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Management of HIV Infection in Prison Populations

Diagnosis and Reporting

1. The CDC recommends the use of an HIV-1/2 antigen/antibody combination immunoassay (fourth-generation) algorithm as the best method to accurately detect and diagnose an individual with early (<6 months) or acute HIV infection.

A. True

B. False


2. Although third-generation HIV testing is highly sensitive and specific, it has which drawback?

A. It cannot detect acute infection.

B. It does not readily differentiate between HIV-1 and HIV-2.

C. Negative or indeterminate results on Western blots during early seroconversion can delay diagnosis.

D. All of the above.


3. All of the following are true with regard to HIV-2, except for:

A. HIV-2 is associated with lower viral load levels compared with HIV-1.

B. HIV-2 resulting in AIDS is associated with much higher viral load levels than AIDS resulting from HIV-1.

C. HIV-2 has slower rates of CD4 decline compared with HIV-1.

D. HIV-2 has slower rates of clinical progression compared with HIV-1.


4. Which of the following is one of the most distinctive manifestations of acute HIV infection?

A. Painful mucocutaneous ulceration

B. Lymphadenopathy

C. Rash

D. Myalgia / arthralgia


Baseline Medical Evaluation for HIV-Infected Inmates

5. As long as cervical cancer screenings in HIV-infected women are normal, screenings should end at 65 years of age.

A. True

B. False


6. All of the following immunizations are recommended for all HIV-positive adults, except for:

A. Hepatitis B vaccine

B. Influenza vaccine

C. Measles, mumps, rubella, and varicella combination vaccine

D. Meningococcal vaccine


Periodic Medical Evaluations for HIV-Infected Inmates

7. HIV-infected patients appear to have a higher risk of which medical condition compared to the general population?

A. Metabolic complications

B. Neuropsychiatric disorders

C. Certain malignancies

D. All of the above


8. Which surrogate marker is used routinely to assess level of HIV viremia?

A. CD4 count

B. Plasma HIV RNA

C. Both (A) and (B)

D. None of the above


Prophylaxis for Opportunistic Infections (OIs)

9. Primary prophylaxis for opportunistic infections is indicated for inmates with HIV infection and significant immunosuppression to prevent acute illnesses that may require hospitalization.

A. True

B. False


10. The preferred treatment regimen for LTBI is all of the following, except for:

A. Isoniazid

B. Pyridoxine

C. Rifapentime

D. Baseline liver transaminases tests


11. Which of the following is a factor to consider before discontinuing secondary prophylaxis for cytomegalovirus?

A. The inmate adherence to ART.

B. The location and extent of retinal disease.

C. The vision in the contralateral eye.

D. All of the following.


Initiating ART in Treatment-Naive Patients

12. ART is recommended by DHHS for all HIV-infected patients to reduce the risk of disease progression and to prevent transmission of HIV.

A. True

B. False


Initial Combination Regimens for the ART-Naive Patient

13. Which of the following regimens are recommended because of their high virology efficacy and their excellent safety and tolerability profiles?

A. INSTI-based regimens

B. PI-based regimens

C. NNRTI-based regimens

D. NRTI-based regimens


14. Which of the following is preferred for patients who must start ART before the genotype is available, due to a relatively high genetic barrier to resistance?

A. INSTI-based regimens

B. PI-based regimens

C. NNRTI-based regimens

D. NRTI-based regimens


Management of the Treatment-Experienced Patient

15. If no drug resistance is identified, a “failing regimen” is almost always associated with:

A. Medication intolerance

B. Pharmacokinetic issues

C. Suboptimal adherence

D. All of the above


Considerations for ARV Use in Patients with Coinfections

16. Chronic HBV substantially alters the progression of HIV infection and influences HIV suppression and CD4 cell responses following ART initiation.

A. True

B. False


Immune Reconstitution Inflammatory Syndrome (IRIS)

17. Current evidence shows that in order to decrease the risk of clinical progression to AIDS and possible death, initiation of ART should generally not be delayed for more than two months after starting treatment for an underlying infection.

A. True

B. False


Infection Prevention and Control

18. While a sustained viral load below the limits of detection will dramatically reduce the possibility of HIV transmission, it does not absolutely assure the absence of HIV in the genital and blood compartments and, hence, the inability to transmit HIV to others.

A. True

B. False


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