Basics of HIV for Esproute

1. Basics of HIV

2. What is HIV ?
H - uman
• Found in Humans
• Transmitted among humans
I - mmunodeficiency
• Immune system is weakened and
lacks ability to fight infections
V-irus
• Is an antigen that causes a production of
antibodies in the body
Human Immunodeficiency Virus

3. What is AIDS?
A - cquired – Received
I - mmuno – Resistance to the disease
D - eficiency – A lack of (Immune system)
S - yndrome – a group of symptoms or disease
Acquired Immuno Deficiency Syndrome

4. Structure of HIV
Anti HIV drugs are designed to inhibit these enzymes and thus prevent the virus from
multiplying and damaging the immune system
Important components of the HIV structure
• HIV RNA
HIV virus contains RNA as genetic
material (in contrast, humans have DNA
as genetic material)
• 3 Enzymes
Reverse Transcriptase
Integrase
Protease

5. Sexual
transmission
Heterosexual
Homosexual
Infected mother
to child
• During
pregnancy
• During delivery
• Breast feeding
Use of Infected
syringes
• Among drug
users
• Healthcare
settings
Occupational
• Healthcare
workers
Blood
transfusions
Transmission of HIV

6. What happens in HIV Infection
Without Treatment, Opportunistic Infection can be Life Threatening

7. HIV and Opportunistic Infection
HIV causes a wide variety of opportunistic infection
Opportunistic Infections in HIV/AIDS
Brain
Toxoplasmosis (Toxo)
Cryptococcal meningitis
Eyes
Cytomegalovirus (CMV)
Mouth & Throat
Candidiasis (Yeast)
Lungs
Pneumocystis carinii pneumonia (PCP)
Tuberculosis (TB)
Histoplasmosis
Gut
Cytomegalovirus (CMV)
Cryptosporidiosis
Mycobacterium avium complex (MAC)
Skin
Herpes simplex, Shingles
Genitals
Genital Herpes, Human papillomavirus (HPV),
Vaginal Candidiasis (Yeast)

8. Diagnosis of HIV
2 Approaches
Detect Antibodies Detect Viral RNA
Detection of antibody is the most
common method of HIV diagnosis
Detection of viral RNA is a more
sophisticated way of HIV diagnosis

9. What are Antiretrovirals (ARVs)?
• ARVs are medications taken for the treatment of HIV infection
• They prevent the HIV virus from multiplying in the body
Drug Class Short Form Mode of Action
Nucleoside Reverse Transcriptase Inhibitor NRTI Inhibits the enzyme Reverse Transcriptase
Non-Nucleoside Reverse Transcriptase
Inhibitor
NNRTI Inhibits the enzyme Reverse Transcriptase
Protease Inhibitor PI Inhibits the enzyme Protease
Integrase Strand Transfer Inhibitor INSTI Inhibits the enzyme Integrase
Entry Inhibitor/ Fusion Inhibitor Inhibits the entry into the CD4 cells
There are 5 classes of ARVs:

10. Antiretroviral Drugs Available for Treating HIV/AIDS
NRTI
(Nucleoside Reverse
transcriptase Inhibitors)
NNRTI
(non nucleoside
reverse
transcriptase
inhibitors)
PI
(Protease
inhibitors)
Entry
Inhibitor/
Fusion
Inhibitor
Integrase
Inhibitor
Zidovudine(AZT, ZDV)
Didanosine(ddI)
Stavudine(d4T)
Lamivudine(3TC)
Abacavir(ABC)
Emtricitabine(FTC)
Tenofovir disoproxil
fumarate(TDF)
Tenofovir Alafenamide
(TAF)
Nevirapine (NVP)
Efavirenz (EFV)
Rilpivirine (RPV)
Etravirine (ETV)
Atazanavir (ATV)
Darunavir(DRV)
Lopinavir (LPV)
Ritonavir (RTV)
Saquinavir (SQV)
Nelfinavir (NFV)
Indinavir (IDV)
Enfuvirtide
(ENF)
Maraviroc
(MVC)
Raltegravir (RAL)
Dolutegravir
(DTG)
Elvitegravir
(EVG)

11. What is Antiretroviral Therapy (ART)?
• ART is combination of 3 antiretroviral (ARV) drugs taken to maximally suppress the HIV
virus and stop the progression of HIV disease.
• It consists of specific combinations of 3 ARVs eg:
2 NRTIs +NNRTIs or
2NRTIs + PIs
Triple regimen is effective in preventing the virus from multiplying in the body
Since the virus is inhibited the immune system is preserved
This results in a long and healthy life in a HIV-infected individual
Point To Note:
• ART does not cure HIV infection
• Hence, ART needs to be taken life long and consistently for the treatment to be effective