Quiz 2: Clinical and immunological diagnosis of HIV infection

Please choose the one, most correct answer to each question or statement.

1. During the first 6 weeks after HIV infection:
   • The child always becomes seriously ill.
   • The CD4 count rises.
   • The amount of HIV in the blood increases.
   • The haemoglobin concentration falls.
2. Acute seroconversion illness usually presents with:
   • A glandular fever-type illness
   • Jaundice
   • Anaemia
   • Vaginal or urethral discharge
3. How long is the latent phase of HIV infection in children who are infected at birth?
   • 10 days
   • 6 weeks
   • About three to six months
   • Usually five to 10 years
4. What is the value of knowing the clinical stage of HIV infection?
   • The clinical stage predicts what the prognosis will be, especially without antiretroviral treatment.
   • It helps to diagnose symptomatic HIV infection at birth.
   • Antiretroviral treatment is not useful in stage 3 and 4 HIV disease.
   • It is of very little clinical help.
5. When is HIV infection called advanced HIV disease in children?
   • At any stage of symptomatic HIV infection.
   • If the clinical stage is 3 or 4.
   • If the CD4 percentage is below 20.
   • If the viral load is above one million copies/ml.
6. Which clinical sign is common in stage one HIV infection?
   • Night sweats
   • Fever
   • Persistent generalised lymphadenopathy
   • Weight loss
7. Which clinical condition is common in stage 2 HIV infection?
   • Skin rash
   • Severe diarrhoea
   • Extrapulmonary tuberculosis
   • Oral candidiasis (thrush)
8. A common clinical condition in stage 3 HIV infection is:
   • Severe recurrent bacterial pneumonia
   • Pneumocystis pneumonia
   • Enlarged parotid glands
   • Hydrocephaly
9. What clinical condition indicates that an HIV-positive child has stage 4 disease?
   • Oral candidiasis
   • Oesophageal candidiasis
   • Diarrhoea for less than two weeks
   • Persistent fever
10. Unexplained severe malnutrition with wasting that does not respond to feeding indicates that the HIV infection has reached what clinical stage?
    • Stage 1
    • Stage 2
    • Stage 3
    • Stage 4
11. What skin rash is common in children with HIV infection?
    • Acne
    • Urticaria
    • Kaposi’s sarcoma
    • Pruritic papular eruption
12. What form of cancer is more common in children with HIV infection?
    • Cervical cancer
    • Leukaemia
    • Lymphoma
    • Neuroblastoma
13. What test is used to screen children older than 18 months for HIV infection?
    • VDRL test
    • PCR test
    • HIV culture
    • Rapid test
14. How many HIV PCR tests are needed to confirm that an infant is infected with HIV?
    • One
    • Two
    • Three
    • Four
15. Which test can confirm that a six-week-old infant has HIV infection?
    • PCR test
    • Rapid test
    • ELISA test
    • CD4 test
16. Viral tests for HIV infection usually become positive when the person has been infected for:
    • Six days
    • Less than six weeks
    • Six months
    • Six years
17. What is the normal CD4 percentage in children?
    • Below 10%
    • 10 to 25%
    • 25% or more
    • 100%
18. During the progression of untreated HIV infection the CD4 count:
    • Rises
    • Falls
    • Stays the same
    • Is not important
19. What is the value of knowing the CD4 percentage?
    • The lower the CD4% the greater the risk of severe illness.
    • The higher the CD4% the greater the risk of death.
    • A low CD4% indicates that the child’s immune system is improving.
    • A normal CD4% indicates that the child does not have HIV infection.
20. In South Africa, who can give consent for a child to be tested for HIV?
    • The consent of both parents is always needed.
    • The consent of the medical superintendent is always needed.
    • A child of 12 years or older can give consent.
    • Any child attending school can give consent.