HIV and AIDS

39 million people have died of HIV since the beginning of the epidemic out of the 76.1 million people who had been infected (about 52%) 36.7 million people are living with HIV today

HIV Human Immunodeficiency Virus

HIV HIV is the virus that causes AIDS HIV is a retrovirus - it makes its genetic material in reverse

Retrovirus An important HIV protein is called “reverse transcriptase” which transcribes genetic material in reverse

HIV causes AIDS Acquired Immune Deficiency Syndrome

Initial HIV Infection It is common to develop a brief flu-like illness two to six weeks after becoming infected with HIV

Illness caused by initial HIV infection Primary HIV Infection Seroconversion syndrome HIV Seroconversion – very early stage of HIV infection. It is a time wherein the body develops antibodies against HIV

Initial HIV Infection The signs and symptoms of seroconversion syndrome or primary HIV infection include fever, headache, sore throat, swollen lymph glands and rash.

Initial HIV Infection Because of these flu like symptoms, one might not realize they have been infected with HIV

Picture of Seroconversion Rash

Initial HIV Infection Some initial HIV Infections have no symptoms at all.

HIV Infection Even if one doesn’t have symptoms of HIV infection, they are still able to give the virus to others.

HIV destroys immunity Your body is not able to get rid of the virus Once the virus enters the body, the immune system comes under attack.

HIV destroys immunity The virus multiplies in the lymph nodes and slowly begin to destroy T helper cells (CD4 cells) – the white blood cells that coordinate the entire immune system CD – cluster of differentiation

Dormant Phase One may remain symptom-free for 10 years after initial infection. But still able to transmit virus to others

Early AIDS Over the years, the virus multiplies and destroys immune cells, one may develop mild infections or chronic symptoms such as…

Early AIDS Swollen lymph nodes Diarrhea Weight loss Fever Cough and shortness of breath

AIDS During the last phase of HIV infection which occurs approximately 10 or more years after the initial infection – more serious symptoms may begin to appear, and the infection may then meet the official definition of AIDS

AIDS AIDS is defined as the presence of HIV infection as shown by a positive HIV-antibody test plus at least one of the following:

AIDS = HIV+ and either 1. the development of an opportunistic infection – an infection that occurs when your immune system is impaired

2. A CD4 lymphocyte count of 200 or less – a normal count ranges from 600 – 1000

Symptoms of infection Soaking night sweats Shaking chills or fever higher for 100F for several weeks Dry cough and shortness of breath

Symptoms of infection Chronic diarrhea Persistent white spots in tongue or in mouth due to fungus Headaches Blurred and distorted vision Weight loss

Cancer in AIDS Kaposi’s sarcoma Cervical cancer Lymphoma Squamous cell carcinoma

Opportunistic infections Called opportunistic because they take advantage of the opportunity offered by the weakened immune system

Opportunistic infections Bacterial diseases such as TB (tuberculosis MAC (mycobacterium avian complex) bacterial pneumonia septicemia (blood poisoning)

Opportunistic infections Protozoal diseases such as PCP (Pneumocystis carinii pneumonia) now called PJP (Pneumocystis jiroveci pneumonia toxoplasmosis microsporidiosis cryptosporidiosis isopsoriasis leishmaniasis

Opportunistic infections Fungal diseases such as - candidiasis - cryptococcosis - penicilliosis

Opportunistic infections Viral diseases such as CMV (cytomegalovirus) herpes simplex herpes zoster virus (Shingles)

AIDS can cause blindness

Shingles

Opportunistic Malignancies HIV-associated malignancies - Kaposi’s sarcoma - caused by another herpes virus (HHV8) Lymphoma Squamous cell carcinoma

History of HIV As recently as the late 1970s, no one was aware of this deadly disease

AIDS Timeline before 1970 HIV probably transfers to humans in Africa in 1930 from monkeys which have identical SIMV viruses – similar to HIV virus HIV probably enters Haiti around 1966

AIDS 1970s HIV probably enters the United States around 1970 African doctors see a rise in opportunistic infections and wasting (such as in tuberculosis and cancer) Western scientists and medical doctors remain unaware of the growing epidemic

AIDS 1980 AIDS is detected in California and New York The first cases are among gay men and injecting drug users

AIDS 1982 AIDS is reported among hemophiliacs and in the USA AIDS is reported in several European countries The name “AIDS” – Acquired Immune Deficiency Syndrome – is created

AIDS 1983 AIDS is reported among non-drug using women and children Experts became more confident that the cause of AIDS is infectious

AIDS 1983 3000 AIDS cases have been reported in the USA 1000 have died

AIDS 1984 Scientists identify HIV (initially called HTLV-III or LAV) as the cause of AIDS

AIDS 1984 Western scientists became aware that AIDS is widespread in parts of Africa The world’s first needle exchange program is set up in Amsterdam, the Netherlands – for injecting drug users to exchange used for needles for fresh ones

AIDS 1985 An HIV test is licensed for screening blood supplies

AIDS 1986 More than 38,000 cases of AIDS have been reported from 85 countries

AIDS 1987 AZT is the first drug approved to treat AIDS

AIDS 1993 An estimated 8 million people are living with HIV worldwide Thailand launches Asia’s most extensive HIV prevention program

AIDS 1994 AZT is shown to reduce the risk of mother-to-child transmission of HIV Infant HIV infections begin to fall in developed countries, due to use of AZT

AIDS 1996 Combination antiretroviral treatment is shown to be highly effective against HIV In developed countries, many people begin taking the new treatment Magic Johnson is part of this discovery

AIDS 2005 Nearly 40 million people are living with HIV, including 25 million Africans More than 25 million people have died because of AIDS since 1981

AIDS 2006 28% of people in developed countries who need treatment for HIV are receiving it

AIDS 2006 Annual global spending on AIDS in low-and middle-income countries $8.9 billion dollars It is estimated that $14.9 billion dollars would be needed for a truly effective response

AIDS 2008 On November 12, 2008, doctors in Berlin announced the results of an experimental bone marrow transplant for an HIV infected person

AIDS 2008 20 months after transplant, the person shows no evidence of viral infection

According to a report by Gero Hütter et al., In a rare and lucky match-up, his donor was not only compatible but also homozygous for mutations in the HIV receptor CCR5 that result in resistance to HIV infection

Virus Like all viruses, HIV cannot grow or reproduce on its own.

HIV In order to make new copies of itself it must infect the cells of a living organism

An HIV virus is around: 0.1 micron 4 millionths of an inch 1/20 length of an E.coli bacterium 1/70 the diameter of a human CD4+ white blood cell