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19. HIV infections and AIDS (Retroviruses (patient dies of 2ndary disease…
19. HIV infections and AIDS
retroviruses composed of 3 subfamilies, 2 infect humans
oncornaviruses
HTLV 1
HTLV 2
HTLV 5
lentiviruses
HIV 1
produces Acquired Immunodeficiency Syndrome (AIDS)
HIV 2
produces a related disease syndrome, restricted to W. Africa
Retroviruses
RNA viruses
make circular DNA from linear RNA
viral DNA can integrate into host cell genome
virus high conc in blood, semen and CSF
low conc in tears, saliva, breast milk, urine
HIV has also been isolated in brain tissue, lymph , bone marrow
HIV transmitted via bodily fluids - through sex, parenteral drug usage or transfusions
specific tropism for CD4+ cells ( t helpers!)
virus can lay dormant for year after infection
eventually infected t cells lose ability to function, loss of humeral and cell mediated immunity
patient dies of 2ndary disease
pneumonia
candidiasis
herpes virus severe
malignancies (Kaposi's sarcoma)
AIDS dementia
epidemiology
first case- 1981
30 million infections worldwide
half are in sub saharan africa
majority of new adult HIV involve 15-24 yr olds
75-85% og HIV+ adults are infected through unprotected sex
transfusion of HIV infected blood 3-5%
sharing of injection equip 5-10%
most children are infected by vertical transmission (in utero or during birth)
clinical
often detected because of secondary disease e.g. sarcoma
lab detects HIV antibodies by ELISA test, Enzyme-Linked Immuno-Sorbent Assay
positive result is confirmed with a Western blot test
prevention
use of condom
no sharing needles
testing of blood
education
treatment with anti-HIV drugs
Nucleoside reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
Protease Inhibitors