1. What was the purpose of "AIDS-defining conditions"?
2. What is the main symptom of patients with lymphadenopathy syndrome (LAS)?
3. Give one function of HIV accessory genes.
4. Which cells of the immune system are prime targets of HIV?
5. What role do asymptomatic people with HIV disease play in the epidemiology of AIDS?
6. How was the risk of contracting HIV disease from clotting factor VIII eliminated?
7. Why might the infant son of a hemophiliac man develop AIDS when the son's parents were strictly monogamous nonabusers of drugs?
8. What are two consequences of the rising percentage of HIV disease cases in women?
9. Name a disinfecting agent active against human immunodeficiency virus (HIV).
Review Questions 763
10. List five groups of people at increased risk for HIV infection.
11. Give two reasons it is a good idea to know whether you are infected with HIV.
12. What are four requirements of an acceptable HIV vaccine?
13. Why is HIV protease so important to replication of HIV?
14. What is a phase III vaccine trial?
15. Why would you expect gp 120 vaccines to be the most advanced?
16. What are the three main types of malignant tumors that complicate HIV disease?
17. How do physicians prevent pneumocystosis in AIDS patients?
18. In AIDS patients with toxoplasmosis, which part of the body is affected in more than half the cases?
19. Name a feared complication of cytomegalovirus infection in AIDS patients.
20. Where in an AIDS patient's surroundings might MAC organisms be found?
1. About how many people have died of AIDS in the United States since the epidemic of HIV disease began?
2. All of the following symptoms are characteristic of the AIDS related complex (ARC), except
E. weight loss.
3. Which one of the following is true of Kaposi's sarcoma?
A. HHV-8 is necessary for development of the tumor.
B. HIV-1 is necessary for development of the tumor.
C. Both HHV-8 and HIV-1 are necessary for development of the tumor.
D. HHV-8 alone is sufficient for development of the tumor.
E. Both HHV-8 and HIV-1 together are sufficient for the tumor to develop.
4. All of the following are HIV accessory genes, except
5. When was AIDS first recognized as representing a new disease?
6. All of the following are AIDS-defining conditions, except
B. herpes simplex of the esophagus.
C. Pneumocystis carinii pneumonia.
D. invasive cancer of the uterine cervix.
E. Kaposi's sarcoma.
7. Which of the following types of cells can be infected by HIV?
A. Th cells
B. Intestinal epithelium
C. Antigen-presenting cells
D. Brain cells
E. All of the above
8. All of the following are HIV antigens, except
9. Which of the following is a cause of Th cell death in HIV disease?
A. Replication of HIV lyses the cell.
B. Infected cells are destroyed by cytotoxic T cells (Tc).
C. Infected cells are attacked by natural killer cells.
D. Cells are killed by fusion and syncytium formation.
E. All of the above.
10. Highly active antiretroviral therapy (HAART) is less than ideal because
A. it does not eliminate latent HIV infection.
B. its cost is too great for 90% of AIDS sufferers.
C. it often has severe side effects.
D. some HIV strains are resistant to it.
E. All of the above.
1. An epidemiologist from the Centers for Disease Control and Prevention was presenting a report on the status of AIDS to a congressional committee. In concluding her remarks, she noted that from an epidemiological perspective it was more important to focus on HIV infection than on AIDS, and urged that the Congress consider redirecting funding of AIDS research to reflect this fact. What was the rationale for her request?
2. A historian researching the influence of society on the spread of communicable disease began to speculate on what it would be like if AIDS had appeared at a different time. What differences might one expect, for example, if AIDS had appeared in 1928 instead of 1978?
3. A newly emerging virus lethal for all felines is rapidly killing off household cats and related zoo animals. The CDC urgently appeals for funds to develop a vaccine against the virus, but a scientific adviser to Congress states that it would be very expensive and may not be possible. Moreover, she states that getting rid of cats would have the side benefit of ridding the world of toxoplasmosis. Is she correct? If so, how long would it take?
1. Vaccines have effectively prevented many viral diseases, witness smallpox and poliomyelitis. Attempts over many years to develop an effective vaccine against HIV disease and AIDS, however, have so far met with little success. Why might this be so?
2. A basic problem in searching for a cure of HIV disease is that the viral genome is "hidden" as a provirus in many host cells. These cells do not express viral antigens on their surface and are not detected by cellular immunity. If the cell becomes activated,
764 Chapter 29 HIV Disease and Complications of Immunodeficiency however, the viral genome leaves the host cell chromosome, it begins to replicate, and viral antigens appear on the host cell surface. Also, antiviral medications are active against the replicating virus. Why not try to find a way deliberately to activate all the infected cells?
3. The graph shows the survival of individuals with HIV disease and different quantities of circulating virus (copies of HIV RNA per ml of blood plasma) early in their infection. How do you interpret these data? What are the implications for treatment of people with HIV disease?
4. Why is reverse transcriptase needed in order for HIV to become a provirus?
Initial viral load (HIV RNA copies per milliliter of plasma)
Years after viral load was measured
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