1. متلازمة العوز المناعي المكتسبة Acquired Immunodeficiency syndrome (AIDS)
Human Immunodeficiency virus HIV Retroviridae R. Gllo – 1978 Retrovirus – Lymphocytes – Leukemia Yori Hinuma – 1981 HTLV – I

2. Luc Montagnier – 1983 (HIV-1) HTLV – 3 Human T-Lymphotropic virus – III >40 M infected w/ HIV / AIDS 2002 Oncogen جينات مسرطنة Except – Subfamily – Lentivirinae Virus Envelope / 100nm , ss RNA Structural Genes

5. Gag gene:
Matrix (P18) (MA)
Capsid (P24) (CA)
Nucleocapsid (P15) (NC)

6. Pol gene:
Protease (p10) (PR)
RT (P 51/66) (RT)
Integrase (P34) (IN)

7. Env gene Surface (gp 120) (SU) Transmembrane (gp 41) ( TM )
(tat, art, orf)

8. HIV – T-Lmphotropic (T-cell) T-Cell / Cell – mediated Response (CTL)
Macrophages …. .
HIV
Cytotoxic-T-Cell Helper–T–Cell B-Cell
(CTL) (Ab)
Activation
Activation

9. HIV - Biology

12. Pathogenesis and Pathology
HIV course of infection
I- Acute infection + Seroconversion
II- Chronic infection
PGL: Persistent Generalized Lymphadenopathy
ARC: AIDS related complex
III- AIDS Syndrome
Untreated HIV infection / decade

13. Primary infection + dissemination:
4-11 day / mucosal and viremia
Viremia / 8-12 weeks
Dissemination to Lymphoid Organs
Macrophages and monocytes
Acute monoucleosis – like Syndrome
CD4 T-Cell numbers drops
Immune response / 1week- 3months
HIV persist in Lymph nodes

14. Clinical Latency + HIV expression:
Last For 10 Years
High Level of Viral – replication
Virus Life-Cycle (2.6 days)
CD4 + T-Lymphocytes / Viral – Replication
CD4 + Cell Life-cycle (1.6 days)

15. Clinical disease + death:
Primary infection and clinical disease/ 10 years
Untreated Cases / 2 years / death
Constitutional symptoms such as opportunistic infection/ or neoplasms
High- Level of Virus/ more Virulent
M- tropic to T-tropic / AIDS progression

16. Clinical Finding / Acute HIV infection
Non – Specific: Fatigue, Rash, Headache, Nausea and Night Sweats.
AIDS:
Suppression of the Immune system
Opportunistic infections or neoplasms (Kaposi’s sarcoma)
Neurological disease (encephalitis, aseptic meningitis)

17. المناعة Immunity Immune Responses / HIV Ag’s
Ab’s to envelope (gp41,120,160) maintained
Ab’s to core (gp24) decline/ clinical signs

18. Diagnosis Virus isolation: HIV – Cultured in peripheral Blood
Serology:
ELISA – HIV antibodies
NA and Antigens:
RT – PCR + bDNA assay

19. طرق انتقال الفيروس Transmission:
Sexual intercourse
Blood + B. Products
Contaminated needles
Organ transplant
Mother to child
Other methods

20. Prevention, Treatment and Control
Antiviral Drugs:
RT- inhibitors: (AZT, 3TC and Nevirapine ,delavirdine)
PR inhibitors: Indinavir, Ritonavir
HAART: Highly active antiretroviral therapy

21. Vaccine:
HIV mutate rapidly
Not expressed in all infected
Not Completely cleared From immune respons after primary infection
Lack of animal model for HIV