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GOING VIRAL, 2-3 weeks - Coggle Diagram

- - - - CD4
        
        Binds to B cells —> diiferentiate to plasma cell & memory B cells.
        
        Release cytokines
        
        Binds to APCs to start immunity response.
        
        Will reduce the CD4 counts
      - CD8
      - They are produced in the bone marrow and mature in the thymus
    - - Macrophages
      - B cells
      - Dendritic cells
      - Contain Major histocompatibility complex (MHC)
        
        MHC I
        
        HLA-A / HLA-B / HLA-C
        
        MHC II
        
        HLA-DR/ HLA- DP / HLA-DQ
- - - - sexual intercourse
        
        Sexually transmitted diseases (STDs),
      - By infected mother
      - Shared needles
- - - - primary test
        
        using ELISA
    - - comformatory
    - - confirmatory ( when western blotting is not decisive )
        
        using real time PCR
  - - - the higher the better - AIDS when CD4+ counts below 200cell/lu
    - - the higher the worst
        
        high CD4+ count --> low viral load and vice versa
- - - - Flu-like symptoms
      - Small reduction in CD4 and CD8
    - - CD4 count below 200cell/mm3
        
        Symptoms appear in association with
    - - CD4 continue reducing
        
        Palpable lymph nodes
        
        Follicular hyperplasia
- - - - Entry/Fusion Inhibitors
        
        MOA
        
        Act extracellularly to prevent the binding/fusion of an HIV with the host cell
        
        Examples:
        
        Enfuvirtide
        
        Maraviroc
      - Nucleoside & Nucleotide Reverse Transcriptase Inhibitors
        
        They are analogs of native ribosides, which all lack a 3’-hydroxyl group
        
        MOA
        
        Cause early chain termination
        
        Adverse effects include:
        
        ) Lactic acidosis with hepatic steatosis
        
        Myopathy
        
        Examples:
        
        Zidovudine
        
        Abacavir
        
        Lamivudine
      - Non-Nucleoside Reverse Transcriptase Inhibitors
        
        MOA
        
        Blocking reverse transcriptase by binding directly to the enzyme's active site
        
        Examples:
        
        Efavirenz
        
        Adverse Effects:
        
        CNS symptoms
        
        Hallucinations
        
        Dizziness
        
        Liver damage
        
        Teratogenicity
      - Integrase Strand Transfer Inhibitors
        
        MOA
        
        Inhibit the strand transfer reaction by integrase enzyme
        
        Raltegravir
        
        Adverse Effects:
        
        Insomnia
        
        Headache
        
        nausea
      - Protease Inhibitors
        
        MOA
        
        Inhibitors that directly bind to HIV protease and prevent the subsequent cleavage of polypeptides.
        
        Examples:
        
        Darunavir
        
        Atazanavir
        
        Indinavir
        
        Lopinavir/Ritonavir
        
        Adverse Effects:
        
        Toxicity in newborns
        
        Diarrhea
        
        Nausea
      - Pharmacokinetic Enhancers
        
        Boost the systemic exposure to other antiretroviral agents
        
        Example:
        
        Cobicistat
    - - 2 Nucleoside/Nucleotide reverse transcriptase inhibitors
        
        +
        
        1 Protease inhibitor (+cobicistat)
        
        1 Nonnucleoside reverse transcriptase inhibitor
        
        1 Integrase inhibitor
    - - Avoid overlapping toxicities
      - Impact of drug interactions
      - Ease of Adherence to the regimen
      - Patient factors
    - - HIV RNA viral load
      - CD4 count
      - Complete blood count
  - - - Referral to a psychiatrist
- - - - Side effects of drugs
      - having to tell other and falling in fear of isolation
      - chance of developing cognitive disorder
  - - - Making judgments for anti-HIV advocates
        
        Internalized stigma --> self torture
        
        Internalization
        
        Chaotic relationships
        
        Delayed healthcare
        
        Fear from testing
        
        Laws that criminalize HIV would discourage HIV prevention practices by making it more of. Taboo driving stigma and discrimnation
      - Feeling that those people desrve
      - Believing certain people contract the disease
    - - unfair treatment
- - - - Such as:
        
        Elders
        
        immunodeficient
        
        New borns
- - - - HIV crossing the blood-brain barrier
        
        Leading to cognitive and behavioral complications
  - - - Molluscum contagiosum
      - Human papillomavirus
      - Staphylococcus aureus
    - - Candida albicans
      - Herpes simplex
    - - Cytomegalovirus
      - Protozoa cryptosporidium
    - - Cryptococcal infection
      - Toxoplasma gondii
      - Papovavirus
    - - Pneumocystis carnii
      - Mycobacterium Avium complex
      - Cytomegalovirus
  - - - Human herpes virus 8
        
        Vascular tumor
    - - B-cell hyperplasia
      - Lymphadenopathy