view all the answers

Which factor is essential for determining the CDC stage of HIV disease?

CD4+ cell count Signup and view all the answers

What is an important outcome of implementing the WHO system for HIV classification?

Improved health measurements and survival Signup and view all the answers

What classification does the WHO system primarily rely on?

Clinical manifestations Signup and view all the answers

Which statement is correct regarding the monitoring of the HIV epidemic?

3 in 10 HIV-infected individuals achieve adequate viral suppression. Signup and view all the answers

How does the CDC staging system assist clinicians and patients?

By informing about the stage of HIV disease Signup and view all the answers

Why is it crucial to properly monitor HIV-infected individuals?

To reduce HIV-related morbidity and mortality Signup and view all the answers

What does the initial treatment for HIV involve?

Two NRTIs and a third drug from either the INSTI, NNRTI, or PI classes Signup and view all the answers

When should ART and TB treatments be initiated?

Both should be started together Signup and view all the answers

Which of the following factors influences medication choices for HIV treatment?

Resistance testing and comorbidities Signup and view all the answers

What is the primary purpose of Pre-exposure Prophylaxis (PrEP)?

To prevent becoming infected with HIV Signup and view all the answers

What is Post-Exposure Prophylaxis (PEP) primarily used for?

Prevention of HIV after potential exposure Signup and view all the answers

How effective is PrEP in reducing the risk of getting HIV from sex when taken as prescribed?

About 99% Signup and view all the answers

What is the time frame within which PEP must be started after a potential HIV exposure?

Within 72 hours Signup and view all the answers

Which of the following is a preventive measure against HIV transmission?

Regular HIV testing and ensuring blood safety Signup and view all the answers

Study Notes

HIV & AIDS Drugs

The presentation covers various drugs used in treating HIV/AIDS.
The presentation includes information on different drug classes used in the treatment of HIV/AIDS.
The presentation includes information on groups and individual members who presented.
The presentation provides information on the group members in different groups who worked on the presentation.

How does HIV and AIDS form in the body?

HIV attacks the immune system, specifically targeting CD4 cells.
HIV enters the body through contact with infected body fluids like blood or semen through unprotected sex, sharing needles, or from mother to child during childbirth or breastfeeding.
HIV replicates in CD4 cells, weakening the immune system over time.
Without treatment, the virus continues to destroy CD4 cells.
When the CD4 count falls below 200 cells/mm^2, the infection progresses to AIDS.

Possible Symptoms for Acute HIV (Primary Infection)

Fever
Headache
Muscle aches and joint pain
Rash
Sore throat
Painful mouth sores
Swollen lymph glands
Diarrhea
Weight loss
Cough
Night sweats

Symptoms When HIV Progresses to AIDS

Sweats
Chills
Recurrent fever
Ongoing diarrhea
Swollen lymph glands
Constant white spots or lesions on the tongue
Constant fatigue
Weakness
Rapid weight loss
Skin rashes or bumps

HIV Pathophysiology

HIV infection (RNA retrovirus)
Target: CD4+ T cells
Destruction of CD4+ T cells
Immune system weakening
Immune response
Initial replication
CD4+ count (indicator of immune function)
Early symptoms
Ongoing replication
Acute Retroviral/Primary HIV infection
HIV RNA Test
HIV primarily targets CD4+ T cells.
The virus attaches to the CD4 receptor and co-receptors (CCR5 or CXCR4).
Allows it to enter and infect them.
Once inside the cell, HIV uses reverse transcriptase to convert its RNA into DNA.
Integrated into the host cell's genome by the enzyme integrase.
The infected cell then produces new viral particles.
Bud off and infect other CD4+ T cells.
Continuous replication of HIV leads to a significant reduction in the number of CD4+ T cells.
This depletion weakens the immune system, making the body more susceptible to opportunistic infections and certain cancers.
Without treatment, HIV infection progresses to AIDS.
Characterized by a CD4+ T cell count below 200 cells/mm^2 or the presence of specific opportunistic infections or cancers.

HIV Life Cycle

Binding and fusion: HIV binds to a CD4 receptor and one of two co-receptors.
The virus fuses with the host cell. After fusion, the virus releases RNA into the host cell.
Reverse transcription: An HIV enzyme called reverse transcriptase converts the single-stranded HIV RNA to a double-stranded HIV DNA.
Integration: The newly formed HIV DNA enters the host cell's nucleus, where an HIV enzyme called integrase "hides" the HIV DNA within the host cell's own DNA—the integrated HIV DNA is called a provirus.
Transcription: The provirus uses a host enzyme called RNA polymerase to create copies of the HIV genomic material.
Assembly: An HIV enzyme called protease cuts the long chains into smaller, individual proteins to assemble a new virus particle..
Budding: The newly assembled virus pushes out from the host cell, stealing part of the cell's outer envelope which is studded with protein/sugar combinations called HIV glycoproteins.
Maturation: The protease enzyme finishes cutting HIV protein chains, combining to make a new working virus.

HIV Transmission

Intimate contact with blood, semen, vaginal fluids, and breast milk
Sexual contact (oral, vaginal, and anal sex)
Direct blood contact (including intravenous drug use with shared needles, or shared drug works, and shared personal care items such as razors or Blood transfusion (now extremely rare in the United States)
Mother-to-child contact (shared maternal-fetal blood circulation, contact during delivery, breastfeeding)

HIV/AIDS Tests

HIV Antibody Tests
These tests look for antibodies to HIV in the blood or oral fluid. It typically takes several weeks for antibodies to develop after infection.
Types: ELISA, Western Blot Test, Window Period
HIV Antigen/Antibody Tests
These tests detect both HIV antibodies and antigens (specifically the p24 antigen) produced by the virus.
HIV Nucleic Acid Tests (NATs)
NAT detects the actual virus in the blood.
HIV RNA blood test

Rapid Tests

Provide rapid results, useful for community settings, clinics, or at home.

CD4 Count

Measures the number of CD4 T-cells in the blood.
Helps determine the stage of HIV infection.
A lower CD4 count indicates a more severe immune deficiency.

Viral Load Tests

Measures the amount of HIV RNA in the blood.
Helps assess how well antiretroviral therapy is working and the level of viral replication.

Testing Procedures

Sample collection (venipuncture or fingerstick and oral fluid tests)
Laboratory processing
Counseling and follow-up

HIV Classification

CDC staging system (revised in 2014)
World Health Organization (WHO) system (revised in 2015)

Indications for Antiretroviral Therapy

Due to undiagnosed HIV or improper monitoring, only 3 in 10 achieve adequate viral suppression.
All HIV-infected individuals regardless of CD4+ count
Significantly improved the health and survival of people with HIV
To reduce HIV-related morbidity, mortality, and transmission.

What Does the Initial Treatment Involve?

Two NRTIs and a third drug from either the INSTI, NNRTI, or PI classes.
Active TB: ART and TB treatments should be started together

Prophylaxis of HIV

Pre-exposure Prophylaxis (PrEP) • Taking medicine to prevent getting HIV • Highly effective for preventing HIV when taken as prescribed
Post-Exposure Prophylaxis (PEP) • Taking anti-HIV drugs shortly after possible exposure • Must be started within 72 hours
Preventive Measures • Using condoms • Regular HIV testing • Safe needle practices • Ensuring blood safety

Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)

A class of antiretroviral drugs primarily used to treat HIV
NRTIs prevent HIV from making copies of itself, slowing the progression of infection.

NRTI Common Complications

Lactic acidosis, hepatomegaly, steatosis
Zidovudine: bone marrow suppression, lipodystrophy
Didanosine and stavudine: bone marrow suppression, pancreatitis (boxed warning), peripheral neuropathy
Lamivudine, tenofovir, and emtricitabine: hepatitis B exacerbations in clients co-infected with HIV and HBV
Tenofovir: osteomalacia
Emtricitabine: skin hyperpigmentation, immune reconstitution syndrome
Abacavir: increased risk of myocardial infarction, immune reconstitution syndrome, severe hypersensitivity reactions.

The 7 NRTIs

Zidovudine (AZT)
Didanosine (ddl)
Stavudine (d4T)
Lamivudine (3TC)
Abacavir (ABC)
Tenofovir (TDF)
Emtricitabine (FTC)

Zidovudine (AZT)

The first drug approved to treat HIV.
Cornerstone in HIV treatment, but replaced by newer drugs due to side effects.
Side effects: Nausea, headache, and fatigue

Didanosine (ddl)

An older HIV drug.
Side effects: Diarrhea, nausea, and rash.

Stavudine (d4T)

Similar to Zidovudine.
Side effects: Peripheral neuropathy, Nausea

Lamivudine (3TC)

A cytosine analogue.
Effective against hepatitis B.
Side effects include: headache, nausea, fatigue, and diarrhea.

Abacavir (ABC)

A guanine analogue.
Side effects: Nausea, headache, and fatigue
Important to note the HLA-B*5701 allele is screened before use

Tenofovir (TDF)

A nucleotide analogue.
Side effects include: Nausea, diarrhea, and headaches.

Emtricitabine (FTC)

A cytosine analogue. Well-tolerated and a common choice for first-line therapy.
Side effects: Nausea, diarrhea, and headaches.

Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Bind to and block reverse transcriptase enzymes while stopping HIV viral reproduction.

The 5 NNRTIs

Efavirenz (EFV)
Etravirine (ETR)
Delavirdine (DLV)
Nevirapine (NVP)
Rilpivirine (RPL)

Efavirenz (EFV)

First choice drug within the NNRTI class.
Penetrates the cerebrospinal fluid (CSF).
Inhibits viral RNA-directed DNA polymerase/reverse transcriptase.
Reduces viral replication.
Side effects: Rash, Nausea, diarrhea, dizziness, insomnia, abnormal dreams, impaired concentration, and anxiety.

Etravirine (ETR)

Second generation NNRTI.
Binds to and inhibits reverse transcriptase.

Delavirdine (DLV)

Inhibits reverse transcriptase.
Side effects: Rash, increased transaminase levels, headaches, nausea, and diarrhea.

Nevirapine (NVP)

Lowers HIV levels in the blood by inhibiting viral replication.
Side effects: Rash, including Stevens-Johnson syndrome, as well as symptomatic hepatitis.

Rilpivirine (RPL)

Taken once daily, preferred for lower resistance compared to other NNRTIs
Side effects: Rash, depression, headache, insomnia

Protease Inhibitors (PIs)

The 8 PIs

Ritonavir (RTV)
Saquinavir (SQV)
Tipranavir (TPV)
Darunavir (DRV)
Amprenavir (APV)
Atazanavir (ATV)
Fosamprenavir (FOS)
Indinavir (IDV)

Fusion (Entry) Inhibitors

Antiviral drugs preventing HIV from entering human cells.
These drugs block the virus from merging with the cell's membrane and injecting its genetic material.

Enfuvirtide

Works by blocking the fusion of HIV-1 with the host cell membrane.
Prevents replication.

Chemokine Coreceptor Antagonists

Block the CCR5 receptor.
Prevent the virus from replicating.

Maraviroc (MVC)

Blocks the CCR5 receptor on immune cells preventing HIV from binding to the cell.
Effective against CCR5-tropic strains of HIV.

Integrase Strand Transfer Inhibitors (INSTIs)

Develop to inhibits integrase, preventing the transfer and insertion of viral DNA into host cell DNA.
Used to reduce the amount of HIV in the body to undetectable levels.

Dolutegravir, Elvitegravir, and Raltegravir

Antiretroviral drugs used to primarily treat HIV infections.

Opportunistic Infections (OIs)

As HIV progresses, individuals become more susceptible to cancers and opportunistic infections.
The use of ART has significantly lowered the occurrence of Ols.
Some of the most frequent Ols include pulmonary tuberculosis (TB), pneumococcal pneumonia, Cryptosporidium, fungal infections, Kaposi sarcoma, toxoplasmosis, histoplasmosis, and cytomegalovirus (CMV).

Antiretroviral Therapy (ART) for Pregnancy

Optimal drug therapy should be used for women of reproductive age.
Goals of treatment identical to other adults and adolescents.
The timing of initiation and selection can differ because of preventing HIV transmission to the fetus.
Consider the timing of initiation of treatment and selection of regimens for pregnant patients.
Necessary considerations during pregnancy: • Neural tube defects • Viral load • Pre-existing conditions

Occupational HIV Exposure and Postexposure Prophylaxis (PEP)

PEP is a treatment regimen after percutaneous exposure to HIV.
For emergency situations only.
Should be taken promptly within 72 hours.
Duration: 4 weeks or 28 days.

Patient Adherence

Educate patients thoroughly on the medication's purpose, how it works, detail possible side effects.
Develop a medication routine: daily schedules, reminders.
Foster supportive relationships: encourage family/friends and establish nurse-patient connections.
Make a follow-up plan: regular check-ins and positive reinforcement.
Address barriers: side effects management, financial and access support, and misunderstandings.
Monitor and adjust the plan as needed: regular blood work helps measure effects on health.

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Description

Test your knowledge on rapid antibody testing methods, including sample collection techniques and the importance of counseling before and after testing. This quiz covers key aspects related to on-site result interpretation and various testing procedures.