HIV/AIDS AND TREATMENT

DEPARTMENT OF LIFE SCIENCE

INSTITUTE OF TECHNOLOGY SLIGO

B.SC. IN PHARMACEUTICAL SCIENCE

PROJECT 2014/2015

PROJECT SUPERVISOR: IVAN SULLIVAN

COMPOSED BY: YURIY URZHUMOV S00115501

What Are HIV & AIDS ?

HIV (Human Immunodeficiency Virus) The virus compromises the body’s ability to handle disease and causes AIDS.

AIDS (Acquired Immune Deficiency Syndrome) It is related to HIV, but they are not the same. A person has AIDS only in the final stages of HIV, after the immune system becomes unable to defend itself against foreign invaders like bacteria, or other viruses, and allows the development of certain cancers.

STATISTICS

HIV on World Map

Key facts

HIV continues to be a major global public health issue, having claimed more than 39 million lives so far. In 2013, 1.5 million people died from HIV globally.

There were approximately 35.0 million people living with HIV at the end of 2013 with 2.1 million people becoming newly infected with HIV in 2013 globally.

Africa is the most affected region, with 24.7 million people living with HIV in 2013. Also Africa accounts for almost 70% of the global total of new HIV infections.

HIV infection is usually diagnosed through blood tests detecting the presence or absence of HIV antibodies.

Key facts contd.

There is no cure for HIV infection. However, effective treatment with antiretroviral (ARV) drugs can control the virus so that people with HIV can enjoy healthy and productive lives.

In 2013, 12.9 million people living with HIV were receiving antiretroviral therapy (ART) globally, of which 11.7 million were receiving ART in low and middle-income countries. The 11.7 million people on ART represent 36% of the 32.6 million people living with HIV in low and middle-income countries.

Pediatric coverage is still lagging in low and middle-income countries. In 2013 less than 1 in 4 children living with HIV had access to ART, compared to over 1 in 3 adults.

History

The world first case of AIDS was discovered in the early 1980’s.

Researchers aren’t sure exactly when and how HIV developed.

The most acceptable theory that HIV was transmitted to humans from chimpanzees sometime in the early 20th century.

SYMPTOMS

When HIV emerges from latency (the period when someone with HIV shows no signs of it)

Symptoms can include:

Dry, flaky skin Chronic fatigue

Fever that comes and goes

Diarrhea that lasts more than a week

Heavy night sweats

Rapid weight loss

Swollen lymph nodes

White spots on tongue, mouth & throat

DIAGNOSIS

To be tested for HIV you usually give a sample of:

Blood

Urine

Mouth Swab

Home testing kits two types:

1. Collect samples and send away.

2. Instant results not as accrued.

HIV Virus

RNA based virus that causes AIDS

1. Attacks the Immune System

2. Destroys the body’s defenses against diseases

3. Body becomes vulnerable to infections & cancers that don’t normally develop in healthy people

Structure of HIV

HIV Capsule HIV Structure

Dissected view of HIV virus

Key Parts of the Immune System

CD4 Cell OR White Blood Cell

Antibodies

HIV Virus

Healthy T cell vs HIV infected T cell

Healthy T Cell (Type of a white blood cell)

T Cell is HIV infected(Yellow dots is a HIV particles )

Dangerous body fluids. Following Body Fluids Are Dangerous If These Enter The Body:

Blood

Semen

Vaginal Secretions

Breast Milk

Safe body fluids. Following Body Fluids Are Safe Even If They Enter The Body:

Saliva

Urine

Sweat

Tears

How Does HIV get into a T Cell ?

This proses occurs in 3 steps:

1: HIV attaches to

infection fighting T cell.

2: Locks on to two entry

areas of the T cell.

3: Injects viral RNA in

to the cell.

HIV Inside a T Cell

Once HIV virus enters T Cell it does the following:

1. Virus’s RNA changes into DNA

2. Enters Cell nucleus & becomes part of Host’s DNA!

3. Programs T cell to produce virus in abundance

4. New viruses kill T cell, & enters bloodstream

5. New HIV viruses infect more T cells

From HIV to AIDS

Window period is a time period between a person’s exposure & actual infection with HIV and until antibodies are detectable in the body.

On average with in three months (in some cases it could be up to six months) HIV antibodies will develop and can detectable by HIV antibody test.

99% of patients develop HIV antibodies

What is AIDS ?

Results of untreated HIV infectionA group of symptoms that occur together. Inability of the immune system to fight

infectionCD4 cell count dropped bellow 200 T cells

(or CD4 cells). CD4 cell count in healthy humans is1000

cells (800-1200)

Progression of HIV to AIDS

Result of AIDS

Soaking night sweats

Shaking chills or fever higher than 38 C for several weeks

Cough

Shortness of breath

Chronic diarrhea

Persistent white spots on tongue or in the mouth

Headaches

Persistent drowsiness

Blurred and distorted vision

Weight loss

Skin rashes or bumps

Treatment of HIV

cART (Combination Antiretroviral Therapy) is the most common treatment used.

There Is 6 Types of Drugs That Exist For HIV Treatment:

1. Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)

2. Immune-Based Therapies

3. Integrase Inhibitors

4. Entry Inhibitors (including Fusion Inhibitors)

5. Protease Inhibitors (PIs)

6. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Nucleoside/Nucleotide Reverse Transcriptase Inhibitors

Prevent the viral enzyme from converting RNA to DNA

As a result HIV's genetic material cannot be incorporated into the healthy genetic material of the cell, and prevents the cell from producing new virus.

Immune-Based Therapies

Boosting the immune system by introducing patients with naturally occurring cytokine that stimulates the production of CD4 cells.

Integrase Inhibitors

HIV converts RNA to DNA and then incorporated into the CD4 cell's DNA.

This is known as integration integrase inhibitors work by blocking this process

Entry Inhibitors

Entry inhibitors work by preventing HIV from entering healthy CD4 cells.

Entry inhibitors work by attaching themselves to proteins on the surface of CD4 cells or proteins on the surface of HIV

Protease Inhibitors

In order for HIV to multiply it need protein-cutting enzyme to make functional new HIV particles.

Protease inhibitors block the protease enzyme and prevent the cell from producing new viruses.

It is recommended that they be used in combination with at least two other HIV drugs to treat HIV infection.

Non-Nucleoside Reverse Transcriptase Inhibitors

Non-nucleoside reverse-transcriptase inhibitors are antiretroviral drugs used in the treatment of human immunodeficiency virus.

NNRTIs inhibit reverse transcriptase, an enzyme that controls the replication of the genetic material of HIV

Treatment of AIDS & Life Expectancy

Treatment help patients to live longer.

In 1997 the life expectancy of an individual would be around 7 years.

In 2007 the life expectancy of an individual rose up to 20 years or more.

Problems Associated With Treatment

Patient required to take a lot of tablets.

Sevier side effects.

Drugs does not work for everyone the same way.

Drugs cost a lot of money.

On average prices for cART in 2002-2003 Per/Person/Per/Day €32.23

Future perspectives

33% decrease in new HIV infections since 2001

29% decrease in AIDS-related deaths (adults and children) since 2005

52% decrease in new HIV infections in children since 2001

40-fold Increase in access to antiretroviral therapy 2002–2012

It is possible that HIV will be cured at some stage.

Conclusion

HIV is mainly transmitted by sexual intercourse.

Untreated HIV result in AIDS

Most common way of treating HIV is by cART

HIV destroys human immune system.

HIV multiplies using cd4 cells

HIV is not airborne and cannot be caught by touching skin, sweat or saliva.

HIV can’t be transmitted by holding hands or sharing drinks.

Mosquito's do not inject other peoples blood when they bite and so can’t spread HIV.

Reference

http://www.unaids.org/sites/default/files/media_asset/JC2571_AIDS_by_the_numbers_en_1.pdf

www.aids.gov

www.aidshealth.org

www.aidsmap.com