Testing and treatment viral load tests gene probes

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Testing and Treatment • Viral Load tests - Gene probes - Polymerase chain reaction • Classes of anti-HIV drugs (anti-retrovirals) - Reverse transcriptase inhibitors Nucleoside analogues Non-nucleoside analogues - Protease inhibitors • H ighly A ctive A ntir etroviral T herapy (HAART) 5/30/2013
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13 Direct Tests for the presence of HIV Detect antigen or nucleic acids of HIV Tests are more complicated and expensive to do Screening for HIV Ag does not reflect level of infection HIV as provirus = not synthesizing virus particles Viral nucleic acid test is more dependable = viral load test - gene probes - gene amplification (PCR)
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14 HIV gene probe Fig. 7.7 HIV gene
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15 DNA hybridization movie http://www.youtube.com/watch?v=76eKnmCtCTU&feature=related
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16 Viral Load Test • From the amount of radioactivity detected with gene probes, the viral load can be calculated • The viral load is the amount of virus in that patient specimen • Viral load is very important in evaluating effectiveness of treatment, choice of drugs, and stage of disease
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17 Problem Need big enough DNA sample for testing Maybe only 1 in 10 000 T cells are infected Need to amplify viral genes = PCR P olymerase C hain R eaction
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Polymerase Chain Reaction 18 Fig 7.8 text Amplification of HIV genes Taq polymerase = heat resistant Synthesizes new DNA strand from primer Primers = 10-15 nucleotides that are complementary to DNA sequences at either end of a gene
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19 PCR Movie http://www.youtube.com/watch?v=ZmqqRPISg0g
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20 Correlation of CD4 T Cell Count With Viral Load CD4 T Blood
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21 Viral Setpoint and Disease Progression Rate of Survival High Low Medium Time Low High Medium
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22 Correlation of Viral Load With Survival High Survival Low Survival (Set Point)
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23 Advantages of viral load test • Can detect HIV infection in newborns • Safer blood supply - minipooling Test can detect 100 HIV particles per ml blood Can detect HIV 10 days after infection • Viral load is indicative of progress of disease • Monitor HIV therapy
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