Compendium Review

Major Topic One: Reproductive System

Part Two

• What is HIV and AIDS?

• Phases of the Infection

• Structure and Life Cycle

• Testing and Treatment

Pic from http://en.wikipedia.org/wiki/AIDS

 What is HIV and AIDS?
What is AIDS? Acquired Immunodeficiency Syndrome
(AIDS) is brought about by a human immunodeficiency virus,
either HIV -1 or HIV-2. The virus fights the one thing every
human being needs to stay healthy, our immune system.
Immune system cells, especially macrophages and T-cells,
are infected and destroyed by the HIV virus which leads to a
weakened immune system and an onset of other illnesses
and opportunistic infections. T-cells display CD4 receptors on
their surface; these are favorable to the HIV virus because
they can attach to the receptors and take over the cell.

What is HIV? HIV is a virus similar to the flu. In order for

viruses to function and replicate, they need living cells that
they can infect because viruses are unable to replicate on
their own. As mentioned above, the HIV virus prefers to infect
the CD4 T-cells which are our immune systems toughest
fighter against diseases.

Pic from http://en.wikipedia.org/wiki/HIV#Treatment

 Pictures from Human Biology Page 345 & some verbiage from http://en.wikipedia.org/wiki/HIV
It is believed that HIV originated in
Africa, particularly from monkeys’
and chimpanzees’ that display
simian immunodeficiency virus
(SIV) in their blood. “The closely
related SIV exhibits a somewhat
different behavior: in its natural
hosts, African green monkeys and
sooty mangabeys, the retrovirus is
present in high levels in the blood,
but evokes only a mild immune
response, does not cause the
development of simian AIDS, and
does not undergo the extensive
mutation and recombination typical
of HIV. By contrast, infection of
heterologous hosts (rhesus or
cynomolgus macaques) with SIV
results in the generation of genetic
diversity that is on the same order
as HIV in infected humans; these
heterologous hosts also develop
simian AIDS.”

“HIV-1 is thought to have originated in southern Cameroon after jumping from wild chimpanzees (Pan
troglodytes) to humans during the twentieth century. It evolved from a Simian Immunodeficiency Virus
(SIVcpz)
HIV-2, on the other hand, may have originated from the Sooty Mangabey (Cercocebus atys), an Old
World monkey of Guinea-Bissau, Gabon, and Cameroon.”
 How HIV is Transmitted

“In the United States, sexual contact is the most common route of HIV transmission. As of
December 2004, 44% of AIDS cases reported to the CDC were among men who contracted HIV
through sex with other men (MSM). The term MSM is important – and used quite a bit in this lesson
– because many men who have sex with men do not necessarily identify themselves as "gay" or
even "bisexual." HIV transmitted through sexual activity among heterosexuals accounted for 13% of
all AIDS cases reported to the CDC, with most of these cases among women infected by men. Only
a small percentage (less than 5%) of AIDS cases in the United States involves men who were
infected with HIV through sexual activity with HIV-positive women…The reason why sexual activity
is a risk for HIV transmission is because it allows for the exchange of body fluids. Researchers have
consistently found that HIV can be transmitted via blood, semen, and vaginal secretions. It is also
true that HIV has been detected in saliva, tears, and urine. However, HIV in these fluids is only
found in extremely low concentrations. What's more, there hasn't been a single case of HIV
transmission through these fluids reported to the CDC.”
 HIV can be classified into three categories: Acute Phase (A), Chronic Phase (B), and AIDS (C).

Pictures from Human

Biology Page 346

Category A: an individual is asymptomatic, highly infectious, and has a normal or close to normal CD4 T-
cell count which has never dipped below 500 cells per mm³ (normal CD4 T-cell count is minimally 800
cells per mm³). HIV antibody tests are usually negative during this phase because it takes time for the
HIV antibodies to rise to a level of detection in body fluids (about 25 days). The body is creating one to
two billion new T-cells everyday to keep up with destruction of DC4 cells by the HIV virus.
Category B: CD4 count between 499 and 200 cells per mm³. The number of HIV particles is rising, the
immune system is weakening, and an individual will show signs of some sort of infection or ailment such
as yeast, shingles, or diarrhea.
Category C: Individual is diagnosed with AIDS. Either the CD4 count is bellow 200 cells per mm³ or they
display one (or more) of 25-AIDS defining illnesses. Since there is no cure for AIDS, death usually follows
in two to four years.
 The Centers for Disease Control have certain criteria they follow when
determining whether an individual with HIV has progressed to AIDS.
Listed below are some of the major opportunistic infections & cancers
that can occur during late-stage HIV disease

Information and Verbiage from http://www.aidsmeds.com/articles/OIs_4898.shtml

 All pics & verbiage from

HIV Structure and Life Cycle

http://www.aidsmeds.com/articl
es/hiv_life_cycle_4707.shtml

1. A virus consists of an outer envelope of protein, fat

and sugar wrapped around a set of genes (in the
case of HIV, genetic information is carried as RNA
instead of DNA) and special enzymes. HIV has
proteins on its envelope that are strongly attracted to
the CD4+ surface receptor on the outside of the T4-
cell. When HIV binds to a CD4+ surface receptor, it
activates other proteins on the cell's surface, allowing
the HIV envelope to fuse to the outside of the cell.
Entry can be blocked by entry inhibitors.

2. HIV's genes are carried in two strands of RNA, while the

genetic material of human cells is found in DNA. In order for
the virus to infect the cell, a process called "reverse
transcription" makes a DNA copy of the virus's RNA. After
the binding process, the viral capsid (the inside of the virus
which contains the RNA and important enzymes) is released
into the host cell. A viral enzyme called reverse transcriptase
makes a DNA copy of the RNA. This new DNA is called
"proviral DNA.” Reverse transcription can be blocked by:
Nucleoside Reverse Transcriptase Inhibitors (NRTIs), and
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs).
 3. The HIV DNA is then carried to the cell's
nucleus (center), where the cell's DNA is kept.
Then, another viral enzyme called integrase
hides the proviral DNA into the cell's DNA. Then,
when the cell tries to make new proteins, it can
accidentally make new HIV's. Integration can be
blocked by integrase inhibitors, a new class of
drugs that are in the earliest stage of research.

4. Once HIV's genetic material is inside the cell's

nucleus, it directs the cell to produce new HIV.
The strands of viral DNA in the nucleus separate,
and special enzymes create a complementary
strand of genetic material called messenger RNA
or mRNA (instructions for making new HIV).
Transcription can be blocked by antisense
antivirals or transcription inhibitors (TIs), new
classes of drugs that are in the earliest stage of
All pics & verbiage from
http://www.aidsmeds.com/articl research.
es/hiv_life_cycle_4707.shtml
 5. The mRNA carries instructions for making new viral
proteins from the nucleus to a kind of workshop in the
cell. Each section of the mRNA corresponds to a protein
building block for making a part of HIV. As each mRNA
strand is processed, a corresponding string of proteins is
made. This process continues until the mRNA strand has
been transformed or "translated" into new viral proteins
needed to make a new virus.

All pics & verbiage from

http://www.aidsmeds.com/articl
es/hiv_life_cycle_4707.shtml

6. The final step begins with the assembly of new virus. Long
strings of proteins are cut up by a viral enzyme called
protease into smaller proteins. These proteins serve a variety
of functions; some become structural elements of new HIV,
while others become enzymes, such as reverse
transcriptase. Once the new viral particles are assembled,
they bud off the host cell, and create a new virus. The virus
then enters the maturation stage, which involves the
processing of viral proteins. Maturation is the final step in the
process and is required for the virus to become infectious.
With viral assembly and maturation completed, the virus is able to infect new cells. Each infected cell can
produce a lot of new viruses. Viral assembly can be blocked by Protease Inhibitors (PIs). Maturation, a
new target of companies developing anti-HIV drugs, may be blocked using Maturation Inhibitors.
 “Colored scanning electron micrograph of a T4 cell (green) infected with HIV (red).”

Picture & verbiage from http://www.aidsmeds.com/articles/hiv_life_cycle_9587.shtml

 Testing and Treatment
Within two weeks to two months most infected individuals will start to develop antibodies to the
virus. Some individuals take up to six months before the presence of HIV antibodies are detected in
their body. The most common test for the HIV virus is called ELISA, or the enzyme-linked
immunosorbent assay test. If this test comes back positive, the laboratory will usually conduct a test
called the western blot. Below are some common means of testing.

Information from http://www.aidsmeds.com/articles/HIVtests_4715.shtml

 “There are tests that can look for the virus—not antibodies—in the blood. Because the virus
becomes detectable in the blood much sooner after infection than antibodies, these tests are an
option for people who simply can't wait 13 weeks to find out the results of standard ELISA/Western
blot testing…These tests look for fragments of HIV, either floating around freely in the bloodstream
or inside cells in the bloodstream. Some tests—known as qualitative tests—yield a "positive" or
"negative" result, meaning that the virus was or wasn't found (GenProbe's Aptima HIV-1 RNA
Qualitative Assay is the only test approved for this purpose). Other tests—known as quantitative
tests—yield a "viral load" result, meaning the amount of virus in a sample of blood. Roche's
quantitative Amplicor HIV Monitor Test is frequently used by doctors and research centers but is not
specifically approved for this purpose. It is only approved to monitor to people who are known to be
infected with HIV, particularly to find out if their treatment is working properly.”

Information & Verbiage from http://www.aidsmeds.com/articles/HIVtests_4715.shtml

 Testing and Treatment
There is no cure for HIV or AIDS, however there is a treatment for HIV patients that can suppress
(but not stop) reproduction of the virus. Highly Active Antiretroviral Therapy, also known as HAART,
is a combination of drugs which hinder HIV’s life cycle. HAART must be taken indefinitely because
the virus will return and replicate at the discontinuance of the therapy.
1. Entry Inhibitors: prevents HIV from entering cells
2. Reverse Transcriptase Inhibitors: Interfere with the function of reverse transcriptase enzyme
3. Integrase Inhibitors: Stops HIV from introducing genetic material into host cells
4. Protease Inhibitors: Stops protease from breaking up new polypeptides

Scientists are working on a vaccine for HIV-negative individuals. Currently, we do not have a results
for any given trial vaccine that show a successful vaccine against the virus. We may never be able
to find a cure for HIV-positive individuals or people with AIDS because HIV has a high rate of
mutation.

Abacavir - a nucleoside analog

reverse transcriptase inhibitors
(NARTIs or NRTIs)

Pic from http://en.wikipedia.org/w/index.php?title=AIDS&oldid=208155516

 Definitions
DNA: DNA is like the "blueprint" for building living cells.

Enzymes: Enzymes are like the workers of a cell. They build new proteins, transport
materials around the cell, and carry out other important cellular functions.

Infection: Several different kinds of cells have proteins on their surface that are called CD4
receptors. HIV searches for cells that have CD4 surface receptors, because this particular
protein enables the virus to bind to the cell. Although HIV infects a variety of cells, its main
target is the T4-lymphocyte (also called the "T-helper cell"), a kind of white blood cell that has
lots of CD4 receptors. The T4-cell is responsible for warning your immune system that there
are invaders in the system.

Nucleus: A small package inside the cell where the genetic material is kept.

Proteins: The building blocks that are used to make living things.

Replication: Once HIV binds to a cell, it hides HIV DNA inside the cell's DNA: this turns the
cell into a sort of HIV factory.

RNA: RNA is like the construction boss. Cells use RNA to tell enzymes how to build a specific
part of a cell. To make a new protein, enzymes will copy a specific part of the DNA into a
piece of RNA. This RNA is then used by other enzymes to build a new protein or enzyme.
All Information from http://www.aidsmeds.com/articles/hiv_life_cycle_4705.shtml
 Works Cited
"AIDS." Wikipedia, The Free Encyclopedia. 24 Apr 2008, 18:03 UTC. Wikimedia Foundation, Inc. 24 Apr 2008
<http://en.wikipedia.org/w/index.php?title=AIDS&oldid=208155516>.
AidsMeds.com. Opportunistic Infections. 6 Sep 2005. Accessed 24 Apr 2008.
<http://www.aidsmeds.com/articles/OIs_4898.shtml>.
"HIV." Wikipedia, The Free Encyclopedia. 24 Apr 2008, 19:32 UTC. Wikimedia Foundation, Inc. 24 Apr 2008
<http://en.wikipedia.org/w/index.php?title=HIV&oldid=207934678>.
Mader, Sylvia S. Human Biology. New York: The McGraw-Hill Companies, Inc, 2008. Pages 343-352