1. AIDS-Acquired ImmunoDeficiency Syndrome Lecturer: Adelheid Cerwenka, PhD, D080, Innate Immunity Sources: Janeway: Immunobiology, 5th edition

2. AIDS Definition: AIDS is the end-stage disease caused by infection with the Human Immunodeficiency Virus (HIV) First recognized in 1981

3. General mechanisms for recognition of viruses by the immune system Groupwork History of AIDS, Epidemiology Structure of HIV The Immune system and HIV AIDS and other diseases (Karposi Sarcoma) Treatment of AIDS Perspectives AIDS-Acquired ImmunoDeficiency Syndrome

4. The course of a typical acute infection

5. The time-course of infection of normal and immuno- deficient mice and humans

6. Innate immune response Natural Killers Macrophages Dendritic Cells T cells A.) Direct recognition and elimination of virus infected cells Virus infected cell Cytokines Cell-cell contact B.) Cross-talk with adaptive immunity

7. Immune response to invading viruses

8. Since 1981 the syndrome known Los Angeles: 5 people in hospital with Pneumocystis Pneumonia. 1983 Virus identified HIV-1 (NIH: Robert Gallo, Luc Montagnier, Pasteur), HIV-2 History

9. 1.) How many people in the world are infected with HIV? 2.) In which part of the world is the highest incidence? 3.) How does transmission of HIV take place? 4.) What goes wrong with the immune system? 5.) Ideas for prevention and cure? Group work

10. HIV Infection is spreading over all continents 16 mio died 3.4 mio people alive with AIDS Sahara Africa: 7% inf Botswana: 30% inf 6 mio newly infected 16 000 newly each day Course of inf: 10% 2-3 years AIDS 80% progress in 10 years

11. Routes of transmission/risk groups Hemophiliac Intravenous drug abusers Homosexuals Heterosexuals Babies of infected mothers

12. Routes of transmission/risk groups

13. Most HIV Infected people progress over a period of time

14. Typical course of untreated infection with HIV

15. The virion of HIV

16. 2 strains of HIV-1

17. CCR5: (ligands RANTES, MIP1a, MIP1b): DC, Macrophages CXCR4 (SDF-1): activ. T cells DC-Sign (possibly traps virus before encounter of susceptible cells) Coreceptors for HIV

18. The infection of CD4 T cells with AIDS

19. Genes and proteins of HIV

20. Only activated cells become infected

21. The immuneresponse to HIV

22. Problems: virus mutates, virus is hiding in storage sited (in mucosa, brain). CD4 T cells: help is missing CD8 T cells: Good in the beginning, later they can’t see the mutated virus, B cells: good, but Ab is directed against the initial virus Immune response against HIV

23. Lymphoid tissue Nervous system Gastrointestinal tract Cancer: Karposi Sarcoma Organs affected with AIDS-lymphoid tissue