HIV Human Immunodeficiency Virus

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HIVHuman Immunodeficiency Virus

• Tyler Hinkle
• Petia Zamfirova
• Anita Zarska
• Heather Ours
• Sara Webster

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White Blood Cells

• Provide the body with its principle line of
  defense against disease.
• Many types including
• NeutrophilsEosinophilsBasophilesMonocytesHelp
  er T cellsCytotoxic T cells Memory T cells
  Suppressor T cells

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Viruses

• Cannot reproduce on their own
• Reproduce by using the cells of other humans or
  animals as hosts
• Don't have cell walls or a nucleus and are made
  up of genetic information wrapped inside a
  protective shell
• Can only replicate within the cell
• Retroviruses, as is HIV, are RNA viruses that in
  order to replicate need to make a DNA copy of
  their RNA which allows the virus to replicate by
  incorporating this DNA into the host cells genes

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Transfer of HIV

• Cannot be transferred through everyday contact as
  in coughing, shaking hands or insect bites.
• Through direct contact with bodily fluids
• Unprotected intercourse heterosexually or
  homosexually through vaginal fluids and semen
• Shared needles
• In saliva in low concentrations
• Can be transmitted through oral sex
• Blood transfusions
• Vertical Transmission (Mother to fetus during
  pregnancy, labor and delivery, and breast
  feeding)

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What does HIV do?

• Attacks Immune System, specifically, Helper
  T-cells, making it difficult for the body to
  fight infection.
• These cells, CD4 T-cells are crucial to the
  normal function of the human immune system and
  without them, all other cells in the immune
  system are prevented from operating. No reaction
  against an invader can me made.
• The HIV virus eventually makes Helper T-cells an
  HIV producing factory.
• The immune system eventually becomes so
  deteriorated that it is susceptible to all
  diseases that even a common cold can potentially
  kill the AIDS infected individual. (Nobody
  actually dies from HIV or AIDS)

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HIV
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HIV Virus Anatomy

• Image from howstuffworks.com

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Process
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Fear as Awareness
Education programs use fear as awareness and
prevention PRIMARY FACT A person can carry and
transmit the HIV virus for many years before any
symptoms show themselves. A person can be
contagious for a decade or more before any
visible signs of disease become apparent
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Symptoms

• Infections
• Dry Cough
• Rapid Weight Loss
• Night Sweats
• Fatigue
• Diarrhea
• Swollen Lymph Glands
• Sores
• Altered Taste

• Herpes
• Difficulty Swallowing
• Headaches
• Change in Vision
• Fatigue
• Receding Gums
• Fevers
• Bruising
• Bleeding

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FDA Approved Treatments
Highly Active Antiretroviral Therapy (HAART) is a
combination of three of more medications in a
regimen.

• Nucleoside Reverse transcriptase inhibitors
  (NRTIs)
• A nucleoside analog that targets the enzyme
  reverse transcriptase to inhibit HIV replication.
• AZT (zidovudine)

• Protease inhibitors
• (Pis)
• Compounds that target the protease enzyme to
  inhibit viral replication.
• IDV (Indinavir)

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FDA Approved Treatments Cont.

• Non-nucleoside Reverse transcriptase inhibitors
  (NNRTIs)
• Targets structure of reverse transcriptase to
  inhibit enzyme activity, preventing the virus
  from reproducing.
• NVP (nevirapine)
• Very potent but resistance develops quickly

• Entry (Fusion) Inhibitors
• (EIs)
• Blocks the viral fusion process and HIV
  reproduction.
• ENF (enfuvirtide)

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Shortcomings and Side Effects

• Not a cure for HIV
• Resistance to drug therapy
• Treatment does not prevent the virus from
  spreading
• Not always able to increase CD4 cell count
• Heath issues - Liver problems, diabetes, abnormal
  fat distribution (lypodystropy syndrome), high
  cholesterol, increases bleeding in hemophiliacs,
  decreased bone density, skin rash, pancreatitis,
  nerve problems (peripheral neuropathy),
  hyperlipidemia, and hyperglycemia

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Clinical Research

• Coreceptor Inhibitor targets the HIV-1 envelope
  and inhibits CD4 receptor binding.
• Activation of viral reservoirs used in
  combination with HAART to eliminate latent viral
  reservoirs in cells by stimulating virus
  expression.
• RNA-based therapeutic approach makes use of
  short interfering RNAs (siRNAs) which bind to
  destroy HIV (only synthetic RNA has worked on
  target cells).

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Clinical Research Cont.

• Vaccines stimulate anti-HIV immune response.
• Subunit Vaccines genetically engineered
  individual proteins and peptides
• DNA Vaccines DNA containing HIV genes is
  injected into the body to produce HIV proteins
• Recombinant Vector Vaccines Harmless levels of
  viruses or bacteria are injected into the body to
  produce proteins from the HIV gene

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Testing

• New 20 Minute Test

Positive Negative
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Global Statistics 2003

• HIV infection global total 42 million
• Total number of deaths between 1981 and 2003 20
  million
• More than 6000 become infected with HIV everyday
• 3 million die every year
• Women more vulnerable than men

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U.S. Statistics

• HIV Infections 1.3-1.4 million
• AIDS 816,000
• Deaths 468,000
• HIV Unaware 250,000
• May lay dormant for years or decades before
  symptoms occur
• In the US, 1 in 1000 chance of contracting HIV in
  any sexual encounter
• Philadelphia ranked 8th in AIDS cases in U.S.
• As of 2001

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Statistics Cont.

• Sub-Saharan Africa - 29.4 million
• South and Southeast Asia - 6 million
• Latin America - 1.5 million
• North America - 980,000
• Eastern Europe/Central Asia - 1.2 million

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History of HIV/AIDS

• 1926-46 - HIV possibly spreads from primates to
  humans. No one knows for sure.
• 1959 - A man dies in Congo in what many
  researchers say is the first proven AIDS death.
• 1981 - The Centers for Disease Control and
  Prevention (CDC) notices high rate of otherwise
  rare cancer
• 1982 - The term AIDS is used for the first time,
  and CDC defines it.
• 1983/84 - American and French scientists each
  claim discovery of the virus that will later be
  called HIV.
• 1985 - The FDA approves the first HIV antibody
  test for blood supplies.
• 1987 - AZT is the first anti-HIV drug approved by
  the FDA.
• 1991 - Basketball star Magic Johnson announces
  that he is HIV-positive.
• 1996 - FDA approves first protease inhibitors.
• 1999 - An estimated 650,000 to 900,000 Americans
  living with HIV/AIDS.
• 2002 - AIDS global death toll reaches nearly 28.1
  million

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Questions?