Explanation of HIV/AIDS Status

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Explanation of HIV/AIDS Status

• Exposure to the HIV virus
• Transmission
• Blood to blood
• Sexual contact
• Pregnancy

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Acute infection

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

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Seroconversion

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

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Latency

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

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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

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

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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

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Diagnosis that are AIDS defining

• Pneumocysitis carinii pneumonia
• Parasitic and acquired early in life
• Karposi Sarcoma
• Mycobacterium Avium infection
• Gastric
• Lungs
• Liver

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

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General constitutional symptoms

• Weight loss
• Diarrhea
• Fever
• Fatigue

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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.

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• 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)

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

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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)

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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

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• 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.

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• ,. 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.

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Side effects

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

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

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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

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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.

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• Like all viruses, HIV can replicate only inside
  cells, commandeering the cells 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
  cells genes.

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Slow viruses

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

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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.

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STRUCTURE OF HIV
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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.

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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.

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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.
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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.
31
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.
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a human population a nearby population of a host
animal an infectious pathogen in the host animal
that can spread from animal to human 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) 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 humans
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EARLY CASES

• In 1958 an English sailor who never visited
  Africa
• 1969 a young man died of Karposis 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

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