The effects of the genetic mutation which alters the

 the effects of the genetic mutation which alters the expression of the
CCR5 cell receptor and its clinical significance
o CCR5- chemokine receptor (react better with macrophage tropic)-
usually cause the primary HIV infection, do not cause syncytium
formation (infected cells that fuse and form multinucleate)
 Protein found on the surface of WBCs
 Use CCR5 as a mode of entry and infect host cells
 Certain individuals carry a mutation of gene, protecting them
against these strains of HIV
 GP120 (protein unit found on envelope glycoprotein
structure) is encoded for HIV-1 gene- spike ike struct located
on surface of virus, is a chemokine mimic and binds to
CCR5
 Binding to CD4 alone can cause GP120 shedding, must bind
to co-receptor CCR5 in order for fusion to proceed
 CCR5-using viruses are the predominant species isolated
during the early stages of viral infection, suggesting that
these viruses may have a selective advantage during
transmission/acute phase of disease
 CCR5 receptor antagonists have been designed to interfere
with associated binding between GP120 envelope and CCR5
 Differentiate between the difference in the diagnoses of HIV Infection and AIDS and
describe the clinical implications.
o HIV diagnosis: Test for antibodies against HIV proteins (particularly p24- comes
directly from the HIV virus), if individual is seropositive, diagnosis of AIDS is
made in association with various clinical symptoms
o AIDS diagnosis : By decrease CD4+ cell numbers at or below 200 cells/uL
 Evaluate the clinical manifestations which indicate a compromised immune system in
a person with HIV infection and develop a plan to decrease the risk for opportunistic
infections.
o Clinical manifestations : Depletion of CD4+ cells causes profound effect on the
immune system, may be asymptomatic in early stages
o ART
 Evaluate the diagnostic tests used to screen for HIV infection and describe the
clinical implications of each test. May use any of 3 body fluids to detect antibodies

(blood, oral fluids- not saliva, urine ) Positive blood tests will need western blot
confirmation, or HIV viral load test
 HIV EIA (3 rd generation immunoassay) : Enzyme linked immunosorbent
assay, screens for antibodies, IgM & IgG, only (as opposed to virus itself),
called an indirect test
 4 th Generation immunoassay : Detects both HIV antibody and p24 antigen,
testing for early infections during window period, good for early detecting
before antibody development as well as antibodies that are present when
chronic infection has been established
Type of Infection Etiology Clinical Manifestations Pathophysiology
pneumocystis jiroveci
pneumonia (PCP)
-Serious infection that
causes inflammation
and fluid buildup in
your lungs
-Spread through the air
Mild symptoms- fever
(low grade for HIV),
dry cough/wheezing,
SOB when active,
fatigue, chest pain with
inhalation,
*most common
opportunistic infection
-ART & preventive
drugs have decreased
infected
-Test to diagnose: look
at fluid/tissue from
lungs from oral sample
bronchoscope, biopsy