1. 29-1 A Human Perspective HIV Disease and Complications of Immunodeficiency Eugene Nester Denise Anderson Evans Roberts, Jr. Nancy Pearsall Martha Nester

2. 29-2 Topics

3. 29-3 Topics Human immunodeficiency virus (HIV)

4. 29-4 Topics Human immunodeficiency virus (HIV) Malignant tumors

5. 29-5 Topics Human immunodeficiency virus (HIV) Malignant tumors Infectious complications

6. 29-6 Human Immunodeficiency (HIV)

7. 29-7 Human Immunodeficiency (HIV) HIV disease

8. 29-8 Human Immunodeficiency (HIV) HIV disease HIV vaccine

9. 29-9 HIV disease

10. 29-10 HIV disease Caused by Human immunodeficiency virus, type 1 (HIV-1)

11. 29-11 HIV disease Caused by Human immunodeficiency virus, type 1 (HIV-1) Acute retroviral syndrome - early stage

12. 29-12 HIV disease Caused by Human immunodeficiency virus, type 1 (HIV-1) Acute retroviral syndrome - early stage Lymphadenopathy syndrome – late stage

13. 29-13 HIV disease Caused by Human immunodeficiency virus, type 1 (HIV-1) Acute retroviral syndrome – early stage Lymphadenopathy syndrome – late stage Acquired immunodeficiency syndrome (AIDS) – late stage

14. 29-14 HIV-1

15. 29-15 HIV-1 Retrovirus family

16. 29-16 HIV-1 Retrovirus family Antigens (ex. glycoproteins)

17. 29-17 HIV-1 Retrovirus family Antigens (ex. glycoproteins) Viral encoded accessory genes

18. 29-18 HIV-1 Retrovirus family Antigens (ex. glycoproteins) Viral encoded accessory genes Target – T cell, macrophage, brain cell, intestinal epithelium, lymphatic tissue

19. 29-19 Human immunodeficiency virus, type 1 Figure 29.3

20. 29-20 HIV accessory gene products Table 29.2

21. 29-21 HIV cellular targets Figure 29.4

22. 29-22 Attachment and entry of HIV Figure 29.5

23. 29-23 HIV replication Figure 29.6

24. 29-24 HIV glycoprotein Figure 29.7

25. 29-25 Natural history of HIV disease Figure 29.8

26. 29-26 Acquired immunodeficiency syndrome (AIDS)

27. 29-27 Acquired immunodeficiency syndrome (AIDS) Late stage manifestation of HIV disease

28. 29-28 Acquired immunodeficiency syndrome (AIDS) Late stage manifestation of HIV disease Infects immune cells (T – helper, macrophages)

29. 29-29 Acquired immunodeficiency syndrome (AIDS) Late stage manifestation of HIV disease Infects immune cells (T – helper, macrophages) Associated with a number of diseases

30. 29-30 Acquired immunodeficiency syndrome (AIDS) Late stage manifestation of HIV disease Infects immune cells (T – helper, macrophages) Associated with a number of diseases AIDS – related complex (ARC) – Ex. Hairy leukoplakia

31. 29-31 Acquired immunodeficiency syndrome (AIDS) Late stage manifestation of HIV disease Infects immune cells (T – helper, macrophages) Associated with a number of diseases AIDS – related complex (ARC) – Ex. Hairy leukoplakia AIDS epidemic

32. 29-32 Acquired immunodeficiency syndrome (AIDS) Late stage manifestation of HIV disease Infects immune cells (T – helper, macrophages) Associated with a number of diseases AIDS – related complex (ARC) – Ex. Hairy leukoplakia AIDS epidemic AIDS is a fatal disease

33. 29-33 Acquired immunodeficiency syndrome (AIDS) Late stage manifestation of HIV disease Infects immune cells (T – helper, macrophages) Associated with a number of diseases AIDS – related complex (ARC) – Ex. Hairy leukoplakia AIDS epidemic AIDS is a fatal disease Medication – Ex. Zidovudine (AZT)

34. 29-34 AIDS related diseases Table 29.1

35. 29-35 Hairy leukoplakia Figure 29.2

36. 29-36 Control of AIDS epidemic Table 29.3

37. 29-37 Person at increased risk for HIV disease Table 29.4

38. 29-38 Estimated deaths due to AIDS Figure 29.10

39. 29-39 HIV/AIDS epidemic Figure 29.1

40. 29-40 Mode of action of zidovudine (AZT) Figure 29.11

41. 29-41 Features of HIV disease Table 29.5

42. 29-42 HIV vaccine

43. 29-43 HIV vaccine Currently no approved vaccine for prevention

44. 29-44 HIV vaccine Currently no approved vaccine for prevention Potential vaccines

45. 29-45 HIV vaccine Currently no approved vaccine for prevention Potential vaccines –Killed HIV

46. 29-46 HIV vaccine Currently no approved vaccine for prevention Potential vaccines –Killed HIV –Virus and bacterial carriers of HIV components

47. 29-47 HIV vaccine Currently no approved vaccine for prevention Potential vaccines –Killed HIV –Virus and bacterial carriers of HIV components –HIV peptides and proteins

48. 29-48 HIV vaccine Currently no approved vaccine for prevention Potential vaccines –Killed HIV –Virus and bacterial carriers of HIV components –HIV peptides and proteins –HIV proteins with adjuvants

49. 29-49 HIV vaccine Currently no approved vaccine for prevention Potential vaccines –Killed HIV –Virus and bacterial carriers of HIV components –HIV peptides and proteins –HIV proteins with adjuvants –Naked DNA containing HIV genes

50. 29-50 Malignant tumors

51. 29-51 Malignant tumors Kaposi’s sarcoma

52. 29-52 Malignant tumors Kaposi’s sarcoma B – lymphocytic tumors of the brain

53. 29-53 Malignant tumors Kaposi’s sarcoma B – lymphocytic tumors of the brain Cervical and anal carcinoma

54. 29-54 Kaposi’s sarcoma

55. 29-55 Kaposi’s sarcoma Caused by herpesvirus 8

56. 29-56 Kaposi’s sarcoma Caused by herpesvirus 8 Arises from blood and lymphatic vessels

57. 29-57 Kaposi’s sarcoma Caused by herpesvirus 8 Arises from blood and lymphatic vessels Associated with immunodeficient individuals

58. 29-58 Kaposi’s sarcoma Figure 29.12

59. 29-59 B – lymphocytic tumors of the brain

60. 29-60 B – lymphocytic tumors of the brain Associated with Epstein – Barr virus

61. 29-61 B – lymphocytic tumors of the brain Associated with Epstein – Barr virus Arise from lymphoid cells (B and T cells) in immunodeficient individuals

62. 29-62 B – lymphocytic tumors of the brain Associated with Epstein – Barr virus Arise from lymphoid cells (B and T cells) in immunodeficient individuals Malignant

63. 29-63 Cervical and anal carcinoma

64. 29-64 Cervical and anal carcinoma Associated with human papillomaviruses (HPV)

65. 29-65 Cervical and anal carcinoma Associated with human papillomaviruses (HPV) Tumors arise from squamous epithelial cells

66. 29-66 Cervical and anal carcinoma Associated with human papillomaviruses (HPV) Tumors arise from squamous epithelial cells Transmitted during sexual activity

67. 29-67 Infectious complications

68. 29-68 Infectious complications Pneumocytosis

69. 29-69 Infectious complications Pneumocytosis Toxoplasmosis

70. 29-70 Infectious complications Pneumocytosis Toxoplasmosis Cytomegalovirus disease

71. 29-71 Infectious complications Pneumocytosis Toxoplasmosis Cytomegalovirus disease Mycobacterial disease

72. 29-72 Pneumocytosis

73. 29-73 Pneumocytosis Caused by Pneumocystis carinii (fungus)

74. 29-74 Pneumocytosis Caused by Pneumocystis carinii (fungus) Commonly found in healthy individuals and animals

75. 29-75 Pneumocytosis Caused by Pneumocystis carinii (fungus) Commonly found in healthy individuals and animals Infects the lungs of immunodeficient individuals

76. 29-76 Pneumocytosis Caused by Pneumocystis carinii (fungus) Commonly found in healthy individuals and animals Infects the lungs of immunodeficient individuals Patients die from lack of oxygen

77. 29-77 Fluorescent antibody stain of Pneumocystis carinii Figure 29.13

78. 29-78 Features of pneumocytosis Table 29.7

79. 29-79 Toxoplasmosis

80. 29-80 Toxoplasmosis Caused by Toxoplasma gondii (protozoan)

81. 29-81 Toxoplasmosis Caused by Toxoplasma gondii (protozoan) Affects immunocompromised individuals (cancer, organ transplants, HIV disease)

82. 29-82 Toxoplasmosis Caused by Toxoplasma gondii (protozoan) Affects immunocompromised individuals (cancer, organ transplants, HIV disease) AIDS patients develop encephalitis

83. 29-83 Toxoplasmosis Caused by Toxoplasma gondii (protozoan) Affects immunocompromised individuals (cancer, organ transplants, HIV disease) AIDS patients develop encephalitis Congenital

84. 29-84 Toxoplasma gondii – invasion and life cycle Figure 29.14

85. 29-85 Features of toxoplasmosis Table 29.8

86. 29-86 Cytomegalovirus disease

87. 29-87 Cytomegalovirus disease Caused by cytomegalovirus (CMV)

88. 29-88 Cytomegalovirus disease Caused by cytomegalovirus (CMV) “owl’s eye” appearance

89. 29-89 Cytomegalovirus disease Caused by cytomegalovirus (CMV) “owl’s eye” appearance Retinitis - blindness

90. 29-90 Cytomegalovirus disease Caused by cytomegalovirus (CMV) “owl’s eye” appearance Retinitis – blindness Medication - ganciclovir

91. 29-91 Cytomegalovirus – “owl’s eye” Figure 29.15

92. 29-92 Cytomegalovirus retinitis Figure 29.16

93. 29-93 Features of cytomegalovirus disease Table 29.9

94. 29-94 Mycobacterial diseases

95. 29-95 Mycobacterial diseases Caused by Mycobacterium tuberculosis and Mycobacterium avium complex (MAC)

96. 29-96 Mycobacterial diseases Caused by Mycobacterium tuberculosis and Mycobacterium avium complex (MAC) MAC infect multiple number of cells (blood, intestinal epithelium, etc.)

97. 29-97 Acid – fast stain of MAC Figure 29.17

98. 29-98 Features of MAC disease Table 29.10