HIV & AIDS – Flashcards

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

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

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

;

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

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

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