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MEDSCI 202 Second half > Lecture 19 > Flashcards

Lecture 19 Flashcards

1
Q

What does HIV stand for?

A

Human Immunodeficiency Virus

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2
Q

What does AIDs stand for?

A

Acquired Immune deficiency syndrome

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3
Q

When and how was HIV first detected?

A

In 1981 when several young homosexual men all began suffering from conditions caused by unusual or uncommon pathogens

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4
Q

What are some of the conditions that can be developed due to the weakened immune system caused by AIDS?

A

Oral Candidas, Kaposi’s Sarcomas, Toxoplasma brain abscess

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5
Q

What are some of the opportunistic pathogens AIDS allows to develop and cause disease?

A 
Pneumocystis Carinii (jiroveci) Pneumonia
Toxoplasma gondii brain abscesses
Candida Albicans oesophagitis
Cryptococcus neoformans meningitis
Mycobacterium Tuberculosis
Kaposi's Sarcoma
CNS Lymphoma
Cytomegalovirus retinitis
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6
Q

What types of patients became susceptible to AIDS allowing the mode of transmission of the virus to be determined

A

Sexual Partners of MSM
Injecting drug users
Infants of those who had been injecting drug users
This pointed to the virus being transmitted by bodily fluids

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7
Q

What structural feature of the HIV virus means that it must be transmitted through bodily fluids?

A

It has a lipid envelope taken from the host cell resulting in the virus being environmentally liable and needing to be wet to survive

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8
Q

What are the origins of HIV?

A

Closely related to SIV (Simian immunodeficiency virus) which infects apes, the virus strain infects chimpanzees is the strain most closely related to HIV

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9
Q

How many times has HIV crossed from apes to humans?

A

3 times via blood contact
HIV1- Chimpanzees
HIV2- Sooty Mangabeys

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10
Q

What were the ‘first’ AIDs Cases?

A

1959- Zaire who stored lood samples
1968- American Man- unknown source
1976- Norwegian sailor, wife, daughter
1977- Danish Surgeon (had worked in Zaire)
1981- Large numbers of homosexual american men

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11
Q

How did HIV spread globally?

A

1900s Originates in central Africa
Spreads to urban africa in 1950s
Spread to US and Europe in 1970

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12
Q

What was the spread of HIV affected by?

A

Prevalence of infections
Rate of sexual partner change and condom use
Rate of unsafe injecting drug use

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13
Q

What are the structural features of the HIV virus?

A

Enveloped Retrovirus
Protein core which in cases genetic material
two stands of RNA

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14
Q

When was HIV discovered?

A

1983-4

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15
Q

How does the HIV virus infect T Helper cells?

A

Protein particles on the virus recognize the CD4 protein found in helper T cells allowing it to fuse with the cell membrane
Reverse transcriptase then converts the RNA genome to DNA
Transported into nucleus, genome then integrated into host cell genome

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16
Q

What type of infection is HIV?

A

Latent infection, very few infected cells will be activated allowing for chronic infection

17
Q

What is the pathogenesis of HIV?

A

10^9 TH cells are produced per day HIV will infect some of these
Infected cells will produce 10^9 HIV/day and productively active cells are killed by Cytotoxic T-Lymphocytes

18
Q

What causes the rapid evolution of the HIV virus and how does this contribute to the viral pathogenesis?

A

The continued production of HIV and creation of the DNA from the RNA genome by reverse transcriptase is highly error prone resulting in a wide range of mutant viruses every day
This means that there is frequently HIV that can not be detected by cytotoxic lymphocytes

19
Q

What is the time course of the HIV infection?

A

Amount of infected cells and virus initially rapidly rises within the first month
Immune system begins to be activated and killing infected cells and virus particles causing a dramatic drop in the amount of virus
The evolution process of the virus means that after this initial drop the T lymphocytes attempt to find the virus but unable to completely eradicate it resulting in a slow increase in the amount of virus present and a concurrent decrease in helper lymphocytes
Eventually the T helper lymphocytes are unable to fight off the diseases which are characteristic of AIDS patients

20
Q

What is a seroconversion illness with respect to HIV?

A

When the patient feels unwell due to the rapid production of antibodies and the increased activity of cytotoxic T lymphocytes causing the initial dramatic drop of virus levels
Once this drop is completed the patient will begin to feel well again

21
Q

What are the two methods through which HIV infection can be diagnosed?

A

HIV antibodies in blood can be detected

HIV genome can be detected in blood PCR

22
Q

What are the two methods that HIV antibodies are detected?

A

ELISA test followed by a confirmation Western Blot test

23
Q

How does the ELISA (Enzyme Linked Imunosorbent Assay( test work?

A

HIV Antigen is stuck to the base of ELISA Wells
Serum sample added, if antibodies to the antigen are present then they will attach while the other antigens are added
Marker antihuman antibodies are then used to detect if anything bound to the antigen

24
Q

What is the western Blot test?

A

HIV proteins are separated via gel electrophoresis
Western blotting is then used to transfer these proteins to a membrane
these bound proteins are then tested with serum to see if antibodies are present which attach to these proteins
These antibodies are then stained with marker antibodies

25
Q

What are the drug targets in the HIV replication cycle?

A

Reverse transcriptase is targeted by AZT, 3TC, efavirenz
DNA Integration is targeted by raltegravir
Protease is targeted by lopinvar, atazanavir
HIV Binding maraviroc

26
Q

What are the different risks for transmission of HIV?

A

Man to man (Anal Sex) 1%
Man to Woman (0.1%)
Mother to Infant (25% at delivery, 12% with breastfeeding)

27
Q

What is the epidemiology of AIDS in 1983-2011 NZ

A

3500 People diagnosed with HIV infection
680 People died from AIDS
1900 People currently receiving care for HV infection
1400 People currently being treated with anti HIV medicines

28
Q

What is the new diagnosis of HIV in NZ?

A

40-80 MSM each year
Peak of about 90 mostly immigrant heterosexual cases in 2006
Very few cases due to injecting drug users or mother to child transmission

MEDSCI 202 Second half (14 decks)

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