BT1010 GROUP 11 AIDS

PRESENTATION
Group members - Aprajithan S, Keshav Saravanan, Divyesh Kumar, Ashok Kumar Meena,
Sumedh Chatterjee, Aditya Kartik, Bhavesh S, Dharunpathi T, Dharani Shri S, Hayagriv V,
Boobalan Mohan, Mayank S, Sai Vyshnavi, Bhavesh S
PUBLIC HEALTH SIGNIFICANCE
 AIDS : CAUSE AND TRANSMISSION
What causes AIDS?? What is HIV??

• Final stage of HIV • A Lentivirus

infection (Retroviridae family)
• HIV attacks CD4 T- with RNA genome
helper cells → • Uses reverse History Transmission
weakens immune transcriptase → RNA →
DNA
system • 1981: First AIDS cases • Unprotected sex
• Integrates into host
• AIDS diagnosed when reported (rare (vaginal, anal, oral)
genome (via integrase) →
CD4 < 200 cells/mm³ persistent infection infections & cancers) • Blood contact (needles,
or opportunistic • HIV-1 (95% cases, global • 1983–86: Virus unscreened
infections/cancers epidemic, from identified → named transfusion)
occur chimpanzees), highly HIV • Mother-to-child
contagious, faster • Origin: From primate (pregnancy, birth,
progression virus (SIV) → breastfeeding)
• HIV-2 (from sooty transmitted through • Unsafe medical tools
mangabeys, mostly West blood exposure (needles, surgical
Africa), less contagious,
• Earliest case: 1959, instruments, tattoos,
slower progression
Kinshasa (DRC) piercings)
 Clinical Symptoms
Acute HIV Infection Clinical Latency AIDS Stage
Stage - I (Chronic HIV) Pediatric AIDS
Stage - II Stage - III

Lasts for nearly 2 to Can last from a few Wasting syndrome

Clinical manifestation of
Chronic diarrhea
4 weeks. weeks to several AIDS in children are
Oppurtunistis
Clinical Symptoms: years. significantly different
Infections (TB, PCP,
Fever No obvious or from those in adults.
Candidiasis, Herpes
Rash severe symptoms. Failure to thrive
Simplex etc)
Sore throat Gradual decline of HIV associated B-cell lymphoma
Swollen Lymph CD4+ Tcells over malighancies (Kaposi’s (uncommon in adults)
sarcoma) Unsual severe
Nodes time.
Neurological infections such as
Muscle Aches
complications in CNS. congential syndrome
Diarrhea
(Like Toxmoplasmosis)
 PATHOPHYSIOLOGY
1. Initial Immune Response:
a. Dendritic cells capture the HIV antigens and take them to the CD4+ T cells in lymph nodes and GALT
b. These CD4+ T cells then activate B cells and CD8+ cytotoxic T cells
2. Target cells of HIV:
a. Cells with CD4+ receptors are affected, primarily the CD4+ T cells, and their destruction is central to disease progression
b. After getting attached to these receptors, the HIV cell fuses with the T cell and the genetic material is released
c. By the process of reverse transcription, the two viral RNA strands form viral DNA which then enters the host nucleus
d. The cell machinery can be used to replicate or it can stay dormant within the cellular DNA
3. Acute infection phase:
a. Within 2-4 weeks after exposure, the viral load spikes and the antibodies also start getting produced (Seroconversion)
b. CD8+ T cells temporarily reduce viral load, but not completely. During this, many CD4+ T cells die and infected ones
are tagged for destruction
4. Immune evasion by HIV:
a. The viral load stabilizes at a set point and may lay dormant within CD4+ T cells -> person may appear healthy but the
CD4+ T cell count gradually declines over the years
b. To evade the CD8+ T cells, HIV mutates rapidly and downregulates MHC-1, to become invisible to the CD8+ T cells
c. This establishes long term reservoirs in lymphoid tissues
5. Progression to AIDS:
a. Once the CD4+ T cell count goes below 200 cells/mm3, the body becomes immunocompromised
b. This stage is clinically defined as AIDS - Acquired Immunodeficiency Syndrome
 Diagnosis Methods

Antigen-antibody Nucleic acid tests Western Blot

tests NATs detect HIV RNA directly in blood.
Western Blot confirms HIV infection
HIV antigen-antibody test (4th gen) after screening (e.g., ELISA).
Use amplification techniques like RT-
detects both HIV antibodies and p24 HIV proteins separated by
PCR, NASBA, RT-LAMP.
electrophoresis, then transferred to a
antigen. Highly sensitive, detect early infection. membrane.
Most common lab test for HIV RT-PCR converts RNA to cDNA, then Patient antibodies bind to specific HIV
diagnosis. amplifies HIV sequences. protein bands, forming color bands.
Detects infection within 18–45 days Used to measure viral load (HIV RNA Former gold standard, now replaced by
of exposure. copies/mL). antigen-antibody tests.

ELISA Readers FLOW CYTOMETRY RT-PCR

Flow cytometry measures CD4+ T-cells Detects and quantifies viral RNA.
Colorimetric test using antibody antigen
reaction and color change. in blood. RNA to cDNA, amplified by thermal
Gives qualitative and quantitative Uses fluorescent antibodies on CD4 cycling.
information about the presence of proteins. Uses fluorescent probes for real-
antigen or antibody. Laser detects fluorescence and cell time detection.
Based on spectrophotometry (measures traits. Ct value shows viral load (lower Ct
light absorption). Software counts CD4+ cells, analyzes = higher RNA).
Indirect ELISA is used to detect HIV subsets. Fast, accurate, and quantitative
antibodies against known antigens. Fast tool for immune monitoring (HIV). test.
 HIV Prevention & Treatment
Measures
Comprehensive Prophylactic and Therapeutic Approaches

Prophylactic Therapeutic
Measures Measures: ART

1. Safe Sexual Practices What is ART?

Consistent condom use + reducing sexual
partners Antiretroviral Therapy uses combination
drug regimens to suppress viral
2. PrEP (Pre-Exposure Prophylaxis) replication, transforming HIV into a
Daily medication (Truvada/Descovy) → 99% manageable chronic condition.
risk reduction

3. PEP (Post-Exposure Prophylaxis) Virologic Control

28-day treatment within 72 hours of exposure Suppresses viral load to undetectable
levels, preventing AIDS progression
4. Blood Safety
Universal screening + NAT testing + pathogen
inactivation Immune Restoration
Rebuilds CD4+ T-cell counts, preventing
5. Harm Reduction (Drug Use) opportunistic infections
Needle exchange + opioid substitution
therapy
Quality of Life
6. PMTCT (Mother-to-Child) Enables normal activities + reduces stigma
ART during pregnancy → <1-2% transmission through effective treatment

Transmission Prevention
U=U: Undetectable = Untransmittable

Prevention + Treatment = Path to Ending HIV Transmission