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HIV/AIDS:

HIV/AIDS By: Bryan Korona

Overview:

Overview Acquired Immune Deficiency Syndrome (AIDS) Caused by Human Immunodeficiency Virus (HIV) Kills or disables agents of the immune system The affected individual cannot fight disease Affects approximately 40 million people worldwide Primarily in 3 rd world countries of Southern Africa Spread through the transfer of bodily fluids Leads to a decrease in the count of CD4 T-cells

HIV is a Retrovirus:

HIV is a Retrovirus Transcribe DNA from an RNA template Using an enzyme called reverse transcriptase Allows it to evade the bodies natural immune defense Contains a viral envelope Contains 2 layers of phospholipids Taken from the human cell as the cell replicates Allows the virus to more easily enter cells

Two Different Strands of HIV:

Two Different Strands of HIV HIV-1 Most common and most contagious form More virulent Has a higher relative capacity to cause disease HIV-2 Isolated to the poor countries of Western Africa Lower infectivity Low levels of the virus are found in the blood compared to HIV-1 Less infectious in the early stages of infection

Origins of HIV:

Origins of HIV HIV is thought to have originated in primates in sub-Saharan Africa First introduced to humans in early 1900’s Likely spread through syringes that were being used for vaccinations and were not being sterilized Also spread through prostitution in African cities First clinically observed in 1981

Spread of HIV:

Spread of HIV Large portion of infections are acquired through sexual relations Occurs when sexual secretions of one partner come in contact with the other .04% risk of female to male transmission .08% risk of male to female Percentages are significantly higher in low-income countries Transmission can be significantly reduced by the use of a condom

Spread of HIV (cont.):

Spread of HIV (cont.) Can be transmitted through blood Spreads when infected blood comes in contact with an open wound of another person Formerly a large problem due to blood transfusions Also affects injection drug users who use unsterilized needles Can affect people who get tattoos or piercings with unsterilized needles as well

Spread of HIV (cont.):

Spread of HIV (cont.) Mother-to-child transmission Can occur during the pregnancy, during childbirth, or through breastfeeding If infection of mother is known, preventative measures can be taken Caesarian sections Not breastfeeding Mother to child transmission accounts for 95% of HIV infections in children

Four Stages of Infection:

Four Stages of Infection Incubation Period Occurs directly after infection Asymptomatic Lasts 2 to 4 weeks Acute infection Virus multiplies and spreads throughout the blood Lowers the count of CD4 T-cells Individual acquires flu-like symptoms Acute HIV infection

Four Stages of HIV (cont.):

Four Stages of HIV (cont.) Latency stage Neutral period after the spread of the virus and before the onset of AIDS Can last from 2 weeks to 30 years AIDS CD4 levels drop below a critical level Cell-mediated immunity is lost Common infection can kill the patient

Genetic Variability:

Genetic Variability Fast rate of replication and high mutation rate leads to high variability Simultaneous infection Two different strains infect the same cell causing a third hybrid virus to be created This high variability and the fact that new strains are being created everyday prevents vaccines and other cures from progressing

Diagnosis:

Diagnosis Difficult due to minimal symptoms and low rates of testing Less than 1% of the sexually active population in Africa has been tested Screening consists of an enzyme-linked assay (ELISA) that detects the level of antibodies to HIV-1 If positive they will be subject to a Western Blot test to confirm Tests are extremely accurate

Treatment:

Treatment There is currently no vaccine or cure Treatment consists of a highly active antiretroviral therapy (HAART) Has many negative side effects such as abdominal pain, diarrhea, headache, and liver failure Most patients that undergo this treatment have reported improvements in their general health and quality of life

Recent discoveries:

Recent discoveries A study showed that stressful events can cause an increased rate of transmission Increase by 24-27% in unprotected sex Due to a compromised immune system in times of stress

Interleukin-10:

Interleukin-10 Successful pathogen clearance depends on a balance between inflammatory immune response and immunoregulatory mechanisms Interleukin plays a critical role in this balance Deceases in IL-10 have been linked to more rapid disease progression in the late stages of HIV infection

HIV Vaccine:

HIV Vaccine The National Institute of Allergy and Infectious Diseases(NIAID) claims to have found two antibodies, VRC01 and VRC02, that neutralize over 90% of all known strains of HIV They bind to the unchanging parts of the virus that allow HIV to enter the cell. These antibodies offer a potential solution to the viruses ability to mutate and develop resistance This is the biggest inhibitor to developing a vaccine

Bibliography:

Bibliography Agrawal , Sachee , Sandhya Sawant , and Jayanthi Shastri . "Prevalence of HIV-2 infection in Mumbai." Indian Journal of Dermatology, Venereology and Leprology 76.6 (2010): 709. General OneFile . Web. 6 Dec. 2010. Boily MC, Baggaley RF, Wang L, Masse B, White RG, Hayes RJ, Alary M. "Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies". The Lancet Infectious Diseases 9 (2) February (2009): 118–129. "Bulletin Board." Pediatric Health 4.5 (2010): 467+. General OneFile . Web. 6 Dec. 2010. Chan, DC., Fass , D., Berger, JM., Kim, PS. (1999)."Core Structure of gp41 from the HIV Envelope Glycoprotein" (PDF). Cell 89 (2): 263–73. Fan, H., Conner, R. F. and Villarreal, L. P. eds , ed. AIDS : science and society (4th ed.) 2005. Boston, MA: Jones and Bartlett Publishers.

Bibliography (cont.):

Bibliography (cont.) Friedman- Kien AE. "Disseminated Kaposi's sarcoma syndrome in young homosexual men". J. Am. Acad. Dermatol . 5 (4): 468–71. Hammer, Eron , Reiss, et al. JAMA 2008; 300:555-570 “Infant diagnosis of HIV." Bulletin of the World Health Organization 88.9 (2010): 649. General OneFile . Web. 6 Dec. 2010. Kuiken , Carla. “HIV Sequence Compendium 2008.” Theoretical Biology and Biophysics 2008. Los Alamos, New Mexico. Kumaranayake , L. and Watts, C. "Resource allocation and priority setting of HIV/AIDS interventions: addressing the generalized epidemic in sub-Saharan Africa". J. Int. Dev. 13 (4) 2001: 451–466.

Bibliography (cont.):

Bibliography (cont.) Kwon DS, and DE Kaufmann. "Protective Anddetrimental Roles OfIL - 10 InHIV Pathogenesis." European Cytokine Network . 21.3 (2010): 208-14. Last, John M. "Retrovirus." Encyclopedia of Public Health . Ed. Lester Breslow . Vol. 3. New York: Macmillan Reference USA, 2002. 1036-1037. Gale Virtual Reference Library . Web. 6 Dec. 2010. Mayer, Kenneth H., Margie Skeer , and Matthew J. Mimiaga . "Biomedical approaches to HIV prevention." Alcohol Research & Health 33.3 (2010): 195+. General OneFile . Web. 7 Dec. 2010. McGovern, Susan L. “ A Common Mechanism Underlying Promiscuous Inhibitors from Virtual and High-Throughput Screening.” Journal of Medicinal Chemistry 2002 45 (8), 1712-1722. Wells Pence B, et al. "Incident Stressful and Traumatic Life Events and Human Immunodeficiency Virus Sexual Transmission Risk Behaviors in a Longitudinal, Multisite Cohort Study." Psychosomatic Medicine . 72.7 (2010): 720-6.

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