AIDS Exam Study Guide I. Pandemic: Facing AIDS (Brazil, India, Russia, Thailand, Uganda) A.

Main risk factor for getting infected with HIV in each country: Brazil unsafe sex India unsafe sex (prostitution) Russia drug use (needles) Thailand unsafe sex (prostitution, sex slaves) Uganda unsafe sex B. How does the government and/or people in that society respond to people with AIDS? Brazil public healthcare programs allow for those from suffering from AIDS to have cheap and extremely effective treatment/people are more open-minded India there is not an effective social healthcare program/it is seen as a stigma by many, some doctors are afraid to treat AIDS victims Russia no social healthcare program to help/many people look down upon those with AIDS and are unaware of any AIDS related information Thailand also no social healthcare plan/scene as a social stigma because it is related to prostitution Uganda no social healthcare program to help treat/not as much of a social stigma, knowledge increasing II. Epidemiology of AIDS A. Which areas of the world are most affected? -Sub-Saharan Africa and South East Asia B. Incidence vs. prevalence vs. death rate Incidence = # of new disease cases within the given amount of time Prevalence = # of infected individuals Population Death rate = # of deaths x 100,000 Population C. % change = (# of cases from later date - # of cases from earlier date) # of cases from earlier date x 100 D. Outbreak the sudden start of disease, contained Epidemic widespread occurrence of disease in a community Pandemic a disease spread over a whole country of the world III. General Aspects of Disease Disease the abnormal functioning of a part of the body 1. Causes of disease -Infectious agents (bacteria, virus, fungus, protozoan, helminthes) Bacteria colonize parts of the body outside cells - starve cells of nutrients - secrete toxin and cause overreaction from the immune system Virus infects cells, multiplies and bursts out of cells, killing other cells -Genetics, hereditary factors

-Environmental factors (carcinogens, UV light) -Dietary factors lack of nutrients of overabundance AIDS Acquired Immune Deficiency Syndrome - Not hereditary -Weakens immune system (immune deficiency) -Many potential opportunistic symptoms linked with weakened immune system IV. Evidence for HIV causing AIDS 1. What evidence supports the idea that HIV causes AIDS? A. The medication used to treat AIDS suppresses HIV replication and improves health and the immune system B. Almost everyone with HIV progresses to get AIDS C. No one who hasnt had HIV has ever gotten AIDS 2. Duesbergs Argument A. Correlation between appearance of AIDS and increase in drug use B. Correlation between drug use and AIDS C. Not every with HIV gets AIDS D. Not everyone with immune deficiencies has HIV E. It takes time for HIV to cause AIDS so just because someone doesnt have it now does not mean it wont progress in to AIDS F. Some immune deficiencies are caused by hereditary factors Rebuttal to Duesberg A. Many non-drug users get AIDS (hemophiliacs, blood transfusion patients) Babies are born to non-drug users with AIDS B. Drug use has occurred for centuries but HIV has only been around for so long V. Biochemistry 1. Relationship between compounds and cells to entire organism A. An organism is made up of organs, which are made of tissues consisting of groups of functioning cells, which perform different functions, which are further broken down in to compounds (nucleic acids, proteins, carbohydrates, lipids) 2. Proteins -Speed up a reaction -Transports other molecules -Necessary for muscle coordination -Necessary for functions of immune system -Structural support for tissue 3. Protein structure -Structure determines function -Globular most, has a crevice where they perform their function -Fibrillar some 4. Amylase - catalyses the breakdown of starch in to sugar Myosin needed for muscle contraction Ferritin stores and releases iron

5. Hemoglobin A. Transports oxygen from lungs to tissues B. Composed of four chains of amino acids known as sub-units C. Each hemoglobin can transport four oxygen molecules D. Each oxygen molecule is bound to a heme in hemoglobin 6. Sickle Cell Anemia A. Lack of ability to transport oxygen to tissues, results in tissue damage B. Prominent in people in Africa/Southern India because sickle cell trait confers resistance to malaria C. The cells clump together and form a solid, distorting the cell to a sickle shape D. The cell dies because of a lack of oxygen or gets stuck in the capillaries and prevents flow of blood cells 7. Enzymes A. Catalyst increase the rate of a chemical reaction B. Substrate a molecule on which an enzyme acts C. Active Site - part of the enzyme where substrates bind and cause chemical reaction D. Competitive Inhibitor -Competes with substrate for binding to the active site -Has to have a complimentary shape to the enzyme substrate E. Non-competitive Inhibitor -Binds to a site on the enzyme other than the active site -Stimulates conformational change in structure of enzymes so that when the substrate binds to the active site, it does not undergo reaction 8. Nucleic Acids A. Store and transit genetic info (info for structure of proteins) B. Gene a unit of hereditary transferred from parent to offspring -One gene contains info for one chain of amino acids, one protein, or one chain of proteins C. DNA structure -A double helix consisting of two strands of nucleic acids D. Protein Synthesis -A process of taking genetic info stored in DNA to make proteins E. Transcription synthesizing an RNA based on sequence of nucleotides in DNA Translation - Synthesizing a protein based on a sequence of nucleotides in mRNA VI. HIV Infection and Replication 1. HIV Structure A. Integrase, protease, reverse transcriptase, gp120, gp141 2. Type of cells HIV infects A. Helper T Cells 3. HIV gp120 protein spike binds to the helper T cell CD4 receptor and either the CXCR4 or CCR5 receptor

4. Retrovirus an RNA virus that inserts a DNA copy of their genome in to the host cell in order to replicate 5. Replication and Infection A. HIV fuses with the cell and dumps RNA, reverse transcriptase, integrase and protease B. Reverse transcriptase catalyses the reaction to DNA C. DNA enters the nucleus D. Integrase catalyses the reaction that inserts viral DNA into host cells DNA E. Transcription catalyse by RNA polymerase F. Both RNAs leave nucleus and go to the cytoplasm G. Proteins and genomic RNA gather underneath cell membrane and gp41 and gp120 are inserted into the cell membrane H. HIV virion leaves cell and rips a role in cells membrane 6. Mechanism by which HIV kills the host cell A. Apoptosis programmed cell death, dies before letting HIV replicate B. Syncytia infected helper T cells binding to many healthy helper T cells to form a dysfunctional unit, thus killing many helper T cells VII. Surviving AIDS 1. Long term non-progressor someone who has HIV but has been able to fight off AIDS for an extended period of time 2. CCR5 mutation and its effect A. Confers resistance to HIV infection B. R5 HIV prefers CCR5 co-receptor C. X4 HIV prefers CXCR4 co-receptor D. In initial infection, primary form is R5