AIDS

ACQUIRED IMMUNODEFICIENCY
SYNDROME

HARSHITA

DEPARTMENT OF MICROBIOLOGY

PATNA WOMEN’S COLLEGE

 DISCUSSION
01 Introduction

02 Virology

03 Transmission

04 Symptoms

05 Diagnosis

06 Treatment and Prevention

07 Conclusion

3/10/2023 2
 01
Introduction
Acquired Immunodeficiency Syndrome (AIDS) is a serious and often
fatal condition caused by the Human Immunodeficiency Virus (HIV)
which attacks and destroys the immune system.

The first cases were reported in the early 1980s among gay men in the
United States, and HIV was discovered in 1983 as the cause of the
condition.

3/10/2023 3
 1st cases of
HIV/AIDS Timeline
African man Pneumocystis
dies of an pneumonia The FDA approves the
illness and Kaposi’s
sarcoma First combination use of Truvada® for
confirmed SIV found in
HIV reported drug therapies for pre-exposure
HIV introduced gorillas prophylaxis (PrEP).

1959 1969 1980 1985 1990 2001 2006 2010 2012 2015 2022

The World Health

Organization
Ryan white an certifies that Cuba
African American American teenager The first confirmed is the first nation
teenager dies having become national poster case of patient cured to eliminate
same symptoms like AIDS child for HIV/AIDS after his mother-to-child
of HIV is reported.
school barred him from transmission of
attending classes after both HIV and
diagnosed with AIDS
syphilis.
U.S doctors announced that a
FDA licenses the first nucleic acid fourth person in history has
test (NAT) systems intended for been cured of HIV through a
screening of blood and plasma stem cell transplant. The
donation. patient had cancer, of which he
has also been cured.

3/10/2023 4
02
HIV Virology
HIV is a retrovirus that primarily infects
CD4+ T cells and macrophages. It uses
its envelope glycoprotein (gp120) to
bind to CD4 and co-receptors (CCR5 or
CXCR4) on target cells. Upon entry, viral
RNA is reverse transcribed into DNA,
integrated into the host genome, and
produces new virions through budding.
Antiretroviral therapy can control viral
replication and slow disease
progression. Scanning electron micrograph of HIV-1 virions (green)
budding from a cultured lymphocyte. Multiple round
bumps on the cell surface represent sites of virion
assembly and budding.
Structure and Classification of HIV
HIV (Human Immunodeficiency Virus) is a retrovirus that belongs to the
family of lentiviruses. The virus is spherical or pleomorphic in shape,
with a diameter of approximately 120 nanometers. Its outer envelope
is derived from the host cell membrane and is embedded with viral
glycoproteins (gp120 and gp41). The viral genome is made up of two
copies of single-stranded RNA, which are reverse-transcribed into
double-stranded DNA and integrated into the host cell genome.

There are two main types of HIV: HIV-1 and HIV-2.

HIV-1 is the most common and virulent strain, responsible for the
majority of HIV infections worldwide.

HIV-2 is less common and less virulent, mainly found in West Africa.
Life Cycle of HIV
• Attachment and fusion: The virus attaches to CD4 receptors on the surface of host cells (mainly T cells,
macrophages, and dendritic cells) and fuses with the cell membrane.

• Entry: The virus enters the host cell and releases its RNA and reverse transcriptase enzyme.

• Reverse transcription: The viral RNA is reverse transcribed into double-stranded DNA by reverse
transcriptase.

• Integration: The viral DNA is integrated into the host cell genome by the viral integrase enzyme.

• Transcription and translation: The integrated viral DNA is transcribed into viral RNA, which is then translated
into viral proteins.

• Assembly: The viral proteins assemble into new virus particles.

• Budding and release: The new virus particles bud from the host cell and mature into infectious viruses.
 Life Cycle
of HIV

3/10/2023 8
03
Transmission of HIV Virus
• Sexual contact: HIV can be transmitted through unprotected
vaginal, anal, or oral sex with an infected person.

• Sharing needles: HIV can be transmitted through sharing

needles or other equipment for injecting drugs. This includes
both injecting drugs and non-injecting drugs, such as crack
cocaine.

• Mother-to-child transmission: HIV can be transmitted from

an infected mother to her baby during pregnancy, childbirth,
or breastfeeding.

• Blood transfusions and organ transplants: HIV can be

transmitted through blood transfusions or organ transplants
from an infected donor
3/10/2023 10
Pathogenesis of HIV Infection
HIV infection can lead to acquired immunodeficiency syndrome (AIDS) if left untreated. The virus
primarily targets CD4+ T cells, leading to their depletion and impairment of the immune system. The
pathogenesis of HIV infection involves several stages:

➢ Acute infection: The virus replicates rapidly and spreads throughout the body, leading to flu-like
symptoms.

➢ Chronic infection: The virus establishes a persistent infection and replicates at a slower rate. The
immune system begins to mount a response, leading to a decline in viral load and a stabilization of
CD4+ T cell count.

➢ AIDS: If left untreated, the virus continues to replicate and deplete CD4+ T cells, leading to a
weakened immune system and the development of opportunistic infections and cancers.
 Effects of HIV on the immune system
HIV primarily infects and kills CD4+ T cells leading

➢ Immune dysfunction

➢ Impaired antibody response

➢ Chronic inflammation

➢ Immune activation

Over time, this can result in a weakened immune system,

increased susceptibility to opportunistic infections, and
the development of acquired immunodeficiency
syndrome (AIDS).

3/10/2023 12
3/10/2023 13
3/10/2023 14
 Symptoms
04
 05
Diagnosis
❑ HIV antibody test: detects antibodies to the virus in
blood or saliva

❑ HIV antigen/antibody test: detects virus and

antibodies to it, provides indication of virus levels

❑ Nucleic acid test (NAT): detects HIV genetic material

(RNA) in blood, used for early detection

❑ Western blot test: confirms positive HIV antibody test,

detects specific virus proteins

❑ Window period: time between infection and accurate

detection of virus or antibodies, varies by test type
 06
Treatment and
Prevention

3/10/2023 17
 HIV Treatment - Antiretroviral Therapy
(ART)
• ART is a combination of medications used to treat HIV infection

• Works by reducing the amount of virus in the body, slowing down the progression of HIV, and
preventing transmission

• Combination of at least three different drugs from different classes of medications

• Recommended for all people living with HIV, regardless of viral load or CD4 count

• Adherence to ART is essential for viral suppression and reducing the risk of drug resistance

• ART is highly effective in reducing the risk of developing AIDS and improving overall health
outcomes

• While ART does not cure HIV, it can effectively suppress the virus and allow people living with
HIV to lead long and healthy lives.
 PrEP
•PrEP is a medication regimen taken by people who are
HIV negative to reduce their risk of contracting HIV

•It involves taking a single pill (containing two

antiretroviral drugs) daily or on-demand before
potential exposure to HIV

•PrEP has been shown to be highly effective in reducing

HIV transmission, with up to 99% reduction in risk when
taken consistently

•PrEP is recommended for people at high risk of HIV,

including men who have sex with men, people who inject
drugs, and people with HIV-positive partners
 Prevention of HIV/AIDS
•HIV/AIDS can be prevented through education, awareness, and adoption of safe practices.

•Needle exchange programs can provide clean needles and reduce the risk of transmission through sharing of drug
injection equipment.

•Pre-exposure prophylaxis (PrEP) medication can be taken by people at high risk of HIV to reduce their risk of infection.

•Post-exposure prophylaxis (PEP) medication can be taken after potential exposure to HIV to reduce the risk of infection.

•HIV testing and treatment can also play a role in prevention by reducing the amount of virus in the body and decreasing
the risk of transmission.

Note: While there is no cure for HIV/AIDS, prevention efforts can help to reduce the

spread of the disease and improve overall health outcomes for individuals living with

HIV/AIDS.
3/10/2023 20
 Complications
Opportunistic infections are infections that occur more frequently or more severely in people with
weakened immune systems, such as those living with HIV/AIDS. Some common opportunistic infections
associated with HIV/AIDS include tuberculosis, pneumonia, and candidiasis.

Cancers associated with AIDS can include Kaposi's sarcoma, non-Hodgkin lymphoma, and cervical cancer.
These cancers are more likely to occur in people with weakened immune systems, and may be more difficult
to treat in people living with HIV/AIDS.

Other complications of HIV/AIDS can include neurological disorders, cardiovascular disease, and kidney
disease. Treatment with antiretroviral therapy (ART) can help reduce the risk of complications and improve
overall health outcomes for people living with HIV/AIDS. It is important for people living with HIV/AIDS to
receive regular medical care and monitoring to manage any complications that may arise.
 Epidemiology of HIV/AIDS
•HIV/AIDS is a global pandemic, with an estimated 38 million people living with HIV/AIDS worldwide.

•Sub-Saharan Africa is the most affected region, accounting for approximately two-thirds of all people living with HIV/AIDS.

•In 2020, an estimated 1.5 million people were newly infected with HIV, and 680,000 people died from AIDS-related illnesses.

•Demographics affected by HIV/AIDS vary by region, but generally include:

• Men who have sex with men
• People who inject drugs
• Sex workers and their clients
• Women and girls
• Transgender people

•Young people are also disproportionately affected by HIV/AIDS, with young women in sub-Saharan Africa being particularly
vulnerable.

3/10/2023 22
3/10/2023 23
 Goals and Objectives of HIV Treatment

Goals of HIV treatment: Objectives of HIV treatment:

Reduce the amount of virus in the body (viral load) Achieve and maintain viral suppression

Preserve and restore immune function (CD4 count) Prevent drug resistance

Improve overall health and quality of life Minimize side effects and toxicity

Prevent transmission to others Ensure adherence to medication regimen

Monitor treatment effectiveness through regular testing

3/10/2023 24
 Conclusion
07
•Tremendous progress has been made in HIV research over the past few decades.

•The development of highly active antiretroviral therapy (HAART) has transformed

HIV into a manageable chronic illness.

•However, challenges still remain, such as the need for improved access to
treatment, prevention, and care, and the development of a cure.

3/10/2023 25
 Future Directions
▪ Develop new and more effective HIV prevention strategies,

such as vaccines and pre-exposure prophylaxis (PrEP).

▪ Continue to improve HIV treatment, including the development

of more effective and less toxic antiretroviral drugs.

▪ Better understand the long-term health effects of living with

HIV, including the impact on aging and comorbidities.

▪ Develop a cure for HIV, including approaches such as gene therapy

and immunotherapy.

3/10/2023 26
3/10/2023 27