Explanation of HIV/AIDS Status Exposure to the HIV virus 1.Transmission 2.Blood to blood 3.Sexual contact 4.Pregnancy

Acute infection Flu like symptoms 1-6 weeks after exposure Usually not noted unless looked at retrospectively

SeroconversionSeroconversion: Development of detectable antibodies in the blood When antibodies are numerous then HIV test is positive

Latency HIV positive Once status is know, the blood count (T cells) determines health Transmission to others is possible No symptoms

Change from HIV to AIDS status –HIV+ –First physical symptoms »Thrush »Herpes zoster (shingles) »Pheumococcal pneumonia »Not PCP pneumonia »Considered to be an AIDS defining illness

»Women »Vaginitis »increase severity »increase frequency »resistant to treatment

AIDS What defines AIDS –1982 – opportunistic infection for an unknown cause –1986 –specific list of opportunistic infection or tumors –1992 – anyone with HIV+ status and T cell cont less

Diagnosis that are AIDS defining –Pneumocysitis carinii pneumonia »Parasitic and acquired early in life –Karposi Sarcoma –Mycobacterium Avium infection »Gastric »Lungs »Liver

–Toxoplasma encephalitis –Cryptococcosis –Cryptosporidiosis »Usually related to cat care »Can be in drinking water –Herpes simples –Cytomegalovirus

General constitutional symptoms »Weight loss »Diarrhea »Fever »Fatigue

TREATMENT –When AIDS first surfaced in the United States, there were no medicines to combat the underlying immune deficiency and few treatments existed for the opportunistic diseases that resulted. –The Food and Drug Administration (FDA) has approved a number of drugs for treating HIV infection.

The first group of drugs used to treat HIV infection, called nucleoside reverse transcriptase (RT) inhibitors, interrupts an early stage of the virus making copies of itself. –AZT (Azidothymidine) –ddC (zalcitabine) –ddI (dideoxyinosine) –d4T (stavudine)

Health care providers can prescribe non- nucleoside reverse transcriptase inhibitors (NNRTIs), such as –Delavridine (Rescriptor) –Nevirapine (Viramune) Efravirenz (Sustiva) (in combination with other antiret

FDA also has approved a second class of drugs for treating HIV infection. These drugs, called protease inhibitors, interrupt the virus from making copies of itself at a later step in its life cycle. They include –Ritonavir (Norvir) –Saquinivir (Invirase)

FDA also has introduced a third new class of drugs known at fusion inhibitors, to treat HIV infection. Fuzeon (enfuvirtide or T-20), the first approved fusion inhibitor, works by interfering with HIV-1's ability to enter into cells by blocking the merging of the virus with the cell membranes

This inhibition blocks HIV's ability to enter and infect the human immune cells. Fuzeon is designed for use in combination with other anti-HIV treatment. It reduces the level of HIV infection in the blood and may be active against HIV that has become resistant to current antiviral treatment schedules.

,. Because HIV can become resistant to any of these drugs, health care providers must use a combination treatment to effectively suppress the virus. When multiple drugs (three or more) are used in combination, it is referred to as highly active antiretroviral therapy, or HAART, and can be used by people who are newly infected with HIV as well as people with AIDS.

Side effects Despite the beneficial effects of HAART, there are side effects associated with the use of antiviral drugs that can be severe.

Some of the nucleoside RT inhibitors may cause a decrease of red or white blood cells, especially when taken in the later stages of the disease. Some may also cause inflammation of the pancreas and painful nerve damage. There have been reports of complications and other severe reactions, including death, to some of the antiretroviral nucleoside analogs when used alone or in combination

Therefore, health care experts recommend that you be routinely seen and followed by your health care provider if you are on antiretroviral therapy.

The most common side effects associated with protease inhibitors include nausea, diarrhea, and other gastrointestinal symptoms. In addition, protease inhibitors can interact with other drugs resulting in serious side effects

HIV IS A RETROVIRUS Retroviruses are RNA (ribonucleic acid) viruses, and in order to replicate (duplicate). They must make a DNA (deoxyribonucleic acid) copy of their RNA. It is the DNA genes that allow the virus to replicate.

Like all viruses, HIV can replicate only inside cells, commandeering the cell’s machinery to reproduce. Only HIV and other retroviruses, however, once inside a cell, use an enzyme called reverse transcriptase to convert their RNA into DNA, which can be incorporated into the host cell’s genes.enzymereverse transcriptase

Slow viruses –HIV belongs to a subgroup of retroviruses known as lentiviruses, or “slow” viruses. lentiviruses The course of infection with these viruses is characterized by a long interval between initial infection and the onset of serious symptoms

Other lentiviruses infect nonhuman species »the feline immunodeficiency virus (FIV) infects cats »the simian immunodeficiency virus (SIV) infects monkeys »These animal viruses primarily infect immune system cells, often causing immune deficiency and AIDS-like symptoms.immune deficiency

STRUCTURE OF HIV

Vaccine Research –The intervention most anticipated by everyone working to stop the HIV/AIDS epidemic is a vaccine to prevent infection. –Vaccine development must not endanger progress already made in HIV prevention. –Until a vaccine is available, and even afterwards, we must continue to reinforce the already proven methods of HIV prevention.

History Of HIV/AIDS AIDS is caused by the Human immunodeficiency virus (HIV), which originated in non-human primates in Sub- Saharan Africa and was transferred to humans during the late 19th or early 20th century.AIDSHuman immunodeficiency virusprimatesSub- Saharan Africa

Scientists generally accept that the known strains (or groups) of HIV-1 are most closely related to the simian immunodeficiency viruses (SIVs) endemic in wild ape populations of West Central African forests. Particularly, each of the known HIV-1 strains is either closely related to the SIV that infects the chimpanzee subspecies Pan troglodytes troglodytes (SIVcpz), or to the SIV that infects Western lowland gorillas (Gorilla gorilla gorilla), called SIVgor.HIV-1ape SIVchimpanzeeWestern lowland gorillas

Using HIV-1 sequences preserved in human biological samples along with estimates of viral mutation rates, scientists calculate that the jump from chimpanzee to human probably happened during the late 19th or early 20th century, a time of rapid urbanisation and colonisation in equatorial Africa.HIV-1

According to the natural transfer theory (also called 'Hunter Theory' or 'Bushmeat Theory'), the "simplest and most plausible explanation for the cross-species transmission" [7] of SIV or HIV (post mutation), the virus was transmitted from an ape or monkey to a human when a hunter or bushmeat vendor/handler was bitten or cut while hunting or butchering the animal.natural transfer [7]apemonkeybushmeat

a human population; a nearby population of a host animal; an infectious pathogen in the host animal that can spread from animal to human;pathogen interaction between the species to transmit enough of the pathogen to humans to establish a human foothold, which could have taken millions of individual exposures; ability of the pathogen to spread from human to human (perhaps acquired by mutation); mutation some process allowing the pathogen to disperse widely, preventing the infection from "burning out" by either killing off its human hosts or provoking immunity in a local population of humanspathogen

EARLY CASES In 1958 an English sailor who never visited Africa 1969 a young man died of Karposi’s sarcoma in a St. Louis Hospital Gaetan Dugay a french flight attendant, while not the first patient in the United States, his sexual partners accounted for 40 of 248 know cases in 1983