HIV infection !

By: Dalal Alanazi

 Introduction

A pregnant woman visits the gynecologist. She is afraid that she

might be HIV-infected. She is a refugee from zimbabwe. Her
husband is HIV-positive.
She is worried that if she turns out to be HIV-positive , probably her
baby would be infected as well . She does not know if her health
insurance will covar all her costs. she is also afraid to talk to her
husband about her worries and she wants to know that if he needs
to know that she is being tested for HIV .
 Objective
₪ Definition of viruses.
₪ Classification and types of viruses.
₪ Pathogenesis of virus.
₪ Definition of HIV.
₪ Difference between HIV-1 & HIV-2.
₪ Difference between HIV & AIDS.
₪ Pathogenesis.
₪ Stages of HIV and their symptoms.
₪ Diagnosis.
₪ Does the refugee centre provide insurance for HIV.
₪ Treatment.
₪ Prevention.
₪ Epidemiology of the world and Zimbabwe.
Viral
 What is the virus

₪ Virus are the smallest infectious, and typically

contain either DNA or RNA But not both.

₪ A virus can replicate only inside the

living cells of an organism.

₪ Viruses can infect all types of

organisms, from animals and plants.
 The classification of viruses
based on

₪ Type of nucleic acid DNA or RNA and the number of

strand of it single or double. Except the Mimivirus contain both
DNA and RNA

₪ The shape of nucleic acid:

segmented Linear circular

 “The classification of viruses based on”

Cont ..
₪ Polarity of viral genome :

positive stranded RNA virus ( +ve ) Or sense strand:
Viral genome can be used directly as mRNA, (coded
information about how to build proteins).

Negative strand RNA virus ( -ve ) Or anti-sense strand: Transcripts
have first to be made, (which does not encode mRNA ).
₪ The envelope: It would be presence or absence.
₪ The symmetry and Asymmetry of the nucleocapsid
“Type of the virus”.
 Type of the virus

₪ Helical (spiral ) symmety

₪ Icosahedral (Cubical symmetry)

Symmetry
 Cont .. “Type of the virus”

₪ Enveloped

₪ Combined Asymmetry
(Complex)
 Viral pathogenesis is the process by which
viruses produce disease in the host. Viral
pathogenesis can be divided into several
stages, including:

₪ Entry into the body.

₪ Initiation of infection at a primary site.
₪ Activation of innate protections.
₪ An incubation period, when the virus is
amplified and may spread to a secondary site.
- Replication in the target tissue, which causes
the characteristic disease signs.
₪ Host responses that limit and contribute
“immuno-pathogenesis” to the disease.
₪ Virus production in a tissue that releases the
virus to other people for contagion.
₪ Resolution or persistent infection/chronic disease.
HIV infection
 Definition of HIV

₪ HIV infection is a condition caused by

Human Immunodeficiency Virus (HIV).

₪ This condition gradually destroys the

immune system, which makes it hard for
the body to fight infections.

₪ It causes acquired immunodeficiency

virus (ADIS).
 Difference between
HIV-1 & HIV-2:

₪ HIV-2 is lower transmissibility.

₪ HIV-2 develops more slowly.
₪ MTCT )Mother to child transmission)
is relatively rare with HIV-2.
₪ HIV-2 is found primarily in West Africa.
₪ HIV-1 is more common worldwide.
 The most methods of transmission
of HIV are:

₪ Sharing needles with infected person.

₪ Having sex with infected person.
₪ A pregnant women can transmit the virus to her
fetus through their shared blood circulation, or
a nursing mother can pass it to her baby in her
breast milk.

HIV/AIDS can’t be transmitted through:

₪ Toilet.
₪ Sharing Utensils.
₪ Mosquito.
 Risk factor of HIV

₪ Have unprotected sex (do not use condoms).

₪ Are a man who has sex with other men.
₪ Have or have recently had a sexually
transmitted disease such as hepatitis B&C.
₪ People who inject drugs or steroids, especially
if they share needles.
₪ Babies who are born to mothers who are
infected with HIV.
Pathogen
esis
of HIV
 Stage 1:
Primary HIV Infection

₪ The first stage is called acute infection.

₪ It is often accompanied by a short flu-like illness
₪ It typically happens within 2 to 6 weeks after
exposure or becoming infected.
₪ During this stage there is a large amount of HIV in
the peripheral blood and the immune system begins to
respond to the virus by producing HIV antibodies.
This process is known as (seroconversion).
 The symptoms of HIV
infection for stage 1

Headache Fatigue

Fever
vomiting Sore throat

Diarrhea that
lasts for more
than a week
 Stage 2:
Clinically Asymptomatic Stage

₪ This stage lasts for an average of ten years

₪ During this period without symptoms, HIV is
slowly killing the CD4 T-cells and destroying the
immune system.
₪ Blood tests during this time can reveal the number
of these CD4 T-cells. For an HIV-infected person,
the number of CD4 T-cells steadily drops.

No clear symptoms appear *

 Stage 3:
Symptomatic HIV Infection

₪ AIDS (acquired immune deficiency

syndrome) is the advanced stage of HIV
infection. When the CD4 T-cell number drops
below 200, people are diagnosed with AIDS.
The symptoms of stage 3
₪ Being tired all of the time.
₪ Swollen lymph nodes in the neck .
₪ Fever lasting for more than 10 days.
₪ Night sweats.
₪ Unexplained weight loss.
₪ Purplish spots on the skin that don't go away.
₪ Shortness of breath.
₪ Severe, long-lasting diarrhea.
Diagnos
is
 The HIV Test:

₪ Enzyme-linked immunosorbent assay (ELISA).

This test is usually the first one used to detect infection
with HIV. If antibodies to HIV are present (positive),
the test is usually repeated to confirm the diagnosis.
 Cont ..
₪ Western blot.
This test is more difficult than the ELISA
to perform.

₪ Polymerase chain reaction (PCR).

This test finds either the RNA of the HIV
virus or the HIV DNA in white blood cells
infected with the virus.
 If you receive a diagnosis of HIV/AIDS, several
types of tests can help your doctor determine what
stage of the disease you have. These tests include:

₪ CD4 count.
- CD4 cells are a type of white blood cell that's specifically targeted
and destroyed by HIV.

- CD4 count vary from 500 to more than 1,000= healthy person .

- CD4 count becomes less than 200 =HIV infection progresses to

AIDS.
₪ Viral load:
- This test measures the amount of virus in your blood.
 Baby’s investigation of
HIV after birth

₪ Most HIV tests look for antibodies to HIV, not the

virus itself. But these tests aren’t very useful for babies
born to HIV-positive mothers.

WHY ?
₪ That’s because the mother’s HIV antibodies get into the
baby’s blood during pregnancy. If the mother is HIV-
positive, the regular HIV test will show that the baby is
HIV-positive, even when that isn’t true.
Treatment
 Treatment
₪ Anti-retroviral medicines work by stopping the HIV from
making copies of itself .
- To strengthen the immune system.
- The amount of virus in your body (viral load) is decreased.
- Allows your body to make more CD4 T cells.

₪ Commonly three different types of medicines are taken

together. This is called combination therapy. And that
helps to prevent the virus from becoming resistant to the
medicines. These medicines are usually taken for life.
 The classes of anti-HIV
drugs include:
₪ Non-nucleoside reverse transcriptase inhibitors (NNRTIs).
It disables a protein needed by HIV to make copies of itself.
₪ Nucleoside reverse transcriptase inhibitors (NRTIs).
They are faulty versions of building blocks that HIV needs to
make copies of itself.
₪ Protease inhibitors (PIs).
It disables protease, another protein that HIV needs to
make copies of itself.
₪ Entry or fusion inhibitors.
These drugs block HIV's entry into CD4 cells.
₪ Integrase inhibitors.
Raltegravir (Isentress) works by disabling integrase, a protein
that HIV uses to insert its genetic material into CD4 cells.
₪ HIV is a disease that requires a lot of management
including doctor visits and treatments.

- Fortunately, most major health insurance will cover HIV

treatment under normal circumstances.
- Unfortunately, there are some exceptions that can occur and
some concerns of which you should make yourself aware.

₪ Because HIV is a relatively new disease, a lot of

treatments and medications for it are still experimental. For
the most part, insurance companies are not required to
cover experimental medications and treatments for HIV.
Preventi
on
 How to protect your baby
from getting HIV :

₪ Mother-to-child transmission of HIV

can be prevented by using antiretroviral drugs,
which reduce the chances of a child becoming
infected with HIV from 20% to less than 5%.
 How to prevent women
from getting HIV

₪ Don't have sex.

₪ Don't use drugs or alcohol with sex.

₪ Use a condom.
Epidemiol
ogy
 Epidemiology
₪ Zimbabwe is one of the five countries hardest hit
by HIV and AIDS globally. One in five
Zimbabwean adults were living with HIV and
AIDS in 2009 while approximately 66,073
people died of AIDS related causes.

₪ It is estimated that 343,460 adults are in need

of Anti-Retroviral Therapy (ART).
 Summary
₪ Viral
₪ HIV infection
- Pathogenesis
- Stages of HIV
- Diagnosis
- Treatment
- Prevention
- Epidemiology
Any Question
 Reference
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