Treatment of HIV-Related Illnesses and AIDS
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Is HIV and AIDS the same thing?
no, but the HIV (the virus) causes AIDS (the syndrome)
What does HIV stand for?
Human Immunodeficiency Virus
What type of virus is HIV?
- a specific type of virus
- a Retrovirus
What are retroviruses?
- RNA viruses that reverse transcribe into DNA
- transcribe RNA to DNA
What does HIV do?
- the virus invades the Helper T cells to replicate itself
- it can hide in the Helper T Cells for a long time (antigenic concealment) can lie dormant
Is there a cure for HIV?
What does AIDS stand for?
Aquired Immunodeficiency Syndrome
Who discovered the AIDS virus?
discovered independently by Luc Montagnier of France and Robert Gallo of the US in 1983-1984
What causes AIDS?
the HIV virus
What does AIDS do?
- this disease limits the body's ability to fight infection
- a person with AIDS has a very weak immune system
Is there a cure for AIDS?
What are the former names of the AIDS virus?
- Human T cell Lymphotrophic Virus (HTLV-III)
- Lymphadenopathy Associated Virus
- AIDS Associated Retrovirus (ARV)
When was the HIV-2 virus discovered?
- Antigenically distinct virus epidemic in West Africa (ask about this)
How many people in the US are infected with HIV-2?
How many people worldwide are infected with HIV-2?
How is HIV related to death?
- 4th leading cause of death in women in the US ages 25-44
- Leading cause of death in men in the US ages 25-44
What are some characteristics of the HIV virus?
- Icosahedral (20 sided) enveloped virus of the lentivirus subfamily of Retroviruses
- Retroviruses transcribing RNA to DNA
- It has 2 viral strands of RNA found in a core surrounded by protien in the outer coat
- ---> the outer envelope contains a lipid matrix within which specific viral glycoprotiens are embedded
- ----------> * these knob like structures are responsible for binding to the target cell
Know picture of an HIV virus
What is the outer shell of the HIV virus known as?
the viral envelope
what is embedded in the viral envelope?
a complex protien known as Env which consists an outer protruding cap glycoprotien 120 and stem glycoprotien 14
What else is within the viral envelope?
an HIV protien called p17 (matrix)
What is within the p17?
the viral core or capsid which is made of another viral protien called p24 (core antigen) *
Explain an early phase HIV infection
- in an early phase HIV infection, initial viruses are M-trophic. Their envelope-glycoprotien, glycoprotien 120, is able to bind to CD4 molecules and and chemokine receptors called CCR5's found on macrophages.
- see picture
Why is it that HIV can mutate so quickly?
- because there is poor proofreading so it can get into your DNA.
- once it gets into your DNA you can't stop it because that DNA gets replicated
Explain the HIV life cycle
- 1. The virus comes in. The glycoprotiens on the virus attach to the CD4 and CCR5 receptors on the T helper Cell/Macrophage. (later on, after fusion, these outside parts stay outside the cell during the "decintigration)
- 2. Fusion of the virus cell and the T Helper Cell, then the viral information goes into the T Helper Cell
- 3. The envelope and capsid disintigrate so then the RNA is exposed
- 4. Reverse transcriptase takes the RNA and makes it into a single strand of DNA. Then it makes another strand of DNA
- 5. Intergrase (an enzyme) grabs hold of the DNA and brings it to the nucleus. The intergrase cuts up the host DNA into 2 pieces and inserts the HIV reverse transcripted DNA made from the transcriptase between them. This determines life long infection, because you will copy this new DNA with the virus
- 6. mRNA is made from the viral DNA, and then all of the viral protiens (envelope, inside of capsid, all parts of the virus) are made to make virus
- 7. Protease helps to make the final viral protiens
What might be a reason why HIV would be so hard to cure?
because it makes RNA to DNA then DNA to RNA. Too many changes making it hard to cure
What types of cells does HIV invade?
- T Helper Cells
What is the difference between HIV and AIDS?
HIV is the actual virus. If you have HIV it compromises your immune system and you could get AIDS, but you don't always have it. AIDS is the syndrome result of HIV. If you have AIDS, you have HIV.
Where does HIV come from?
The HIV virus is a ....
- 20 sided virus
- has an envelope around it
- is a type of lentivirus
Where are CD4 and CCR5 located?
- the host cell
- ---> T helper Cells
- ---> Macrophages
What are the 4 stages of HIV?
- Stage 1: Primary Stage
- Stage 2: Asymptomatic
- Stage 3: Symptomatic
- Stage 4: HIV -> AIDS
Explain The Primary Stage
- first stage
- short, flu-like illnessesoccurs
- 1-6 weeks after infection
- no symptoms of AIDS, you would just think you have a regular flu- like sickness
Explain the Asymptomatic Stage
- 2nd stage
- no symptoms of AIDS
- lasts an average of 10 years
- ---> if you take REALLY good care of your immune system, it can last longer.
- there may be swollen glands
- the level of HIV in the blood drops to very low levels, preventing you from getting AIDS
- HIV antibodies are detectable in the blood
Explain the Symptomatic Stage
- 3rd Stage
- Symptoms are mild
- ---> flu like symptoms, small infections
- Immune system begins to deteriorate
- Emergence of opportunistic infections and cancers
Explain the HIV -> AIDS Stage
- 4th Stage
- the immune system weakens
- Kaposi's lesions form (cancerous sores)
- The illnesses become more severe leading to an AIDS diagnosis
When is the time to start taking Antiretroviral Agents?
when you become infected with HIV
What do Antiretroviral Agents do?
- they are very expensive drugs
- they don't cure HIV, since it has no cure, but their goal is to prevent/delay development of opportunistic disease
- won't get rid of the virus, but keeps it's levels low
- effect depends on the person
- inhibit reproductions of the virus, but once again, doesn't kill it
What is the Reccomendation for taking Antiretroviral Agents?
drugs should be started before CD4 cell count falls below 20
When do you get AIDS?
- When your immune system goes down and opportunistic infections get into your body, causing you to get AIDS
- HIV is an opportunistic virus- it will attack weak spots of your immune system
What are the opportunistic Infections associated with AIDS (like what is that definition)
these are infections that you can get if you have AIDS
What are the types of opportunistic Infections associated with AIDS?
What are the bacterial opportunistic infections associated with AIDS
- Strep Pneumonia
What are the viral opportunistic infections associated with AIDS
- Kaposi Sarcoma *
- Oral Hairy Leukoplakia
- Oral Candidiasis
What are the parasitic opportunistic infections associated with AIDS
Pneumocytic Carinii: parasite that gets into your lungs
What are the fungal opportunistic infections associated with AIDS
What are the cancer opportunistic infections associated with AIDS
Kaposi Sarcoma *
What is Oral Hairy Leukoplakia
- being that HIV reduces imminologic activity, the intraoral environment is a prime target for chronic secondary infections and inflammatory processes, including OHL
- due to Epstien-Barr Virus under immuno-suppressed conditions
What is Oral Candidiasis?
What is Kaposi Sarcoma?
- one of the classic HIV/AIDS type sicknesses
- Kaposis sarcoma is a rare cancer of the blood vessels that is associated with HIV.
- Normal people would be able to fight it off w/ cytotoxic T cells but people with HIV/AIDS dont make healthy cytotoxic T Cells
- manifests as blush-red
What happens when you get AIDS?
- CD4 count drops below 200
- ---> this means the person is considered to have advanced HIV disease
If preventative medications are not started when count drops below 200, what does the HIV infected person becomes at risk for?
- pneumocytis carinii pneumonia
- cryptococcal meningitis
What is the person at risk for it the CD4 count drops below 50?
- mycobacterium avium
- cytomegalovirus infectus
When do most deaths by HIV occur?
when the CD4 count drops below 50
What are the treatment options for HIV?
- Antiretrovirual Drugs
- Opportunistic Infection Treatment
What are the three types of antiretroviral drugs?
- Neucleoside Reverse Transcriptase Inhibitors
- Non-Neucleoside Transcriptase
- Protease Inhibitors
What is a Neucleoside Reverse Transcriptase Inhibitor?
- AZT (Zidovudine)
- Fake neucleotides that go into the viral DNA that don't work so the viral DNA can't be transcribed
What is the difference between a neucleotide and a neucleoside?
- neucleotide: a sugar, a phosphate and a base
- neucleoside: a sugar, a base, and three phosphates
What is a non-neucleoside Transcriptase Inhibitor?
- viramune (Nevirapine)
- a drug that attaches itself to the reverse transcriptase so that it cannot work
What are Protease inhibitors?
- stop functions of protease (making virus protiens)
- Norvir (Ritonavir)
What is opportunistic infecton treatment?
- they treat just the symptoms, which isn't good enough
- issued in an event where antiretroviral drugs are not available
- ---> usually if antiretroviral drugs are too expensive, etc
What are complications of Opportunistic Infection Treatment?
- complications vary from patient to patient
- AIDS wasting syndrome
- --->occurs in most patients with AIDS
- weight loss of more than 10% of body weight
- chronic weakness or fever for more than 30 days
- chronic diarrhea of 2 loose stools daily for greater than 30 days
What is the AIDS dementia complex?
- infection of the brain¢ral nervous system
- mild to severe
- memory impairment/ personality changes, hallucinations, loss of balance, slower responses
- end stage before you die
The movie, And the Band Played On, discusses the origin of the AIDS virus and how it spontaneously spread across the world. It used the Ebola disease to foreshadow the forth coming of another serious disease. The world was not prepared to handle such a contagious plague. Doctors around the world assumed that the first cases of the HIV virus to be just an abnormality of a certain disease, their carelessness of this matter was the start to the spread of this disease. Throughout this movie, it illustrates different points, such as the beginning of HIV, the misconceptions it gave, and the panic it aroused amongst doctors and the common people.
The AIDS epidemic did not have to happen. It was caused by the negligence from doctors that did not think the matter was a concern. It started out when one patient had the disease, and the doctors concluded that it was a mutated version of a disease. But it turned out that that was the first patient to suffer the HIV virus. If this situation was taken as an important matter, they could have taken that patient to a special institute so that the patient would not be capable of transmitting the disease
know basic idea of movie too
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