MLS 101

1
HIV
Human Immunodeficieny Virus

• Is a lentivirus, which is a subgroup of

Retroviruses.
• It is the virus that causes HIV Infection.
• HIV lowers the immune system of the body
by killing CD4 cells, notably T helper cells,
which are lymphocytes central to the
immune response.
• the human body can’t get rid of HIV
completely, even with treatment
AIDS
Acquired Immunodeficieny Syndrome

A (Acquired) - not inherited;

I (Immuno) - It attacks the immune system and increases
susceptibility to infection;
D (Deficiency) - deficiency of certain white blood cells in immune
system.
S (Syndrome) - a group of symptoms or illnesses that result from HIV
infection

• A group of serious illnesses and opportunistic infections that

develop after being infected with HIV for a long period of time
• is the last and most advanced stage of HIV Infection.
 STRUCTURE OF HIV
• It has cylindrical center surrounded by a sphere-
shaped lipid bilayer envelope.
• gp120 and gp41- two major viral glycoproteins in
this lipid bilayer.
Inner sphere:
RNA/ribonucleic acid – where the genetic
information is stored
p24, p17, reverse transcriptase, integrase, and
protease
HIV genes and proteins they encode
Gene Protein

Pol Reverse transcriptase (makes DNA copies of viral RNA)

Gag Core protein p24

External (envelop) glycoprotein (for attachment of

Env
HIV to target cells
STRUCTURE OF HIV
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 ETIOMOLOGY
THE ORIGIN
The origin of HIV has been a
AFRICA matter of extensive conjecture,
but the current consensus is that it
evolved in Africa as a result of the
transmission of the Simian
Immunodeficiency Virus (SIV)
from infected Chimpanzees to
man. Studies show that HIV may
have jumped from apes to
A B C
humans as far back as the late
1980 HIV-1 HIV-2 1800s.
100, 000 were MOST WEST AFRICA
initially thought to COMMON
be infected with CAUSE OF HIV
HIV INFECTION

HIV-2
-the first type discovered
-also once called HTLV-III, and LAV
- is found throughout the world.
- Various subtypes of HIV-1 have been
found in specific geographic areas and
in specific high-risk groups
ETIOMOLOGY
HIV-1 vs HIV-2
They have the same modes of
transmission and are associated
with the same opportunistic
infections
-similar to the monkey virus, simian
immunodeficiency virus
- is uncommon except in West Africa.
-HIV-2 appears to progress more slowly
-There are no known subtypes of HIV-2
HIV continues to be a
major global public health
issue, having claimed
more than 35 million lives
Approximately, there are In 2017, 21.7 million people
36.9 million people living with HIV were
living with HIV at the receiving ART ( 59% of In 2017, 940 000 people
end of 2017. adults and 52% of children ) died from HIV-related
causes globally.

Currently only 75% of
people with HIV know
their status.
African Region is the
most affected region,
with 25.7 million people
living with HIV in 2017.
Between 2000 and 2017, new HIV
infections fell by 36%, and HIV-
related deaths fell by 38% with
11.4 million lives saved due to ART
in the same period.

77.3 million people have
1.8 million people become infected with
became newly infected HIV since the start of
with HIV in 2017. the epidemic
AIDS-related deaths have
been reduced by more
than 51% since the peak
in 2004
The risk of acquiring HIV is 27 times
higher among men who have sex with
men; 23 times higher among people
who inject drugs; 13 times higher for
female sex workers; 12 times higher
for transgender women.

TB remains the leading UNAIDS estimates that Around 56% of the total
cause of death among US$ 26.2 billion will be resources for HIV in low- and
people living with HIV required for the AIDS middle-income countries in 2017
response in 2020 were from domestic sources.
 scale-up of treatment &
recognition of the a related virus was found failure of both
evidence of what
syndrome in the in parts of West Africa behavior change &
contributes to successful
USA & Europe and was called HIV-2 vaccine development
prevention

1980s 1985 1995-2005 1997

1983 - 1985 1985-1995 2015

1995

researchers isolated learning about the the number of adults CRISPR/Cas9

a new virus—HIV— disease as it and children living with Development
the cause of AIDS. spreads around the HIV or AIDS rose to
world more than 33.4 million
 DOH tallied 50,72
first case of HIV the Philippine NHSS gradually
cases of Filipinos with
Infection in the National AIDS Council expanded
HIV/AIDS
Philippines (PNAC) was created

1984 1992 1996 2017

1987 1993 1998

DOH established National HIV Sentinel Philippine AIDS

the HIV/AIDS Surveillance System Prevention and
Registry (NHSS) was Control Act of 1998
established
 MODES OF TRANSMISSION

• HIV can be transmitted sexually through
vaginal sex, oral sex and anal sex.
• HIV can be transmitted during unprotected
sexual intercourse or through contact with
infected blood, semen, or cervical or vaginal
fluids of the infected person.
• The presence of other Sexually Transmitted
Infections (STIs) increases the chance of
contracting or transmitting HIV.
HIV-infected blood enters the body through:
•A transfusion
• Sharing of contaminated needles, syringes,
razors or other sharp objects.
• Infected blood entering the body through open
wounds
•Occupational exposure includes accidental
needle stick

Sexual contact HIV infection

was the reported
modes of 86% 27 by needle-
sharing among
transmission for
HIV/AIDS with
Male to male
sexual contact. Cases drug users in
1,068 cases . PH
MODES OF TRANSMISSION

Mother to child
3 Transmission
CASES in the
. Philippines
Add a Slide Title - 1
 CLINICAL MANIFESTATION
SIGNS & SYMPTOMS
Immune function is typically measured by CD4 cell count. The CD4 Count is a criterion that
determines whether the client is HIV-positive or whether the illness is categorized as AIDS.
Normal CD4 count ranges
from 500-1500.
A viral load of less than
10,000 is considered low,
and a viral load of more than
100,000 is high.
The higher the viral load, the
faster the CD4 T cells are
killed by HIV.
Thus, a CD4 count of 230
with a viral load of 350,000
would be considered a
serious risk for disease
progression to HIV/AIDS.
Clinical Symptomatic PROGRESSION
Primary HIV
latency stage Stage TO AIDS
Stage (Acute
(Chronic HIV) HIV-infected patients This is the stage of HIV
HIV)
refers to the time when with weakened infection that occurs when
In some people, your immune system is
HIV first enters the body. persistent swelling of immune systems can
develop life- badly damaged and you
At the time of primary lymph nodes occurs become vulnerable to
during this stage. threatening infections.
infection with HIV, a opportunistic infections.
Otherwise, there are Their viral load
person’s blood carries a When the number of your
no specific signs and continues to increase, CD4 cells falls below 200
high viral load, meaning symptoms. HIV
that there are many and the CD4+ count cells per cubic millimeter
remains in the body of blood (200 cells/mm3),
individual viruses in the and in infected cells. falls to less than 200-
you are considered to
blood. 349 cells per cubic
have progressed to AIDS..
millimeter of bloods
 SIGNS & SYMPTOMS Multiple opportunistic diseases
HIV wasting syndrome
HIV encephalopathy
HSV & CMV
CLINCAL Kaposi’s sarcoma
STAGE 4
Weight loss of more 10%
CLINICAL Unexplained chronic diarrhoea & prolonged fever
STAGE 3 Oral candidiasis and hairy leukoplakia
Pulmonary Tubercolosis
CLINICAL Bacterial Infection
STAGE 2
Weight loss of less 10%
CLINICAL Minor mucocutaneous manifestations
STAGE 1 Herpes Zoster (5 years)

Asymptomatic
Generalized lymphadenopathy
 DIAGNOSIS
ELISA Test Rapid Test Viral Load Test
which stands for gives reactive results This test measures the
are confirmed by amount of HIV in your
enzyme-linked blood. Generally, it's
Western blot assay.
immunosorbent used to monitor
Rapid test is quick and
assay, is used to easy assay devoid of treatment progress or
detect HIV infection. any complex equipment. detect early HIV
infection.

The only way to determine whether you Viral Load test HIV testing
are infected is to be tested for HIV technology Western Blot principles
infection. Serological tests, detect the This is a very sensitive  informed Consent
presence or absence of antibodies to HIV-  RT-PCR,
blood test used to  Confidentiality
1/2 and/or HIV p24 antigen. No single HIV  bDNA
. confirm a positive  Counselling
test can provide an HIV-positive  NASBA  Correct test results
ELISA test result.
diagnosis. It is important that these tests  Connection
are used in combination and in a specific
order
interfere with a
critical step
interfere with a
protein that HIV
block the virus
block an
enzyme HIV
TREATMENT
during the HIV uses to make
from entering
needs to make The primary treatment for HIV
life cycle and the body's cells is antiretroviral therapy
infectious viral copies of itself.
keep the virus particles (ART), which has been shown
from making
copies of itself to improve survival rates and
immune system function,
decrease the risk of
complications, and reduce the
likelihood of HIV transmission.
Therapy typically consists of a
Reverse regimen of 3 or more
transcriptase Protease Fusion Integrase antiretroviral (ARV) drugs.
(RT) inhibitors inhibitors inhibitors inhibitors
 Abstinence and Safe Sex

Do not use/share used sterile

injecting equipment

Voluntary medical male circumcision

Pre-exposure prophylaxis
(PrEP)

Post-exposure prophylaxis

Education
REFERENCES:

Johnston LG, Sabin ML, Global AIDS monitoring

Prybylski D, Sabin K, McFarland W,
Baral S et al. Policy and practice:
the importance of assessing self-
reported HIV status in bio-
behavioural surveys. Bull World
Health Organ. 2016;94:605–612
2017: indicators for monitoring
the 2016 United Nations Political
Declaration on HIV and AIDS.
Geneva: UNAIDS; 2017
(http://www.unaids.org/sites/def
ault/files/media_asset/2017-
Global-AIDS-Monitoring_en.pdf)
Keogan, M., Wallace, E.,
& O'Leary, P. (2006). Concise
Clinical Immunology for
Healthcare Professionals.
Great Britain: Routledge
Taylor & Francis Group

WHO (2018).
HIV/AIDS Fact
Sheet. Accessed Abbas, A., Aster,
on August 2018. J., Kumar, V., &
Retrieved from Mitchell, R. (2017).
http://www.who.int/ Pocket Companion to
UNAIDS (2018). UNAIDS Robin and Cotran
news-room/fact- FACT SHEET. Accessed on
sheets/detail/hiv- Pathologic Basis of
August 2018. Retrieved from Disease. Elsevier.
aids. http://www.unaids.org/en/resour
ces/fact-sheet
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