Human Immunodeficiency Virus

Justin Pegueros11/20/2012

HIV

Group VI (-) sense RNA, ~9kb Enveloped Family: Retroviridae Genus: Lentivirus HIV-1, HIV-2

HIV

Herbert W. Virgin & Bruce D. Walker. Nature 464, 224-231(11 March 2010)

Sexual, Needles, Blood Transmission

Primarily Infects Dendritic Cells

Travels to lymph, depletes CD4 cells

Opportunistic Infections take advantage of weak immune system ---> AIDS

HIV Case Study

A 28-year-old man had several complaints. He had a bad case of thrush (oral candidiasis) and low-grade fever, had serious bouts of diarrhea, had lost 20 pounds in the past year without dieting, and most seriously, he complained of difficulty breathing. His lungs showed a bilateral infiltrate on radiographic examination, characteristic of Pneumocystis carinii pneumonia. A stool sample was positive for Giardia organisms. He was a heroin addict and admitted to sharing needles at a "shooting gallery."

1. What lab tests should have been done to support and confirm the diagnosis of HIV infection and AIDS?

Screening ELISA Rapid Oral Antibody

Confirmation Western Blot

1. What lab tests should have been done to support and confirm the diagnosis of

HIV infection and AIDS?

AIDS Confirmation CD4:CD8 count to evaluate AIDS progression RT-PCR to determine viral load

Used to gauge effects of drugs Also used to screen infants for HIV

AIDS Related Complex

2. How did this man acquire the HIV Infection? What are other high risk behaviors?

Sharing Needles

Drug Abuse

Unprotected Sex

http://news.bbc.co.uk/olmedia/1315000/images/_1317054_shooting_gallery_300_ap.jpg

3. What was the immunological basis for increased opportunistic infection?

Depleted CD4 count, CD8 kill them

Normally asymptomatic fungal infections Pneuomocystis pneumonia Candidiasis (oral thrush)

Giardia parasites

http://en.wikipedia.org/wiki/File:PCPxray.jpg

4. What precautions should have been taken in handling patient samples?

Universal Precautions Protective Gear Disinfect all surface areas Introduce barriers to bodily fluids

5. What are the possible components of an HIV vaccine? Who would receive them?

Vaccines Recombinant Viral Vaccines Protein Subunit Vaccines DNA Vaccines Killed Virus Vaccine (1)

Patients Clinical Trials Phase II Therapeutic v. Preventive HIV infected patients, ARC v. AIDS

Killed Virus Vaccine (SAV001)

References

EK Wagner, MJ Hewlett, DC Bloom, and D Camerini. Basic Virology, Third Edition. Blackwell Publishing, 2008.

P. R. Murray et al. Medical Microbiology 5th ed. Elsevier Health Sciences, 2005.UCSF Center for HIV Information. HIV Insite: Gateway to HIV and AIDS

Knowledge. University of California, San Francisco (2012). Web. 18 Nov 2012. <http://hivinsite.ucsf.edu/InSite>

Chhatbr C, Mishra R, Kumar A, Singh SK. HIV vaccine: hopes and hurdles. Drug Discovery Today. Vol 16(21/22): 948-956. November 2011

Sumagen. AIDS Vaccine. Sumagen (2005). Web. 19 Nov 2012. <http://www.sumagen.co.kr/english/business/aids_vaccine.htm>