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HIV (Pathogenesis (gp120 undergoes conformational change, exposing binding…

- - - - Cytomegavirus
      - Interstitial Pneumonia
      - Pneumocystis Jiroveci
      - TB
- - - - LYSIS OF INFECTED CELLS BY CD8 CYTOTOXIC CELLS
      - PARAPOPTOSIS
      - T CELL INFECTION WITH VIRUS CAUSES T CELL DEATH WITH RELEASE OF NEW PROGENY VIRUS
  - - - Protozoal
        
        Cryptosporidium( on surface of gut epithelium)
        Isospora belli
        Microsporidium
        
        watery
        
        debilitating
        
        Persistent diarrhea
        
        abundant
        
        Toxoplasmosis
        
        Pneumonia
        
        Encephalitis
        
        CNS masses
      - Fungal
        
        Candida
        
        Mouth, esophagus &skin
        
        Disseminate to visceral organs
        
        Elongated spores
        
        Cryptococcus
        
        Meningitis
        
        Pneumocytosis Jiroveci
        
        Silver stain
        
        Exudate in alveoli= hypoxia
        
        Pneumonia
        
        PJP
        
        Histoplasmosis
        
        Pneumonia
        
        Murcomycosis
      - Bacterial
        
        Tuberculosis
        
        HIV+ on ART must not be given BCG vaccine because:
        
        Immune system may over react to the TB antigen (Immune Reconstitution Inflammatory Syndrome)
        
        Persistent ulceration
        
        Discharge from vaccine site
        
        Lymphadenopathy
        
        HIV+ children not on HAART have disease at site of vaccine with axillary lymphadenopathy on one side
        
        Pneumonia
      - Infections by org.that rarely cause severe disease in immunocompetent people
      - Virus
        
        Human Papovirus (JC)
        
        Progressive Multifocal Encephalopathy
        
        Herpes Simplex
        
        Cold sores in mouth
        
        Ulcers in GIT
        
        Local lesions
        
        Haemorrhage lesions in temporal lobes of brain
        
        Cytomegavirus
        
        Smaller bluish basophilic granular cytoplasmic inclusions
        
        Pneumonia,
        
        Large intranuclear inclusion (OWL's EYE)
        
        @ CD4 count <50, RETINA is at risk of infection.
        
        Enlarged cell & nucleus
        
        Brain infection
        
        Colitis
        
        Chorioretinitis
      - Malignancies
        
        Kaposi Sarcoma
        
        Vascular neoplasm
        
        Lesions are proliferation of spindle shaped cells
        
        Human Herpesvirus (HHV8)
        
        Multiple reddish purple skin lesions
        
        Spreads to nodes, GIT, mucous membranes & lungs
        
        Squamous Carcinoma of conjunctiva
        
        Carcinoma of cervix (HPV)
        
        B cell lymphomas
        
        With T cell depletion, B cells undergo unchecked proliferation, prone to mutations & tumors
        
        Diffuse B cell lymphoma
        
        Burkitt's lymphoma
        
        Primary CNS & body cavity lymphomas
      - CNS Manifestation
        
        Infected monocytes carry HIV to brain
        
        Infections ( Toxoplasmosis, Cryptococcus,TB, JC)
        
        Meningitis
        
        Progressive multifocal leukoencephalopathy
        
        White matter destructed
        
        Demyelination
        
        B cell lymphoma
    - - Due to spontaneous B cell activation & inability of Ab responses to new antigens
      - Contributing is lack of CD4 help
- - - - Antigen picked up in HIV tests
    - - gag
        
        Surface=gp120,gp41
      - pol
        
        Reverse transcriptase
        
        HIV RNA to proviral DNA
        
        Protease
        
        Viral maturation after new is formed
        
        Integrase
        
        Integrates proviral DNA into host genome
      - env
        
        Inner component=capsid, nucleocapsid
    - - gp41
      - gp120