HIV/AIDS - Vocabulary flashcards from lecture notes

A vocabulary set covering HIV infection, transmission, perinatal transmission, key clinical trials, pregnancy management, testing algorithms, treatment principles, resistance testing, and relevant resources.

HIV-1 infection

Infection with human immunodeficiency virus type 1 (HIV-1); defined by a positive HIV-1 antibody or antigen test.

AIDS

Acquired Immunodeficiency Syndrome diagnosed when HIV infection leads to a CD4 count <200 cells/mm3 or <14%, or the presence of AIDS-defining illnesses.

AIDS-defining illnesses

Illnesses that establish progression to AIDS (examples include PCP pneumonia, toxoplasmosis, Kaposi sarcoma, tuberculosis, non-Hodgkin lymphoma, cryptococcal meningitis, MAC infection, CMV disease).

Pneumocystis jirovecii pneumonia (PCP)

AIDS-defining opportunistic pneumonia caused by Pneumocystis jirovecii.

Toxoplasmosis

Toxoplasma gondii infection; AIDS-defining when the brain is involved or it disseminates.

Kaposi sarcoma

Avascular tumor associated with AIDS; AIDS-defining illness.

Tuberculosis (TB) in HIV

Active TB is an AIDS-defining illness and a critical co-infection in HIV.

Non-Hodgkin lymphoma

Hodgkin-like lymphoma associated with HIV infection; considered AIDS-defining.

Cryptococcal meningitis

Fungal meningitis caused by Cryptococcus; AIDS-defining illness.

Mycobacterium avium complex (MAC) infection

Nontuberculous mycobacterial infection; AIDS-defining illness.

Cytomegalovirus (CMV) infection

CMV disease (e.g., retinitis) associated with AIDS-defining illness.

Modes of HIV transmission

Classification of how HIV is transmitted: sexual contact, perinatal (vertical), and parenteral (e.g., IV drug use).

MSM

Men who have sex with men.

Heterosexual contact

Sexual contact between heterosexual partners as a mode of transmission.

Receptive anal intercourse risk

Estimated per-exposure risk of HIV transmission ~0.3%.

Insertive anal intercourse risk

Estimated per-exposure risk of HIV transmission ~0.06%.

Receptive vaginal intercourse risk

Estimated per-exposure risk of HIV transmission ~0.1%–0.2%.

Insertive vaginal intercourse risk

Estimated per-exposure risk of HIV transmission ~0.03%–0.14%.

Oral sex receptive risk

Estimated per-exposure risk of HIV transmission ~0.06%.

IV drug use (IDU) transmission risk

Per-exposure risk of HIV transmission ~0.67%.

Perinatal (vertical) transmission risk without ARVs

About 25% risk of mother-to-child transmission in the absence of antiretroviral therapy.

ACTG 076 trial

Pivotal study showing oral zidovudine started in pregnancy, IV zidovudine at delivery, and neonatal zidovudine for 6–8 weeks reduced perinatal transmission by ~92% vs placebo.

Zidovudine (AZT) prophylaxis in pregnancy

AZT given to mother and/or neonate to reduce mother-to-child transmission of HIV.

Maximally suppressive ART in pregnancy

Antiretroviral regimen aimed at achieving maximal suppression of HIV replication during pregnancy.

HIV RNA >1000 copies/mL at delivery

If maternal HIV RNA exceeds 1,000 copies/mL, add IV zidovudine during delivery to reduce transmission.

Dolutegravir (DTG) in pregnancy

Integrase inhibitor; associated with neural tube defects when used at conception; now considered a preferred agent for use throughout pregnancy.

Efavirenz (EFV) in pregnancy

EFV is no longer strictly contraindicated in the first 8 weeks of pregnancy; considered an alternative rather than the preferred option in pregnancy.

Cytarabine monotherapy in pregnancy

Cytarabine alone is not recommended; fully active ART regimen is preferred during pregnancy.

Breastfeeding with HIV

Breastfeeding is not recommended for HIV-infected women, regardless of ART status.

Elective cesarean section (C-section) in HIV

Elective C-section is considered when HIV viral load >1000 copies/mL to reduce fetal transmission.

Blood transfusion risk with HIV

Historically >90% risk with HIV-infected blood; since 1985 donor blood is screened for HIV.

HIV prevention measures

Standard precautions, condoms (latex or polyurethane), water-based lubricants, needle exchange programs.

US Preventive Services Task Force 2013 screening

Routine annual HIV screening for Americans aged 15–65; risk-based screening for those outside this range.

Fourth-generation HIV Ag/Ab combo test

Initial screening test that detects HIV-1/2 antibodies and p24 antigen; reduces window period.

Antibody differentiation assay

Test distinguishing HIV-1 versus HIV-2 antibodies after a reactive initial screen.

HIV-1 NAAT

Nucleic acid amplification test for HIV RNA; used when initial antibody tests are negative or indeterminate.

HIV rapid testing (OraQuick)

Point-of-care test using blood or oral fluid; reactive results follow the standard testing algorithm.

Window period (testing)

Time from HIV infection to detectable test results; combination assays shorten this window.

Two to three active ARV drugs from at least two classes

Treatment principle to prevent resistance and achieve viral suppression.

Salvage therapy

ARV regimens used after resistance or failure, often involving unconventional combinations.

HLA-B*57:01 testing

Genetic test before abacavir to reduce risk of hypersensitivity reaction.

HIV drug resistance testing (genotype)

Genotypic analysis of mutations in reverse transcriptase, protease, and integrase to guide therapy.

Genotype testing in pregnancy

Recommended for all pregnant women before ART and for those with detectable HIV RNA on therapy.

GenoSure Archive

Archived HIV DNA test using next-generation sequencing to identify resistance mutations not seen in plasma RNA.

Stanford HIV Drug Resistance Database

Online resource to interpret HIV resistance mutations and guide therapy.