HIV molecule

Dermatological manifestations of HIV Done by : Group B2

Objectives: 1-Identify the Pathogenesis of HIV infection. a-Types of virus and life cycle. b-Briefly clinical manifestations of HIV infected . 2-Basis of drug used in treatment of HIV . 3-Dermatological manifestations among HIV.

What is Human Immune Deficiency Virus: Genus Reoviridae Lentivirus, which literally means slow virus - it takes such a long time to develop adverse effects in the body. This virus attacks the immune system Known as retrovirus, lentivirus also found in various animals such as cats, sheep, horses & cattle

These contain RNA, the genetic material of HIV The outer layer of the HIV virus cell is covered in coat proteins, which can bind to certain WBCs. This allows the virus to enter the cell, where it alters the DNA. The virus infects and destroys the CD4 lymphocytes which are critical to the body’s immune response.

Types of HIV Two species of HIV infect humans: HIV-1 HIV-2 More virulent, relatively easy to transmit Majority of HIV infections globally 3 types of HIV-1: (based on alterations in env gene) Clades M, N, and O HIV-2 Less transmittable Largely confined to West Africa

HIV Life Cycle

steps in the HIV Life Cycle Fusion of the HIV cell to the host cell surface. HIV RNA, reverse transcriptase, integrase, and other viral proteins enter the host cell. Viral DNA is formed by reverse transcription. Viral DNA is transported across the nucleus and integrates into the host DNA. New viral RNA is used as genomic RNA and to make viral proteins. New viral RNA and proteins move to cell surface and a new, immature, HIV virus forms. The virus matures by protease releasing individual HIV proteins.

Pathophysiology HIV produces cellular immune deficiency characterized by the depletion of helper T lymphocytes (CD4+ cells). The loss of CD4+ cells results in the development of opportunistic infections and neoplastic processes.

Clinical signs of hiv infection Major signs Weight loss > 10% of body weight. Chronic diarrhea > 1 month. Fever > 1 month ( intermittent or constant ). Minor signs Persistent cough . General pruritic dermatitis . Recurrent herpes zoster. Oropharyngeal candidiasis. Chronic progressive & disseminated herpes simple infections . General lymphadenopathy.

Basis of drug used in treatment of HIV There is no cure for HIV. Antiretroviral therapy can reduce the presence of the virus in the body, but can not eliminate it. HIV medicines are grouped into six drug classes according to how they fight HIV. The six drug classes are: 1- Nucleoside reverse transcriptase inhibitors (NRTIs) 2- Non-nucleoside reverse transcriptase inhibitors (NNRTIs) 3- Protease inhibitors (PIs) 4- Integrase inhibitors (INSTIs) 5- Fusion inhibitors (FIs) 6- Chemokine receptor antagonists (CCR5 antagonists) There is no cure for HIV. Antiretroviral therapy can reduce the presence of the virus in the body, but can not eliminate it.

Dermatological manifestations among HIV 1- Exanthem :appear 2-3days after onset of fever “morbilliform rash” Dull red, violaceous, maculopapular lesions on the upper part of the trunk in a 49-year-old man with primary HIV-1 infection.

2- Kaposi sarcoma in a man with HIV infection.

3- Lipoatrophy ;striking loss of fat is seen on cheeks and temples.

4- Eosinophilic folliculitis; multiple pruritic red papule on the face and neck Eosinophilic folliculitis A 38-year- old male with HIV disease. Multiple pruritic red papules on the face and neck occurred shortly after reinstituting cART. This represents the immune reconstitution in am- matory syndrome (IRIS

5- Papular pruritic eruption of HIV disease ; Multiple excoriated papules on the arms.

6- Linchenoid photosensitive eruption; hyperpigmented plaques in sun-exposed sites on the face. 7- Depigmentation on the forehead.

8- Hairy leukoplakia ; white plaque On the lateral tongue.

Lipohypertrophy; increase subcutaneous fatty tissue of neck with “buffalo hump on upper back.

Kaposi sarcoma

9- seborrheic dermatitis

Thank you