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  • 1. Fields  of  Chemistry  in   HIV/AIDS   Ildiko Sebyll Onbasi! Vienna University of Technology! sebyllonbasi@yahoo.com ! ECTNA International Open Contest ! for students and young chemists,2013!
  • 2.    Introduc:on  
  • 3. Introduc:on   THE   SCIENTIFIC   DISCIPLINE     OF   CHEMISTRY   PROSPECTS   OF   ADAPTATION   WITH   THE   REVOLUTIONARY   TECHNICAL   TOOLS.   THESE   WIDESPREAD   DEVELOPMENTS   AND   UTILIZATION   HAS   A   SIGNIFICANT   IMPACT   IN   OUR   SOCIETY.   IT   CAN   BE   MEASURED   FROM   THE   INDUSTRIAL   LEVEL   TILL   THE   PUBLIC   HEALTH.   THIS   FACTS   LEAD   US   TO   CONSIDER   THE   IMPORTANCE   AND   THE   BEAUTY   OF   THIS   COLLABORATIVE   SCIENCE,   WHICH   IS   THE   CRUCIAL    CONTRIBUTOR  FOR  IMPROVING  THE  QUALITY  OF  LIFE.  
  • 4. LETTER  TO  CHEMISTS…   CHEMISTS   ARE   OBSERVER,   WHO   LOOK   AT   THE   ATOMS,   MOLECULES   AND   ANALYZE   HOW   DO   THEY   INTERACT.   WE   HAVE   THE   TOOLS   AND   THE   THEORY   TO  UNDERSTAND  THE  COMPLEXITY  OF  NATURE.  THE   RESEARCH   GIVES   THE   DIRECTION   TO   UNDERSTAND   THINGS   AND   DESIGN   AT   A   MOLECULAR   LEVEL.   CHEMISTS   CAN   MANIPULATE/CREATE   MOLECULES   AND   FUNCTIONS   THAT   MIGHT   HAVE   A   GREAT   CONSEQUENCE.    
  • 5. AREAS  OF  CHEMISTRY  IN  AIDS   GENERAL  CHEMISTRY     Nutri:ve  elements  of  metals  and  non-­‐metals,    e.g.  Mg,  Ca,  Fe  and  Zn,  Se  &  I   play  an  important  role  to  manage    HIV  disease.  Most  reac:ons  in  pa:ents   result  in  produc:on  of  free  radicals  (ozone  reac:ons)  that  are  oncogenic   predisposing  to  cancer.  Popula:ons  in  areas  where  soils  are  rich  in  selenium   have  low  HIV  prevalence  (West  Africans).     Chemical  reac:ons,  An:gen  and  an:bodies  in  HIV  infec:on.  The  responsible   forces  for  ag/ab  interac:ons  are  weak  chemical  bonds  (Van  der  Waals).       Chemical  bonding  in  HIV  (binding  of  gp0  and  the  CD    receptors  of  target   cells).  The  binding  of  an:gen  and  an:body  in  HIV  involves  weak  forces  and   may  result  in  precipita:on  reac:ons.  The  forces  governing  interac:ons   during  HIV  tes:ng  (Enzyme  Linked  Immunosorbent  Assays)  are  weak  Van  der   Waals  interac:ons.    
  • 6.   Lace  energy:  A  HIV/AIDS  pa:ents  need  a  lot  of  energy.     opportunis:c  infec:ons  in  HIV  disease.   HIV  screening  as  a  measure  of  determining  purity  i.e.  Absence  of  HIV.            Irreversible  reac:ons  analogous  to  HIV  infec:on.  The  nature  of  co-­‐ receptors  on  the  CD  determines  the  suscep:bility  to  HIV.  Africans   compared  to  other  races.    Healthy  individual  +  Infected  Individualè  HIV  infected  (Irreversible).   The  rates  of  reac:ons  are  analogous  to  disease  progression  in  HIV   infec:on.  The  higher  the  viral  load,  the  higher  the  risk  of  MTCT,  HIV   infec:on  and  progression  to  AIDS.  
  • 7. PHYSICAL  CHEMISTRY           Risk  factors  in  HIV  infec:on:  mul:ple  sexual  partners,  drug  and  substance   abuse,  poverty,  malnutri:on,  pregnancy  are  analogous  to  rate  limi:ng   factors  of  reac:ons.    Factors  that  decelerate  the  rate  of  HIV  progression  to  AIDS:  An:retroviral   drugs,  Vitamin  A,  elec:ve  caesarean  sec:on,  healthy  ea:ng  habits.   Catalysis:  bioorganic  enzymes  that  facilitate  replica:on  of  the  HIV.  Catalysts   are  analogous  to  factors  that  enhance  progression  of  HIV  to  AIDS  such  as   malnutri:on,  mul:ple  sexual  partners,  drug  and  substance  abuse,   pregnancy,  steroid  therapy  etc.   ARV  (An:  Retro  Viral)  acts  as  inhibitors  of  HIV  replica:on.  The  role  of  ARV  as   targets  of  drug  ac:on  by  inhibi:ng  the  HIV  life  cycle.  The  role  of  ARV’s  in   Post  Exposure  Prophylaxis  (PEP)  following  accidental  contact  with  HIV   infected  fluids.  Mul:ple  infec:ons  from  mul:ple  sexual  partners  are   analogous  to  second  and  third  order  reac:ons.    
  • 8.   HIV  affects  the  entropy  of  the  body  by  disrup:ng  body  processes  by  causing   generalized  immunosuppression.  The  higher  the  viral  load,  the  higher  the   degree  of  entropy.     The  irreversibility  cells  by  HIV.     Weak  acids  and  bases  analogous  to  different  strains  of  HIV.  Some  are  more   virulent  than  others.     Chromatographic  techniques  in  HIV  diagnosis.     Protec:ve  mechanisms  of  HIV  with  emphasis  of  cellular  immune  responses   which  could  be  measured  in  a  recall  prolifera:ve  responses  by  use  of   radionucleids  (T).     Comparison  between  radioac:ve  decay  with  decline  of  CD    cells  following   HIV  infec:on.     The  analogy  between  nuclear  fusion  and  the  fusion  of  HIV  and  the  target  cell   should  be  used  to  describe  the  target  cell  of  HIV  and  the  role  of  ARV  in   blocking  fusion.     Compare  half  life  of  radioisotopes  and  the  half  life  of  the  T  cell.  The  role  of   radioisotopes  in  HIV  diagnosis,  effects  of  ARV’s  and  HIV  pathogenesis  and   complete  destruc:on  of  infected  host.  
  • 9. SPECTROSCOPIC  METHODS     OF  ANALYSIS     Use  of  spectroscopic  methods  in  HIV  tes:ng.Direct  and  indirect   ELISA.     The  basis  of  HIV  tes:ng,  benefits  for  posi:ve  and  nega:ve  persons   and  the  barriers  that  hinder  tes:ng.  The  role  of  HIV  tes:ng  in   mi:ga:ng  the  spread  of  HIV.  The  use  of  Indirect   Immunofluorescent  Assay  (IFA)  as  a  confirmatory  test  for  HIV.     The  use  of  fluorescence  to  determine  drug  ac:on  on  selected   organs.  The  role,  mode  of  ac:on,  side  effects  and  barriers   hindering  ARV  usage  among  PLWAs.     X-­‐ray  crystallography  in  analysis  of  the  composi:on  of  drugs  and   screening  of  opportunis:c  infec:ons  (ARV).  
  • 10. KINETICS  AND  ELECTROCHEMISTRY     HIV  concentra:on  in  body  fluids  (Viral  load)  influences  the  efficiency  of  fluids   in  HIV  transmission.     Factors  increasing  the  risk  of  HIV  infec:on.  Also  influencing  progression  from   HIV  to  full-­‐blown  AIDS  as  analogy.  Applica:ons  of  electromo:ve  force  in  HIV   tes:ng.  Benefits  of  HIV  tes:ng.   COORDINATION  CHEMISTRY     Mul:-­‐dentate  and  chela:ng  proper:es  of  protein  (e.g.  in  HIV).     The  charge  transfer  in  chromophores  (S,  P,  N,  O  etc  in  proteins).     Haemoglobin  as  a  metallo-­‐protein  complex:  role  in  uptake  and  distribu:on   of    oxygen  in  human  body.     The  role  of  iron  in  HIV  disease  Important    
  • 11. SURFACE  AND  COLLOID  CHEMISTRY     The  more  the  HIV  par:cles  adsorbed  on  the  cell  the  more  the   destruc:on  of  the  CD  cells.     HIV  only  binds  on  CD  selec:vely;  colloidal  nature  of  protein  separa:on  in   electrophoresis.       Chromatographic  techniques  in  separa:on  of  HIV  proteins.  The  role  of   HIV  proteins  in  HIV  replica:on.  
  • 12. ADVANCED  ORGANOMETALLIC  AND   SOLID  STATE  CHEMISTRY     Catalysts  in  drug  synthesis  (ARVs/ART).  Solid  state  behaviour  of  ARVs.  Applica:on  of   organometallic  chemistry  in  synthesis  of  ARVs     Organometallic  laces  for  rapid  HIV  tes:ng.     Zeigler-­‐Naga  catalysis  in  polymerisa:on  alkenes  for  making  polythene  (condoms).  HIV   preven:on  and  protec:on.  
  • 13. SECONDARY  METABOLITES     AND  BIOMOLECULES       Biosynthesis  of  RNA  the  role  of  reverse  transcriptase  in  HIV  replica:on.     RT  as  a  target  for  chemotherapeu:c  agack.  ARV  drugs,  mode  of  ac:on,   limita:ons  in  use.     Viruses  as  ae:ological  agents  of  disease:  The  example  of  HIV.    
  • 14. ENVIRONMENTAL  CHEMISTRY     The  epidemic  is  related  to  global  issues  like  poverty,  water  pollu:on  and   water  waste  treatment  .     Cleanliness  of  water  is  analogous  to  HIV  free  body.  Contaminated  water  is   analogous  to  a  body  infected  by  HIV  .  Rela:onship  between  malaria  and  HIV   infec:on.     Importance  of  pure  drinking  water  in  HIV  infected  persons.  Water  harves:ng   and  storage.  
  • 15. BIOCHEMICAL  ANALYSIS     Solvent  extrac:on  of  RNA  from  viruses  for  HIV  characteriza:on.  HIV  the   ae:ological  agent  for  AIDS.     Enzyma:c  analysis  methods.  The  role  of  enzyme  based  assays  for  HIV   diagnosis.  Immunoassays  in  determina:on  of  immune  effectors   (an:bodies).     The  role  of  blood  and  other  fluids  in  transmission  of  HIV.  Methods  of   contac:ng  infected  blood  (blood  transfusion,  sharing  of  sharp  objects,   intravenous  drug  users,  cultural  prac:ces,  accidental  contact  among   researchers,  health  care  givers,  TbA’s  etc).     The  role  of  radioimmunoassay  in  determining  IgG  levels  in  HIV  infected.     Proper:es  and  func:ons  of  an:bodies.  An:bodies  as  therapeu:c  agents   in  HIV  infec:on,  Monoclonal  an:bodies  as  diagnos:c  agents.  
  • 16. GLOBAL  PERSPECTIVE  
  • 17. HIGHLIGHT  ON  AUSTRIA     The  XVIII  Interna:onal  AIDS  Conference  2010  was    in  Vienna.     Life  Ball    AIDS  charity  event    in  Vienna  (May,  2013).      AIDS  Day  in  2011,  Mogo  :  Geng  To  Zero    (Minister  for  Health   Alois  Stöger).      Austrian  HIV  Cohort  Study  (AHIVCOS)  has    gained  approval  of  the   ethical  commigees  for  the  majority  of  the  HIV  treatment  centers   (AKH  Vienna,  Ogo-­‐Wagner-­‐  Hospital  Vienna,  AKH  Linz,  LKH   Innsbruck  and  LKH  Graz  West,  LKH  Salzburg  and  LKH  Klagenfurt)     The  report  proves  that:  Austrians  living  with  HIV  and  AIDS  can  rely   on  their  health  care  system.       the  Austrian  social  insurance  system  accepts  the  incurring  costs   almost  fully.       Tests  and  therapies  are  largely  free  of  cost.      In  Austria,  as  opposed  to  other  countries,  HIV  is  not  a  mandatorily   no:fiable  disease.  This  has  not  proven  to  be  a  disadvantage,  since   our  health  and  welfare  systems  are  well  equipped  to  handle  any   chronic  disease.  Nonetheless,  the  significance  of  HIV  and  AIDS   should  not  be  minimized.  
  • 18. HIV  -­‐  THE  TREATMENT  GAP  IN  LOW-­‐   AND  MIDDLE-­‐INCOME  COUNTRIES  
  • 19. SUMMARY  OF  HIV/ AIDS  TARGETS     Drug  Strategies  to  Target  HIV     Enzyme-­‐Targe:ng  Drugs  to  Fight  HIV     HIV  Agacks  Helper  T  Cells       Research  indicates  importance  of  individuals  knowledge,  community  and  peer   approaches  tailored  to  specific  modes  of  transmission  and  links  between  HIV   tes:ng/care     Global  solidarity  and  shared  responsibility  (preven:on).     People  make  the  difference:  individuals,  scien:sts  ,  caregivers,  leaders  etc.     Demonstrate  the  importance  of  con:nued  HIV      Investments  to  broader  health  and  development  goals     Innova:ons  in  Science,  hope  and  need  (therapeu:c  advances  ,HIV  vaccine),   microbicides     More  research  is  needed  to  improve  the  available  treatments,  making  them   more  tolerable  to  pa:ents  and  more  accessible.     To  succe  figh:ng  epidemics  it’s  also  important  to  develop  the  basic  sustainable   life  standards  in  countries  with  high  poverty  rate     Basic  access  for  health-­‐care,  pure  water     In  June  2011,  52  countries  had  implemented  one  of  more  elements  of  the   WHO’S  HIV  drug  resistance  preven:on  and  assessment  strategy,  and  27   laboratories  had  become  members  of  the  WHO  HIV  drug  resistance  laboratory   network.  (Par:cipated  from  Austria  :  Fabienne  Hariga,  office  UN  Austria)     The  WHO  Global  health  sector  strategy  on  HIV/AIDS,  2011–2015  guides  the   health  sector  response  to  HIV  epidemics  in  order  to  achieve  universal  access  to   HIV  preven:on,  diagnosis,  treatment,  care  and  support  
  • 20. Elements  of  the  AIDS  response   h#p://www.unaids.org/en/media/unaids/contentassets/images/ infographics/2011/20110607_ElementsAIDSresponse_en.pdf  
  • 21. “  We  all  want  to  change  the  world  ,,   The  Beatles Showing impact: HIV treatment saves lives The number of people dying from AIDS-related causes began to decline in the mid-2000s because of scaled up antiretroviral therapy and the steady decline in HIV incidence since the peak of the epidemic in 1997. In 2011, this decline continued, with evidence showing that the drop in the number of people dying from AIDS-related causes is accelerating in several countries. 673 413413 Source: UNAIDS 2012 Global Report 39% Germany 18 13 28 % 28% Croatia Croatia 508 373 27% Bahamas 6,678 4,862 27% 3,208 49 Mexico 1,646 % 10,884 9,925 5,825 4,323 46% 61% Haiti Jamaica 6,157 Dominican Republic 36 Guinea 12,717 47 243 60% 56% Guyana 675 294 Suriname 6,722 55 3,029 % 2,196 Peru 1,592 299 % Paraguay 46,684 AIDS-related deaths 46,684 22,800 49% 30 19,788 19,788 6,614 4,630 4,630 15,337 Ghana 22,800 51% (2005 - 2011) Country 26% Djibouti Ethiopia 23,147 49% Thailand 6,232 1,449 77% Cambodia Benin % 880 2,759 Côte d’Ivoire 21,803 1,184 53,831 53% Central African Central African Republic Republic 30% 6,353 68% 70,685 133,503 Kenya 11,904 31,282 56 % 56% 61,691 54% Rwanda Congo 12,825 5,184 5,184 60 % 2,113 131,704 37 5,787 51% 83,528 % 1,134 46% Papua New Guinea United Republic of Tanzania Burundi 4,208 71% Botswana 147,876 Namibia Namibia 370,874 AIDS-related deaths in 2011 Percentage of decline in Liberia 113,825 14,542 14,542 399 25 AIDS-related deaths in 2005 30% 51% 45,146 Eritrea Zambia Zambia 28% Bolivia 2,331 1,402 34% 10,278 10,278 31% 31% % 5,451 3,353 2,121 Chad Chad 14,982 6,758 Burkina Faso Barbados 12,034 25%% 25 Mali 4,028 35% 26 28% 600 15,967 15,967 6,553 34% 1,696 270,190 27 % 27% 76,589 43,858 43% Malawi 58,339 61% Zimbabwe South Africa South Africa 9,914 21,714 36 13,986 % 6,813 31% Swaziland Lesotho 18 UNAIDS World AIDS Day Report 2012 Thank  you!   Results 19