H: Infects only Human beings I: Immunodeficiency Virus weakness the Immune system and increases the risk of infections V: Virus that attacks the body and finally kills the body’s immune system

1. HIV/AIDS
AmjadKhanAfridi
Lecturer,
Department of Health & Biological Sciences
World AIDs Day, 1st December

2. INTRODUCTION

3. What is HIV?
Human immunodeficiency virus (HIV)
H: Infects only Human beings
I: Immunodeficiency Virus weakness the Immune system
and increases the risk of infections
V: Virus that attacks the body and finally kills the body’s
immune system

4. What is HIV?
 Group: Lentivirus
 Subgroup: Retroviruses
 All viruses except Retroviruses contain DNA
 Other Lentiviruses include SIV, FIV, Visna and
CAEV, which cause diseases in monkeys, cats,
sheep and goats.
Human immunodeficiency virus (HIV) is a type of virus that specially targets white
blood cells called Helper-T cells (CD4 cells). By killing more and more of these
cells, the body's immune defenses are weakened and eventually compromised. There
is ongoing damage to immune defense cells. As this happens, the body becomes
increasingly less able to fight off infections. When this happens, a person is said to
have acquired immunodeficiency syndrome (AIDS).

5. What is HIV…?
 Human immunodeficiency virus (HIV) is a type of virus that
specially targets white blood cells called Helper-T cells (CD4 cells).
 By killing more and more of these cells, the body's immune defenses
are weakened and eventually compromised.
 There is ongoing damage to immune defense cells. As this happens,
the body becomes increasingly less able to fight off infections.
 When this happens, a person is said to have acquired
immunodeficiency syndrome (AIDS).
 Human immunodeficiency virus (HIV) is a virus that can be
transmitted from someone with HIV to someone without through
body fluids like semen, blood, vaginal secretions, and breast milk.

6.  HIV enclosed with coat called viral
envelope.
 This envelop possess little spikes around 72
in numbers.
 These spikes are made of proteins gp120
and gp41.
 Bellow the envelop a layer is present called
matrix, made of protein p17 (Matrix
proteins)
 Bellow the matrix another layer of protein
p24 forming viral core (capsid) and usually
bullet-shaped.
 Inside the core, three types of enzymes are
present which are required for HIV
replication called (Reverse transcriptase,
Integrase and protease).
 Inside the core, HIV genomes are present,
which consists of two identical copies of
ssRNA.
HIV Structure

7. Where it came from?
 In 199: Was found that, Chimpanzees Virus, SIV (Simian
Immunodeficiency Virus) almost identical to HIV.
 Chimpanzees were the source of HIV-1 Virus from chimps to
human.
 More research: How SIV could have developed in the chimps?

9. How did virus cross from chimps to Humans?
Simple and plausible theory: “ Hunter Theory”
or “ Bush Meat Theory”
Blood of chimps getting into cuts or wounds on
the human hunter.

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Epidemiology
 Since the first cases of AIDS were identified in 1981,
close to 30 million people have died as a result of HIV
infection. This makes AIDS one of the most destructive
epidemics in recorded history.
 In 2009, HIV infected approximately 33 million people
worldwide. Approximately 68% of these cases are in
sub-Saharan

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Epidemiology
 In 2009 alone, approximately 1.8 million
people died from AIDS and 2.6 million
people were newly infected with HIV.
 Most of these infections were acquired
through heterosexual transmission.
 As of December 2009, women accounted for
52% of all people living with HIV worldwide.
 Persons aged 15 to 24 years accounted for
approximately 40% of new HIV infections
worldwide.

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HIV virus infection
 The HIV Virus:
 Invades the helper-T cells (CD4
cells) in the body of the host
(defense mechanism of a person).
 Is threatening a global epidemic.
 Is preventable & manageable but is
NOT curable.

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HIV and AIDS
 When the immune system becomes
weakened by HIV, the illness
progresses toAIDS
 Some blood tests, symptoms or
certain infections indicate
progression of HIV toAIDS

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HIV and AIDS
 AIDS Predisposes our body to other
opportunistic infections.
 Opportunistic infections and malignancies that
rarely occur in the absence of severe
immunodeficiency (e.g. Pneumocystis
pneumonia, central nervous system lymphoma).
 Persons with positive HIV serology who have
ever had a CD4 lymphocyte count below 200
cells/mcL or a CD4 lymphocyte percentage
below 14% are considered to haveAIDS.
24th May, 2022

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Types of HIV
 HIV –1
 Group M- 9 subtypes, 90% of all cases
world wide
 Group O (Now able to be detected with most
routine HIV antibody tests)
 HIV – 2
 1% of cases world wide
 Slower progression
 WestAfrica
 79 cases in US, but most wereAfrican born

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HIV-1 and HIV-2
 Transmitted through the same routes
 Associated with similar opportunistic infections
 HIV-1 is more common worldwide
 HIV-2 is found in WestAfrica,
Mozambique, andAngola
 HIV-2 is less easily transmitted
 HIV-2 is less pathogenic
 Duration of HIV-2 infection is shorter

19. HIV Pathogenicity

21. RISK FACTORS

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Risk Factors
I. Sexual Practices that promote Disease
Transmission
 Under the influence of drugs
 Multiple partners
 Sores in genital area

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Risk Factors
II. Exposure to blood/body fluids
 Administration of blood or blood products
 Transplantation of tissue or organs
 Implantation of infected semen
III. Use of injected drugs (drug abuse)
IV. Occupational exposure
o Accidental needle stick
V. HIV-infected mothers to infants during pregnancy,
delivery, or breastfeeding

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Other Risk Factors
 Ulcerative STD’s
o Syphilis (Treponema pallidum)
o Chancroid (Haemophilus ducreyi)
o Herpes simplex
 Non-ulcerative STD’s
o Gonorrhea (Neisseria gonorrhoeae)
o Chlamydia (chlamydia trachomatis)
o Trichomoniasis (Trichomonas vaginalis)

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Primary infection
(Acute HIV)
 Most develop a flu-like illness within a month
or two after the virus enters the body.
 May last for a few weeks.
 Fever , Headache ,Muscle aches and joint pain
 Rash
 Sore throat and painful mouth sores
 Swollen lymph glands, mainly on the neck
 These symptoms can be so mild that you might
not even notice them.

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Clinical latent infection
(Chronic HIV)
 Person is HIV+ but asymptomatic
 lasts for several years (subclinical)
o Viral replication occurring up to 10-billion virons
per day
 Chronic lymphadenopathy

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Early Symptomatic Disease
 CD4 counts drop to 500-600
cells/ml
 Symptoms:
 Recurrent fever, night sweats,
malaise, headache, diarrhea &
fatigue etc.
 Physical findings:
 Lymphadenopathy, spleen
enlarged, rash & weight loss

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Some symptoms of AIDS
 Soaking night sweats
 Recurring fever
 Chronic diarrhea
 Permeant white spots or unusual lesions on your
tongue or in your mouth
 Permeant, unexplained fatigue
 Weight loss
 Skin rashes or bumps

30. DIAGNOSIS

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Laboratory diagnosis
 Evidence of HIV infection: Evidence of clinical or
immunologic deterioration
 Virus isolation: HIV can be cultured from lymphocytes in
peripheral blood.
 Measurement of viral nucleic acid: By RT-PCR
 Detection of viral antigen: P24 antigen tests
 Detection of viral antibody: ELISA & Western Blot assay
 Recognition of immunodeficiency
 CD4+ T cell count
 Recognition ofAIDS related disease

32. TREATMENT

33.  There's no cure for HIV/AIDS, but many different drugs are
available to control the virus called Antiretroviral therapy, or ART.
 Each class of drug blocks the virus in different ways.
 ART is now recommended for everyone, regardless of CD4 T cell
counts.
 It's recommended to combine three drugs from two classes to
avoid creating drug- resistant strains of HIV.
Antiretroviral therapy

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Antiretroviral Agents
I. Entry inhibitors: (Enfuvirtide (Fuzeon)
II. Reverse Transcriptase inhibitors (Abacavir, Nevirapine)
III. Protease inhibitors (Ritonavir – Saquinavir)
IV. Integrase inhibitors (Raltegravir)
https://www.youtube.com/watch?v=604tb9pehxE&feature=emb_imp_woyt

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When to start treatment
 Everyone with HIV infection, regardless of
CD4 T cell count, should be offered antiviral
medication.
 HIV therapy is particularly important for the
following situations:
 severe symptoms.
 Presence of an opportunistic infection.
 CD4 T cell count is under 350.
 Pregnant.
 HIV-related kidney disease.
 Presence of hepatitis B or C.

37. PREVENTION

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Prevention of HIV
Infections
I. Vaccines
II. Education, Counseling & Behavior mod.
III. Free needles for IV drug users
IV. Improved blood supply
V. Screening and treating pregnant women
Remunehttps://www.cdc.gov/hiv/basics/hiv-prevention/resources.html
https://www.cdc.gov/hiv/basics/hiv-prevention/resources.html

40. END
25th May, 2022