BASICS OF

HIV
HIV History
o HIV is thought to have entered into humans somewhere
between 1914 and 1940.

 Disease first described in USA- 1980( 4 H club)

 Luc Montagnier (Pasteur Institute)-Lympadenopathy Assoc

Virus LAV-1983.
 Robett Gallo (NIH)- HTLV-III-1984

 Jay Levy (Univ of California) AIDS Assoc Retrovirus (ARV)

o In 1983, a retrovirus, now called human immunodeficiency

virus (HIV), had been identified as the cause of AIDS.
Epidemiology

 In India first report –1986(Madras )

 First AIDS patient –1986(Bombay)
 HIV is now seen in all states in India –
highest in Manipur, Maharashtra and
Tamilnadu
 HIV
 “Human Immunodeficiency Virus”
 A specific type of virus (a retrovirus)
 HIV invades the helper T cells to
replicate itself.
 No Cure
 AIDS
 Acquired Immunodeficiency Syndrome
 HIV is the virus that causes AIDS
 HIV infects the immune system cell called
the Helper T cells (-most important white
blood cell involved in identifying
infections.)
 Disease limits the body’s ability to fight
infection
 No Cure
Structure &
Life Cycle of
of HIV
 HIV Genome

Structural Genes
 env - gp160 (gp120:outer membrane part, gp41: transmembrane part)
 gag core proteins - p15, p17 and p24
 pol - p16 (protease), p31 (integrase/endonuclease)))

Non Structural Genes

tat- trans activator of transcription vif - viral infectivity factor
rev- regulator of viral protein expression vpr- viral protein R
nef - negative regulatory factor vpu- viral protein U
 TAT and REV are essential for HIV replication
Antigenic variation
 Highly mutable virus- due to error prone
nature of RT.
 Classification of HIV1
 Group M –10 subtypes A-J
 Group O ( Out liers) –Cameroon 9 subtypes
 Group N ( new)
 Classification of HIV 2
 5 subtypes A-E
Geographical HIV1

 INDIA subtype -C
 USA subtype-B
 Thailand -E
 Asia – heterosexual transmission
 USA –homosexual/ blood transfusion
Resistance

 Highly labile
 Inactivated –100oC in seconds
 10% ethanol
 5% lysol
 35% isopropyl alcohol
 1% Hypochlorite (fresh) 10 mts.
 10% Dettol ( Undiluted)
  Gluteraldehyde 2%- Endoscopic equip (30mt)
  House hold bleach –10 mts.
 Dried Blood HIV survives- 7 days
  Dead Body- 4 weeks
Pathogenesis

 HIV attaches to
 CD4 cells (Helper T cells)
 5-10% B lymphocytes
 10-20% monocytes and macrophages.
 Glial cells and microglia
 HIV damages CD4 – no cytokines released.
 Humoral immunity- polyclonal B cell stimulation.
 Monocytes/macrophages decreased
 The disease AIDS is due to immune deficiency .
Body Fluids with High
Concentrations of
HIV
 Blood
 Semen/Vaginal fluids (as high as blood)
 Breast milk
 Pus from sores
Low concentrations of HIV
It is highly unlikely you will be infected if
you come into contact with:
 Sweat
 Tears
 Urine
 Saliva (-highly possible if blood from
mouth sores is present)
How is HIV Spread?
 ANY type of sexual activity (highest risk)
 Sharing used drug needles
 Pregnancy-from mother to child
 Sharing razors- if blood is present
 Tattoos/body piercing if equipment is not
clean.
Virus does not spread through

 -Hugs
 -Hand shakes
 -Sneeze
 -Cough
 -Sharing food,Cooking vessels
Four Stages of HIV
Stage 1 - Primary
 Short, flu-like illness - occurs one to six
weeks after infection
 no symptoms at all
 Infected person can infect other people
Stage 2 – Asymptomatic
 Lasts for an average of ten years
 This stage is free from symptoms
 There may be swollen glands
 The level of HIV in the blood drops to
very low levels
 HIV antibodies are detectable in the
blood
Stage 3 - Symptomatic
 The symptoms are mild
 The immune system deteriorates
 emergence of opportunistic infections
and cancers
Stage 4 - HIV  AIDS
 The immune system weakens
 The illnesses become more severe
leading to an AIDS diagnosis
 Person dies of rare opportunistic infections
that take advantage the weakened immune
system:
 Person dies in a matter of months.
Can HIV be cured?
 NO! Drugs are available to manage the
disease, but HIV stays in the body
forever!
 PROBLEM: RNA viruses mutate at a
very high rate. A person with HIV under
control can evolve resistance to the drug
treatments.
 Some infected persons have several
strains of HIV in their bodies.
Thank you