PATHOPHYSIOLOGY DIAGRAM: HIV/AIDS

Predisposing factors: Precipitating factors:

Age (sexually active persons Lifestyle
aged 20-49) Unprotected sex
Sex Injecting drug use
Multiple sex partners
Type of work (healthcare
Men having sex with men
workers)
Recently had STI
HIV enters the body

HIV binds to CD4 receptor and one of two co-receptors

on the surface of CD4+ T-lymphocytes

The virus then fuses with the host cell

The virus releases RNA, its genetic material into the host cell

Reverse transcription: reverse transcriptase converts the

single-stranded HIV RNA to double-stranded HIV DNA

Integration: The newly formed HIV DNA enters the host cell's
nucleus, where an HIV enzyme called integrase "hides" the
HIV DNA within the host cell's own DNA. The integrated
HIV DNA is called provirus

Transcription: When the host cell receives a signal to become

active, the provirus uses a host enzyme called RNA
polymerase. The mRNA is used as a blueprint to make long
chains of HIV proteins

Assembly: An HIV enzyme called protease cuts the long

chains of HIV proteins into smaller individual proteins.
 Budding: The newly assembled virus pushes out from the host
cell. These HIV glycoproteins are necessary for the virus to
bind CD4 and co-receptors. The new copies of HIV can now
move on to infect other cells

The virus will make its way to the Death or destruction of mature CD4
lymph nodes cells

Peripheral blood; migration of CD4 Suppression of CD4 cells

cells to the lymph nodes

Immunosuppression
Generalized lymphadenopathy/acute
retroviral syndrome

Opportunistic infection
Oral esophageal thrush
Diarrhea, vomiting,
Herpes
flu-like symptoms, Simplex
fatigue, loss of Weight loss TB, CMV
appetite Pneumocytosis

AIDS
Because HIV is an infectious disease, it is important to understand how HIV-1 integrates itself into a
person’s immune system and how the immune response plays a pivotal role in the course of HIV disease.
This knowledge is also essential for understanding medication therapy and vaccine development. Viruses
are intracellular parasites. HIV is in the subfamily of lentiviruses and is a retrovirus because it carries its
genetic material in the form of ribonucleic acid (RNA) rather than deoxyribonucleic acid (DNA)

Etiology

HIV infection is caused by the human immunodeficiency virus. You can get HIV from contact with
infected blood, semen, or vaginal fluids.

 Most people get the virus by having unprotected sex with someone who has HIV.
 Another common way of getting it is by sharing drug needles with someone who is infected with
HIV.
 The virus can also be passed from a mother to her baby during pregnancy, birth, or breastfeeding.

Symptomatology

Most people don't know right away when they've been infected with HIV. But they may have symptoms
within 2 to 6 weeks after they’ve gotten the virus. This is when your body's immune system puts up a
fight. It's called acute retroviral syndrome or primary HIV infection. The symptoms are similar to those of
other viral illnesses, and they're often compared to the flu. They typically last a week or two and then go
away. Early signs of HIV include: Headache, Fatigue, Aching muscles, Sore throat, Swollen lymph
nodes, A red rash that doesn't itch, usually on your torso, Fever, Ulcers (sores) in your mouth, esophagus,
anus, or genitals.

AIDS Symptoms

AIDS is the advanced stage of HIV infection. This is usually when your CD4 T-cell number drops below
200 and your immune system is badly damaged. You might get an opportunistic infection, an illness that
happens more often and is worse in people who have weakened immune systems. Some of these, such as
Kaposi's sarcoma (a form of skin cancer) and pneumocystis pneumonia (a lung disease), are also
considered “AIDS-defining illnesses.” If you didn't know earlier that you were infected with HIV, you
may realize it after you have some of these symptoms: Being tired all the time, Swollen lymph nodes in
your neck or groin, Fever that lasts more than 10 days, Night sweats, Weight loss with no obvious reason,
Purplish spots on your skin that don't go away, Shortness of breath, Severe, long-lasting diarrhea, Yeast
infections in your mouth, throat, or vagina, Bruises or bleeding you can't explain, Neurological symptoms
such as memory loss, confusion, balance problems, behavior changes, seizures, and vision changes