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Paper II — 2022 October (Supplementary) (2010 Scheme) — Q9

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Paper II
2022 October (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Opportunistic viral infections in AIDS patients.

Q92 marksShort Notes

Answer

Opportunistic viral infections in AIDS patients — reactivation or severe manifestation of viral infections that are generally mild/latent in immunocompetent hosts, becoming significant in advanced HIV/AIDS due to loss of cell-mediated immune surveillance:

  1. Cytomegalovirus (CMV) — causes CMV retinitis (a leading cause of blindness in untreated AIDS), colitis, and oesophagitis, from reactivation of latent infection.
  2. Herpes simplex virus (HSV) — causes severe, chronic, non-healing mucocutaneous ulcers (particularly oro-genital/perianal) in advanced AIDS, distinct from the typical self-limiting lesions in immunocompetent hosts.
  3. Varicella-Zoster virus (VZV) — causes severe, sometimes multidermatomal or disseminated herpes zoster.
  4. JC virus — reactivates to cause Progressive Multifocal Leukoencephalopathy (PML), a demyelinating CNS disease.
  5. Human Papillomavirus (HPV) — causes more extensive and treatment-resistant anogenital warts, and a higher risk of HPV-related anogenital malignancy.
  6. EBV — associated with oral hairy leukoplakia and an increased risk of EBV-driven lymphomas (e.g., primary CNS lymphoma) in advanced AIDS.

Clinical significance: the specific viral opportunistic infection often correlates with the degree of CD4 depletion, and their recognition is important for both diagnosis and for guiding decisions about initiating/optimizing antiretroviral therapy to restore immune function.

  1. 1General Properties of Viruses and Virus Host Interaction

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