AIDS.pptx

Topic for BAMS

1. AIDS Presented by : Pooja Patel BAMS 2 ND YEAR Batch 2017 -18

2. INTRODUCTION AIDS stands for Acquired immunodeficiency syndrome caused by HIV ( Human immunodeficiency virus ). It is severe immunosuppression leads to opportunistic infections, secondary neoplasms , and neurologic manifestations.

3. Index Introduction Epidemiology Etiology Routes of transmission Pathogenesis Symptoms Risk factors Diagnosis Management Conclusion

4. EPIDEMIOLOGY AIDS is a global pandemic.As of 2017,approx. 36.9 million poeple are infected with HIV globally. In 2018 approx. 43% are women. There were about 9,40,000 deaths from HIV in 2017. The gov . Of India estimates that about 2.4 million Indians are living with HIV.

5. ETIOLOGY AIDS is caused by HIV, which is a non transforming human retrovirus belonging lentivirus family. Reteroviruses are RNA-viruses having an enzyme called reverse transcriptase,which prepares a DNA copy of the RNA genome of the virus in the host cell. HIV occurs in two genetically different but related main forms, HIV-1 and HIV-2 .

6. Structure of HIV Shape : Spherical Size : 90-120nm in diameter It consist of electron dense, cone shaped core surrounded by nucleocapsid cell which is covered by lipoprotein envelope. Parts of virus : 1.Viral core 2.Nucleocapsid 3. Lipid envelope

7. continue...... 1.Viral core : It contains major capsid protien p24 , used for diagnosis of HIV infection. 2. Nucleocapsid protien : It is present between viral core and lipid envelope. 3. Lipid envelope : Consist of - lipid derived from the host Two viral glycoprotiens – 1. gp120 2. gp41 These glycoprotiens are essential for HIV infection of cells.

8. Routes of transmission 1.Sexual transmission : By Sexual contact because HIV is present in genital fluid. 2. Parenteral transmissison : a. Intravenous drug abusers , transmission occur by sharing of needles and syringes contaminated with HIV containing blood. b. Haemophiliacs c. Transfusion of blood or blood components. 3.Perinatal transmission : (Mother to infant transmission) It is major mode of transmission in children. In utero : by transplacental spread. During vaginal delivery through an infected birth canal. After birth : By ingestion of breast milk.

9. Pathology of AIDS

10. Pathogenesis Infection is transmitted when the virus enters the blood or tissues of an individual. Major targets: HIV can infect many tissues, but two major targets of HIV infection are the: 1. Immune system 2.Central nervous system (CNS). Life Cycle of HIV Consists of four main steps namely: 1) infection of cells by HIV, 2) integration of the provirus into the host cell genome, 3) activation of viral replication, and 4) production and release of infectious virus

11. 1. Infection of Cells by HIV: Cell tropism: HIV has selective affinity for host cells with CD4 molecule receptor. Th e cells with such receptors include CD4+ T cells and other CD4+ cells such as monocytes / macrophages and dendritic cells. Th e HIV envelope contains two glycoproteins , surface gp120 noncovalently attached to a transmembrane protein, gp41. Gp120 of HIV binding to CD4 molecule receptor on the host cell is the fi rst step in HIV infection. Binding alone is not enough for infection and requires participation of a coreceptor mole. Conformational change: Binding to CD4 leads to a conformational change in the HIV, that results in the formation of a new recognition site on gp120 for the coreceptors CCR5 or CXCR4. Gp120 binding to chemokine receptor: New recognition site on gp120 of HIV bind to chemokine receptors, i.e. CCR5 and CXCR4. Penetration of host cell membrane by gp41: Binding of gp120 to the chemokine coreceptors leads to conformational changes in gp41. Membrane fusion: Th e conformational change in gp41 allows HIV to penetrate the cell membrane of the target cells (e.g. CD4+ T cells or macrophages), leading to fusion of the virus with the host cell. Entry of viral genome into cytoplasm of host cell: Once internalized, the virus core containing the HIV genome enters the cytoplasm of the host cell.cule

12. 2 . I ntegration of the proviral DNA into the genome of the host cell After the internalization of the virus core, the RNA genome of the virus undergoes reverse transcription leading to the synthesis of double-stranded complementary DNA ( cDNA / proviral DNA). Episomal form: In quiescent T cells, HIV cDNA may remain as a linear episomal form in the cytoplasm of infected cell. Integration of cDNA : In dividing T cells, HIV cDNA enters the nucleus, and becomes integrated into the genome of the host cell using a viral integrase protein. 3. Viral replication: After the integration of proviral DNA it can either be latent or productive infection. Latent infection: During this, the provirus remains silent for months or years. Productive infection: In this the proviral DNA is transcribed leading to viral replication formation of complete viral particles. 4. Production and release of infectious virus: Th e complete virus particle formed, buds from the cell membrane and release new infectious virus. Th is productive infection when extensive, leads to death of infected host cells.

13. SYMPTOMS OF AIDS

14. Risk factors Lymphadenopathy Weight loss Fever Mucocutaneous disease : Psoriasis Kaposi’s sarcoma Oral candida Oral hairy leucoplakia GIT Diseases : Oesophageal candidiasis , large and small bowel diarrhoea Hepatobilliary diseases : Hepatitis –B and Hepatitis –C Respiratory diseases : Pulmonary TB, Bacterial infection Nervous system : Cognitive impairement , stroke , maningitis , myelopathy , retinopathy. Rheumatological problems Haematological problems Renal disease Cardiac disease

15. DIAGNOSIS ELISA (Enzyme linked immuno sorbent assay) It detects antibodies against viral protiens . It is the most sensitive and best screening test for the diagnosis of AIDS. Western blot : most specific or the confirmatory test for HIV. Direct detection of viral infection : a. p24 antigen capture assay b. Reverse transcriptase polymerase chain reaction (RT-PCR). C. DNA-PCR d.Culture of virus from the monocyte and CD4 + T cells The prognosis of AIDS is poor.

16. Western blot banding ELISA Kit

17. Management of AIDS Prevention of opportunistic infections Effective ART is the best protection, but other protective measures remain important: ● Avoidance of contaminated water. ● Barrier contraception. ● Avoidance of animal-borne infection (cats). ● Malaria vector control Adherence to lifelong treatment is vital, and is enhanced by: ● Disclosure of HIV status. ● Joining support groups. ● Patientnominated treatment supporters. ● Management of coincident depression and substance abuse.demic areas.

18. Myths about AIDS

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