Section 8 slides

Section 8 slides - HIV Disease is Primarily a Disease of...

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11/12/11 1 HIV Disease is Primarily a Disease of the Immune System Lymphatic System Bone marrow-new cells infected Thymus- fewer cells/ new cells infected - less competent cells - naive cells destroyed Spleen- major HIV reservoir Tonsils - major HIV reservoir Adenoids - major HIV reservoir Lymph nodes- massive infection - infection of cells coming through node - destruction of node Lymph Node HIV seeded to node during acute infection PGL Size decreased with disease progression as follicular dendritic cells die and germinal centers are destroyed Atrophied on autopsy HIV Affects the Human Body by Direct effect of HIV on body cells or tissue Indirect disruption by immune system components Disruption of immune system leads to OIs and cancers Drug/treatment side effects Psychological reactions Classification Public purpose CDC 1986 Classification of Disease CDC 1993 Diagnostic Criteria Staging for Clinical Management and Clinical Research Classification Staging for Clinical Management and Clinical Research (Sande;Volberding) Acute, Early, Middle, Advanced and Late HIV Disease Normal CD4 Count is 800-1200 Perhaps lower in women Infection and Course of Infection Depend on subtype (clade) of virus and route of possible transmission (B vs. A/E etc.) Wildtype (R5) or mutant virus (X4) (early vs. late) receptors and co-receptors present R5 are M-tropic (Mø /APC) X4 are T-tropic (T-cell)
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11/12/11 2 Early HIV Infection: Strain SF 162 (“Wild type” virus. Most easily transmitted) HIV isolates replicate slowly and attain low viral levels Infects Mø preferentially (M -Tropic) Mø have CCR5 (R5) receptors Do not induce syncytia (NSI) Late HIV Infection: Strain SF 33 (Later mutants. Less easily transmitted. Associated with disease progression.) HIV isolates replicate rapidly and attain high viral levels Infects T-Cells preferentially (T- Tropic) T-Cells have CXCR4 (X4) receptors Induce syncytia (SI) Transmitted in < 20% of cases Transmission of Different Clades (Different clades (subtypes) of HIV-1 show differences in transmission routes) Subtype B: less likely to cross mucous membranes transmitted primarily by blood exposure (IV drug users) anal sex (receptive 1:10 to 1:40, overall 1:100) (vaginal intercourse transmission only 1:500 to 1:1000 exposures) found in US and Europe Transmission of Different Clades (Different clades (subtypes) of HIV-1 show differences in transmission routes) Subtype A, C, D, E: more likely to cross mucous membranes transmitted primarily by vaginal intercourse (1:40 to 1:500 exposures) found in Africa and Southeast Asia Acute HIV infection (Acute retroviral syndrome) Incubation period 1-12 weeks Acute stage 3-49 days (fever, malaise, nausea, vomiting, rash) HIV type (in >80% of cases): slow low non-syncytia forming Remember women more apt to have a variety of strains
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This note was uploaded on 12/06/2011 for the course BIOL 327 taught by Professor Peteringmire during the Fall '11 term at S.F. State.

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Section 8 slides - HIV Disease is Primarily a Disease of...

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