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H.I.V. &AIIDS
WHAT IS HIV??
 “Human Immunodeficiency Virus”
 A unique type of virus (a retrovirus)
 Invades the helper T cells (CD4 cells) in the body
of the host (defense mechanism of a person)
 Threatening a global epidemic.
 Preventable, manageable but not curable.
OTHER NAMES FOR HIV
 Former names of the virus include:
 Human T cell lymphotrophic virus (HTLV-III)
 Lymphadenopathy-associated virus (LAV)
 AIDS-associated retrovirus (ARV)
WHAT IS AIDS ???
 “Acquired Immunodeficiency Syndrome”
 HIV is the virus that causes AIDS
 Disease limits the body’s ability to fight infection due
to markedly reduced helper T cells.
 Patients have a very weak immune system (defense
mechanism)
 Patients predisposed to multiple opportunistic
infections leading to death.
AIDS (definition)
 Opportunistic infections and malignancies that rarely
occur in the absence of severe immunodeficiency
(eg, 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 have AIDS.
HIV
•Human Immunodeficiency Virus
•H = Infects only Human beings
•I = Immunodeficiency virus weakens
the immune system and increases the
risk of infection
•V = Virus that attacks the body
AIDS
•Acquired Immune Deficiency
Syndrome
•A = Acquired, not inherited
•I = Weakens the Immune system
•D = Creates a Deficiency of CD4+
cells in the immune system
•S = Syndrome, or a group of illnesses
taking place at the same time
HIV and AIDS
• When the immune system
becomes weakened by HIV, the
illness progresses to AIDS
• Some blood tests, symptoms or
certain infections indicate
progression of HIV to AIDS
HIV-1 and HIV-2
• • HIV-1 and HIV-2 are
• Transmitted through the same routes
• Associated with similar opportunistic
infections
▪ • HIV-1 is more common worldwide
▪ • HIV-2 is found in West Africa, Mozambique,
and Angola
HIV-1 and HIV-2
• HIV-2 is less easily transmitted
• HIV-2 is less pathogenic
• Duration of HIV-2 infection is shorter
• Mother To Children Transmission of HIV is
relatively rare with HIV-2
“THE VIRAL GENOME”
 Icosahedral (20-sided), enveloped virus of the
lentivirus subfamily of retroviruses.
 Retroviruses transcribe RNA to DNA.
Two viral strands of RNA
found in core surrounded by
protein outer coat.
Outer envelope contains a lipid
matrix within which specific viral
glycoproteins are imbedded.
These knob-like structures
responsible for binding to target
cell.
Modes of HIV/AIDS Transmission
◼ Blood products
◼ Semen
◼ Vaginal fluids
◼ Breast Milk
 Through Bodily Fluids
IntraVenous Drug Abuse
 Sharing Needles
 Without sterilization Increases the chances of
contracting HIV
 Unsterilized blades
 Through sex (Unprotected )Intercourse
 Oral
 Anal
 From mother to baby
 Before Birth
 During Birth
Transmission of HIV
HIV is not transmitted by
• Public baths
• Handshakes
• Work or school contact
• Using telephones
• Sharing cups, glasses,
plates, or other utensils
• Coughing, sneezing
• Insect bites
• Touching, hugging
• Water, food
• Kissing
NATURAL COURSE OF HIV/AIDS
 Stage 1 - Primary
 Short, flu-like illness -
occurs one to six
weeks after infection
 Mild symptoms
 Infected person can
infect other people
Stage 2 - Asymptomatic
 Lasts for an average of ten years
 This stage is free from symptoms
 There may be swollen glands
 The level of HIV in the blood drops to low
levels
 HIV antibodies are detectable in the blood
Stage 3 - Symptomatic
 The immune system deteriorates
 Opportunistic infections and cancers start to
appear.
Stage 4 - HIV  AIDS
 The immune system
weakens too much as
CD4 cells decrease in
number.
Opportunistic Infections associated with AIDS
CD4<500
 Bacterial infections
 Tuberculosis (TB)
 Herpes Simplex
 Herpes Zoster
 Vaginal candidiasis
 Hairy leukoplakia
 Kaposi’s sarcoma
Opportunistic Infections associated with AIDS
CD4<200
 Pneumocystic carinii
 Toxoplasmosis
 Cryptococcosis
 Coccidiodomycosis
 Cryptosporiosis
 Non hodgkin’s lymphoma
CD4 <50
 Disseminated mycobacterium avium complex (MAC)
infection
 Histoplasmosis
 CMV retinitis
 CNS lymphoma
 Progressive multifocal leukoencephalopathy
 HIV dementia
TB & HIV CO-INFECTION
 TB is the most common opportunistic infection in HIV and
the first cause of mortality in HIV infected patients (10-30%)
 10 million patients co-infected in the world.
 Immunosuppression induced by HIV modifies the
clinical presentation of TB :
 Subnormal clinical
 High rate of treatment failure and relapse (5% vs < 1% in HIV)
Blood Detection Tests
HIV enzyme-linked
immunosorbent assay (ELISA)
Screening test for HIV
Sensitivity > 99.9%
Western blot Confirmatory test
Speicificity > 99.9% (when combined with
ELIZA)
HIV rapid antibody test Screening test for HIV
Simple to perform
Absolute CD4 lymphocyte count Predictor of HIV progression
Risk of opportunistic infections and AIDS when
<200
HIV viral load tests Best test for diagnosis of acute HIV infection
Correlates with disease progression and
response to HAART
Oral Testing
 Orasure
 The only FDA approved HIV
antibody.
 As accurate as blood testing
 Draws blood-derived fluids from
the gum tissue.
 NOT A SALIVA TEST!
HAART = highly active anti-retroviral treatment
Antiretroviral Drugs (HAART)
 Nucleoside Reverse Transcriptase inhibitors
 AZT (Zidovudine)
 Non-Nucleoside Transcriptase inhibitors
 Viramune (Nevirapine)
 Protease inhibitors
 Norvir (Ritonavir)
PREVENTION:
Five ways to protect yourself?
 Abstinence
 Monogamous Relationship
 Protected Sex
 Sterile needles
 New shaving/cutting blades

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lecture 10..............................pdf

  • 2. WHAT IS HIV??  “Human Immunodeficiency Virus”  A unique type of virus (a retrovirus)  Invades the helper T cells (CD4 cells) in the body of the host (defense mechanism of a person)  Threatening a global epidemic.  Preventable, manageable but not curable.
  • 3. OTHER NAMES FOR HIV  Former names of the virus include:  Human T cell lymphotrophic virus (HTLV-III)  Lymphadenopathy-associated virus (LAV)  AIDS-associated retrovirus (ARV)
  • 4. WHAT IS AIDS ???  “Acquired Immunodeficiency Syndrome”  HIV is the virus that causes AIDS  Disease limits the body’s ability to fight infection due to markedly reduced helper T cells.  Patients have a very weak immune system (defense mechanism)  Patients predisposed to multiple opportunistic infections leading to death.
  • 5. AIDS (definition)  Opportunistic infections and malignancies that rarely occur in the absence of severe immunodeficiency (eg, 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 have AIDS.
  • 6. HIV •Human Immunodeficiency Virus •H = Infects only Human beings •I = Immunodeficiency virus weakens the immune system and increases the risk of infection •V = Virus that attacks the body
  • 7. AIDS •Acquired Immune Deficiency Syndrome •A = Acquired, not inherited •I = Weakens the Immune system •D = Creates a Deficiency of CD4+ cells in the immune system •S = Syndrome, or a group of illnesses taking place at the same time
  • 8. HIV and AIDS • When the immune system becomes weakened by HIV, the illness progresses to AIDS • Some blood tests, symptoms or certain infections indicate progression of HIV to AIDS
  • 9. HIV-1 and HIV-2 • • HIV-1 and HIV-2 are • Transmitted through the same routes • Associated with similar opportunistic infections ▪ • HIV-1 is more common worldwide ▪ • HIV-2 is found in West Africa, Mozambique, and Angola
  • 10. HIV-1 and HIV-2 • HIV-2 is less easily transmitted • HIV-2 is less pathogenic • Duration of HIV-2 infection is shorter • Mother To Children Transmission of HIV is relatively rare with HIV-2
  • 11. “THE VIRAL GENOME”  Icosahedral (20-sided), enveloped virus of the lentivirus subfamily of retroviruses.  Retroviruses transcribe RNA to DNA. Two viral strands of RNA found in core surrounded by protein outer coat. Outer envelope contains a lipid matrix within which specific viral glycoproteins are imbedded. These knob-like structures responsible for binding to target cell.
  • 12. Modes of HIV/AIDS Transmission ◼ Blood products ◼ Semen ◼ Vaginal fluids ◼ Breast Milk  Through Bodily Fluids
  • 13. IntraVenous Drug Abuse  Sharing Needles  Without sterilization Increases the chances of contracting HIV  Unsterilized blades
  • 14.  Through sex (Unprotected )Intercourse  Oral  Anal  From mother to baby  Before Birth  During Birth
  • 15. Transmission of HIV HIV is not transmitted by • Public baths • Handshakes • Work or school contact • Using telephones • Sharing cups, glasses, plates, or other utensils • Coughing, sneezing • Insect bites • Touching, hugging • Water, food • Kissing
  • 16. NATURAL COURSE OF HIV/AIDS  Stage 1 - Primary  Short, flu-like illness - occurs one to six weeks after infection  Mild symptoms  Infected person can infect other people
  • 17. Stage 2 - Asymptomatic  Lasts for an average of ten years  This stage is free from symptoms  There may be swollen glands  The level of HIV in the blood drops to low levels  HIV antibodies are detectable in the blood
  • 18. Stage 3 - Symptomatic  The immune system deteriorates  Opportunistic infections and cancers start to appear.
  • 19. Stage 4 - HIV  AIDS  The immune system weakens too much as CD4 cells decrease in number.
  • 20. Opportunistic Infections associated with AIDS CD4<500  Bacterial infections  Tuberculosis (TB)  Herpes Simplex  Herpes Zoster  Vaginal candidiasis  Hairy leukoplakia  Kaposi’s sarcoma
  • 21. Opportunistic Infections associated with AIDS CD4<200  Pneumocystic carinii  Toxoplasmosis  Cryptococcosis  Coccidiodomycosis  Cryptosporiosis  Non hodgkin’s lymphoma
  • 22. CD4 <50  Disseminated mycobacterium avium complex (MAC) infection  Histoplasmosis  CMV retinitis  CNS lymphoma  Progressive multifocal leukoencephalopathy  HIV dementia
  • 23. TB & HIV CO-INFECTION  TB is the most common opportunistic infection in HIV and the first cause of mortality in HIV infected patients (10-30%)  10 million patients co-infected in the world.  Immunosuppression induced by HIV modifies the clinical presentation of TB :  Subnormal clinical  High rate of treatment failure and relapse (5% vs < 1% in HIV)
  • 24. Blood Detection Tests HIV enzyme-linked immunosorbent assay (ELISA) Screening test for HIV Sensitivity > 99.9% Western blot Confirmatory test Speicificity > 99.9% (when combined with ELIZA) HIV rapid antibody test Screening test for HIV Simple to perform Absolute CD4 lymphocyte count Predictor of HIV progression Risk of opportunistic infections and AIDS when <200 HIV viral load tests Best test for diagnosis of acute HIV infection Correlates with disease progression and response to HAART
  • 25. Oral Testing  Orasure  The only FDA approved HIV antibody.  As accurate as blood testing  Draws blood-derived fluids from the gum tissue.  NOT A SALIVA TEST!
  • 26. HAART = highly active anti-retroviral treatment
  • 27. Antiretroviral Drugs (HAART)  Nucleoside Reverse Transcriptase inhibitors  AZT (Zidovudine)  Non-Nucleoside Transcriptase inhibitors  Viramune (Nevirapine)  Protease inhibitors  Norvir (Ritonavir)
  • 28. PREVENTION: Five ways to protect yourself?  Abstinence  Monogamous Relationship  Protected Sex  Sterile needles  New shaving/cutting blades