36,810,776

every 12 seconds someone else is infected

mostly in Africa, Sub-saharan then India

Butchering and food consumption

Old World Monkies

2 primates with SIV; Simian Immunodieficiancy Virus

Butcher killed two monkeys with HIV and got both of their virus'

It is a Enveloped RNA Retrovirus

Uses Reverse Transcriptase going from RNA to DNA to RNA

Hybrid virus' due to antigenic shift

The 1950's

1981 in the United States; San Fran and NY

gay related immune disorder

(GRID)

HIV 1, 2, and 3

Subtype is called clades; each has an abcd

Flu symptoms

The titer/amount of virus in the blood

The T cell levels in the immune system (cd-4)p; once low enough will see symptoms, 50% in days

Starts with fatigue

Massive chronic diarrhea; gastric system overgrowing

Weight loss

Neurological changes

Leads to Aids Dimensia - confusion and mood swings

HIV is the virus = infection

Aids is the disease caused by HIV

What are the three types of infection of HIV

describe them

Acute - within 5 years devlop AIDS- rapid

Mid-level - develop AIDS in 5 to 10 years

Long term- non progressor- longer than 10 years to develop

What is the progression of Aids based on?

How are the types of HIV determined?

Can everyone get Aids?

Genetics and access to medical care

Type is determined by the amount of T cells and titer levels

some people never get aids

still circulates and transmittable

Using cells and their receptors

What is AIDS

and

why are opportunistic infections a problem?

Aquired immune deficiency syndrome

(wipes it out)

 can't present them to the immune system

Macrophages activate T cells that activate B cells

No macrophages= no adaptive immune response

Stage 1: Not aids: HIV infection asymptomatic,

need to get to AIDS

Stage 2: not aids: Minor recurrent upper resp. infection; colds, lasting 8 to 12 weeks

Stage 3: several bacterial infections (no immune system)

 = strep for a long time

Step 4: Toxoplasmosis of brain and esophagitis indicate aids

Must have HIV infection; cd4 T cell count below 200 and having indicator diseases like opportunistic infections

-hormone imbalances

-matabolic disturbances = wasting disease

-Nights sweats

-Lesions on the brain, meninges, spine, and peripheral nerves

Kaposi's sacroma; skin cancer associated

 caused by Kaposi's sarcoma associated herpe virus

People do not normally get KS

90%

others die of other things, car accidents, gun shots, ect

Viral load increase within 2 weeks

Starting to feel sick, get better within 7 - 10 days

Within 2 months antibodies die off

Stage 2 and 3 can last years depending on type

viral load drops because of T cells presenence

virus will take over, just a matter of time

once T cells below 200 automatically classified with AIDS

Only way to get it is blood borne

 1. Blood transmission

2. Transmission within the host - HIV integrades into the host

-cd4 infected, binds to it, sysnthesis integrates it

and puts it into the host genome 

-syncitia formation; cells fusing to make one giant nucleic cell

Exception to blood is saliva, one gallon at on time

90% sexual transmission

10% birth or IV drug users

Risks of developing HIV

greatest influences

Females: 

Greatest in underdeveloped countries

1. Prostitutes, 2. IV drugs users,  3. Blood

Males:

Greatest in developed countries

**1. Homosexual contact 2. IV drug users, & Prostitutes

-Middle east doesn't report

-35 to 45 mill living with HIV

-District of Columbia; 2060/20 miles

-Some states do no have to report

homosexuality privacy and discrimination

-New York is the state with the most infection

-Virginia Islands is the territory with the most AIDS

Pennsylvania - 16,750/100,000

Philadelphia highest incidence

1. Bind- HIV using GP-120 portion with accessory receptors of

CYCR4 of CD4 or CCRS of MAC

2. Uncoat - Ph in vessicle drops and RNA moves out

3. Synthesis - RNA converted to DNA by reverse transcriptase, intergrates intos the host genome with integrase then goes back to RNA with transcription

4. Assembly - inclusion bodies come together

5. Release by exocytosis/budding

How transmission can occur within the body

The enzyme required for integration,

tells HIV host cell must replicate

CXCR4 and CCR5

lock and key fit for the hold

blood exposure

 needles, sex, oral sex, semen and vaginal fluid

or

infection by macrophages

splash of blood

They do not have the right receptors, HIV can not get in

No Nucleus; no DNA; no integration

ONLY WBC, DC, MAC, or T cells can integrate

Transinfection

-Infection from another cell; Virus infects mac or dc when transmitting virus, two cells coming together

Cyst infection

-infected cell replicating, transmitting within the host = cd4 multiplying and infecting others

Problem: contact with thousands of cells per day = latent period

HAART

Highly Active Anti Retroviral Therapy

Cocktail drugs for HIV

Entry inhibitor - stops binding by endocytosis;

stops cell from being infected, not person

others stop active virus from being made; already infected 

-Nucleoside analogue - stop reverse transcriptase

= no DNA= no integration

 -Protease inhibitor - stops assembly, no proteins

 -integrase inhibitor - stops viral dna from integrating

None of them

Can't stop infection, only prevent

HIV isn't constant, every cell is at different stages

If you only hit one, you won't inhibit all reactions

Must give different types of drugs

Tocix side effects

Expensive

All four pills are single pills; must take 30 - 40 per day

Takes all pills and puts it into one

Side effects are the reason they took so long to make

Very expensive, people still take the old way

Fuzeon: entry inhibitor; stops binding of CCR5, mac and dc

Isentrase (wonderdrug): IV; for integrase inhibitor - drops viral load and stops integration

Lexiva: Only drug allowed for kids; 2 to adult; Prokase inhibitor; oral drink

Ziagen: Reverse transcriptase inhibitor; no made viral dna; pill

Patient non-compliance

if stop taking drugs, virus' change gradually with antigenic drift, new virus' made and drugs won't work anymore

also they cannot completely erradicate HIV

Disease that take advantage of the week immune systems

Fairly common, usually by germs

HIV disables the immune system - no T cells or MACS= no presentation or adaptive immune response

Reduce risks by good hygiene

Prohopylaxis treatment

takings drugs before getting it or attempting to resist it

Cannot die, AIDS is a syndrome, you die from the infection

ie. pneumonia, esophasgus, ect

-droplet transmission, aerobic

-tuberculos and granulomas that form in the lungs by T cells

Symptoms: Chronic cough, weight loss, bloody sputum,

high fever and night sweats

 Diagnosis: X ray and culturing, 3 days, 3 times

Treatment: Anitbiotic therapy and retrovirals; 19 pills per day for the rest of life

Myobacterium Tuberculosis combined

with HIV is a problem why?

infection of the lungs

HUGE problem with HIV b/c it can't be controlled

HIV cannot get granulomas so they get 2nd TB and leads to extrapulmonary TB, they cant wall off infection

 -must have HIV, not just TB

- decrease life with dual forms

-stage 3 and 4 of AIDS

-12.4% infected with HIV, 1.4 mill people, 1 person per second

-leading secondary infection in developing countries

-MTB is the normal death infection 

-Drug in trial for MTB in HIV that blocks protein, doesn't stop it, just stops replication. Quality of life drug

increase in viral replication:

5 to 160 during acute phase of MTB

1. Myobacterium Tuberculosis

2. Candida albican

-Most common funal infection for HIV

-Normal biota, fungus

-Contact transmission, commensal organism living on the skin

-Sentinel infection of Oral thrush

Recurrent episodes:

-oral thrush

-esophagus: leads to death:

yeast infects lining of esphagus, can't eat

indictive to a major problem 

Oral thrush is sentinel to candida albican

90% with HIV develop oral thursh and is the lead cause of esphoageal disease

1. Psuedomembranous candidosis - most recognizable

2. Ethythematous candidosis - red lesions in mouth

3. Angular cheilitis - found in the corners of the mouth

4. - Hyperplastic candosis - invades/breaks capillaries, palets

Oral pain, swallowing

in pseudomembrane: white plaque on tongue or mucosa

Anything with -azole

Lemons to be a cure for oral thursh, acidic,

change of ph in the mouth

Obligate intracellular parasite - protozan

Cause is toxiplasma gondii leads to encephalitis and mennangitis

60% WW, 15% in U.S and 75% in Europe

Transmission: cat poop and undercooked meat

Reactivation of chronic infection: 10-14%

Symp: altered mental status, fever, vision, glucoma, headaches depends on area of brain

Diagnosis, MRA, CT for lesions; Treat: Folic acid makes bases of DNA without it damages DNA = cancer

Singles or chicken pox; cant catch shingles

airborne; tested for HIV with these

Affects the neurons that go everywhere = massive skin lesions

 80% infected

HIV person is at great risk; 95% positive

comes from ther dermatope

latent and then activates at infection

First evidence of HIV - stage one and 2 asymptomatic

Symptoms: cough 4 to 7 days

Skin lesions 2 weeks after

Lesions are diagnosed

Treatment is Acyclosis or Valtrex