INDEX

ABSTRACT

INTRODUCTION TO AIDS

INTRODUCTION TO HIV VIRUS

LIFE CYCLE OF RETROVIRUS

TYPES OF TESTS FOR AIDS

MANIFESTATION OF AIDS

TREATMENT FOR AIDS

PREVENTION FROM AIDS

REASON FOR TRANSMISSION

STEPS TAKEN TO PREVENT AIDS

CONCLUSION

OBSERVATION

PROBLEMS FOR PATIENT

BIBLIOGRAPHY
ABSTRACT

Many of the clinical features of HIV/AIDS can be ascribed to the profound immune
deficiency which develops in infected patients. The destruction of the immune system by the
virus results in opportunistic infection, as well as an increased risk of autoimmune disease
and malignancy. In addition, disease manifestations related to the virus itself may occur.
For example, during the primary illness which occurs within weeks after first exposure to
HIV, clinical symptoms occur in at least 50% of cases, typically as a mononucleosis
syndrome. HIV-related complications are rarely encountered in patients with preserved
immunity (i.e. CD4 T-cell counts greater than 500 cells/mm3). Recurrent mucocutaneous
herpes simplex (HSV), herpes zoster (VZV), oral candidiasis and oral hairy leucoplakia occur
with increasing frequency as the CD4 count drops below this level. Immune
thrombocytopenia (ITP) occurs in association with HIV and often presents early in the
clinical course. The risk of developing opportunistic infections and malignancies typical of
AIDS increases progressively as CD4 counts fall below 200 cells/mm3.
The clinical manifestations of infections associated with AIDS tend to fall into well-
recognized patterns of presentation, including pneumonia, dysphagia/odynophagia, diarrhoea,
neurological symptoms, fever, wasting, anaemia and visual loss.
The commonest pathogens include Candida albicans, Pneumocystis carinii, Mycobacterium
tuberculosis, Toxoplasma gondii, Cryptococcus neoformans, Mycobacterium avium
intracellular and cytomegalovirus. Malignant disease in patients with HIV infection also
occurs in a characteristic pattern. Only two tumours are prevalent: Kaposi's sarcoma, a
multifocal tumour of vascular endothelium which typically involves skin and mucosal
surfaces; and non-Hodgkin's lymphoma, which is typically high grade in phenotype, often
arising within the central nervous system.
The principles of therapy include reduction of HIV replication by antiretroviral agents,
prophylaxis against the common opportunistic infections and treatment followed by
subsequent lifelong maintenance therapy for infections when they do occur.

INTRODUCTION TO AIDS

What is AIDS?
Expansion: Acquired Immuno Deficiency Syndrome. It is a pandemic disease. AIDS cannot
be compared to disease like malaria and cholera which claim more live in country currently.
It has a greater impact than other disease. The treatment options are still in the initial stages
and are prohibitively expensive. There are instances of quacks taking advantage of the
situation. This has compounded the misery of AIDS patients.
History of AIDS
It was first noticed in USA in 1981. The American and French scientist independently
identified the AIDS virus 1984. The virus first named as HCLV III ( Human cell leukemia
virus III). The name (Human cell leukemia deficiency virus) is now preferred. It now seems
that HIV first passed into human from chimpanzees by eating butchered chimps. 10% of the
people, who get AIDS virus infection, actually develop full blown AIDS.
Causes of AIDS
The main causes of AIDS is a disorder of cell mediated immune system of the body. The
disorder is characterized by a reduction in the number of helper. T-cell which stimulate
antibody production by B-cells. This result in the loss of natural defence against viral
infection.
Transmission of AIDS
It is only transmitted by a direct contact of infected cells - containing blood of patient to the
blood of a healthy person as in –
1) Sexual intercourse with an infected partner if there is tissue injury to permit blood contact.
2) Use of contaminated needles and syringes to inject drugs or vaccines.
3) Use of contaminated razors, needles for boring pinnae.
4) Transfusion of infected blood or blood product.
5) Organ transplant.
6) Artificial insemination.
7) Parturition from mother to baby due to rupturing of blood vessels.
AIDS is not a contagious disease. It does not spread by casual contact, such as handshake,
body contact in crowded places, working or playing together, sharing clothes, eating food
cooked by infected person, using same toilet, swimming pools. It is also not and ribavirin
seem most promising. A drug named zide vuidine prolongs the life of many AIDS patient.
However, some patients’ AIDS virus has already mutated to zidovudine resistant forms.

INTRODUCTION TO HIV VIRUS

It is 100 to 140 nm. in diameter and has a cylindrical core. It is found in blood and semen and
to a lesser extent In milk tears and saliva. It is a retrovirus, i.e. its genetic material is - RNA
(single stranded linear) which can make a DNA copy of itself with the help of the reverse
transcriptase enzyme. The virus binds specifically to a surface receptor on a helper T-cell and
introduce its RNA and reverse transcriptase enzyme into the cells here it multiplies and the
release of new virus destroys the cell. AIDS occurs when the helper T-cell falls too low to
fight the disease.
LIFE CYCLE OF RETRO VIRUS

The retroviral life cycle begins in the nucleus of an infected cell. At this stage of the life cycle
the retroviral genome is a DNA element integrated into and covalently attached to the DNA
of the host cell. The genome of the virus is of approximately 8-12 kilobases of DNA
(depending upon the retroviral species). Full-length genomic mRNA is made initiating at the
beginning of the R (repeat) at the 5' LTR (Long Terminal Repeat). The free particle can infect
new cells by binding to a cell surface receptor. The specificity of the virus-cell interaction is
determined largely by the envelope protein(s) of the retrovirus. Infection leads to injection of
the virus nucleoprotein core (consisting mostly of gag-derived proteins, full-length genomic
RNA, and the reverse transcriptase protein).

Once inside the cell, the nucleoprotein complex accesses intracellular DNA nucleotide
triphosphate pools, whereupon the reverse transcriptase protein initiates creation of a double-
stranded DNA copy of the genome of the virus in preparation for integration into the host cell
chromosome. Upon completion of reverse transcription, the viral enzyme Integrase searches
the DNA for an appropriate "home", whereupon the integrase clips the host DNA and sews
the double-stranded DNA into the host DNA. The virus is now prepared to initiate a new
round of replication

TYPES OF TESTS FOR AIDS

Antibody test
An antibody test looks for antibodies to HIV in your blood or oral fluid.

 Most rapid tests and the only HIV self-test approved by the U.S. Food and Drug
Administration (FDA) are antibody tests.
 In general, antibody tests that use blood from a vein can detect HIV sooner than tests
done with blood from a finger stick or with oral fluid.

Antibody/Antigen test
An antigen/antibody test looks for both HIV antibodies and antigens.

 Antigen/antibody tests are recommended for testing done in labs and are common in
the United States. This lab test involves drawing blood from a vein.
 There is also a rapid antigen/antibody test available that is done with blood from a
finger stick.

Nucleic Acid Test

A NAT looks for the actual virus in the blood.

 With a NAT, the health care provider will draw blood from your vein and send the
sample to a lab for testing.
  This test can tell if a person has HIV or how much virus is present in the blood (HIV
viral load test).
 A NAT can detect HIV sooner than other types of tests.
 This test should be considered for people who have had a recent exposure or a
possible exposure and have early symptoms of HIV and who have tested negative
with an antibody or antigen/antibody test.

ELISA

The enzyme-linked immunosorbent assay (ELISA) is an immunological assay commonly

used to measure antibodies, antigens, proteins, and glycoproteins in biological samples. Some
examples include: diagnosis of HIV infection, pregnancy tests, and measurement of cytokines
or soluble receptors in cell supernatant or serum. ELISA assays are generally carried out in
96 well plates, allowing multiple samples to be measured in a single experiment. These plates
need to be special absorbent plates (e.g., NUNC Immuno plates) to ensure the antibody or
antigen sticks to the surface. Each ELISA measures a specific antigen, and kits for a variety
of antigens are widely available.

MANIFESTATION OF AIDS

Manifestation: - It can manifest in two major ways –

i) Maligent tumours in connective tissue

ii) Viral, bacterial, protozoan and fungal infection of any system of the body. There are
destruction of WBC’S, damage to brain, unexplained fever, unexplained loss of appetite,
unexplained loss weight over a short time, chronic diarrhea, cough, night sweats, enlargement
of lymph glands, shortness of breath, weakness.

TREATMENT FOR AIDS

i) Antiviral therapy is one of the most exciting aspects of virology, since it has successfully
employed basic science to generate very effective treatments for serious viral
infections. Table 1 lists selected examples of those human viral diseases for which there are
established antiviral drugs. Therapy for human immunodeficiency virus (HIV) infection has
demonstrated that the potential impact antivirals can have on a lethal, chronic infection with
lifesaving therapy.

ii) Immuno simulative therapy to increase the number of resistance - providing cells in the
body or both. However no specific treatment has been found so far and the mortality form
AIDS is virtually 100%. A victim of full-blown AIDS dies within 3 years from infection of
many drugs tried, azithmidine transmitted by blood sucking insects such as mosquitoes,
AIDS virus has been found in urine, tears saliva, breast milk and vaginal secretions, but is
seems not to transmitted by these fluids unless it gets a cut.

PREVENTION FROM AIDS

Following steps may help in controlling this dreaded disease.

i) People particularly those in high-risk group should be educated about AIDS transmission.

ii) High risk group should refrain from blood donation.

iii) Disposable needles and syringes should be used.

iv) Sexual habits should be changed immediately.

v) Before receiving blood, ensure that it has been screened for HIV.

vi) Routine screening may be done in

a) Blood Donors

b) Organ Donors

c) Donors of semen and growth hormone,

d) Patient receiving haemodialysis

e) Females in high-risk group, who are pregnant or contemplating pregnancy.

Chastity, life-long monogamy, and a clean needle for each injection are the only ways to
prevents the spread of AIDS. These measures will succeed only in persons not already
infected. Major causes & steps to prevent it Reasons of spreading AIDS among world people
More than 90% of the infected persons are belong to developing countries.

REASONS FOR TRANSMISSION OF AIDS

(i) Low-level of socio-economic development.

(ii) Low health consciousness and facilities

(iii) A growing unmarried youth population due to delayed marriage

(iv) High rate of labour migration.

(v) Low level of literacy among high-risk groups.

(vi)High incidence of sexuality transmitted diseases and reproductive tract infections among
men and women.

STEPS TAKEN FOR PREVENTION OF AIDS

(i) National AIDS programme of south East Asian countries are beginning to yield
encouraging results. The 100% condom use programme in Thailand and the Sonagachi
project in Calcutta, a model peer education programme among sex workers, have helped
bring down AIDS infection and also reduced the incidence of STD.

(ii) Non-government organizations have brought Baptist interest litigations against such cases
of discrimination and the courts have pronounced the rights of such peoples. This has helped
alleviate the misery of affected persons.

CONCLUSION

After studying the cause and effects of ‘AIDS’ from different views, we conclude that it is a
pandemic disease. It is mainly spreading sexually and person of the age group of 25-45 years
are the most affected group. There are some methods like ‘Antiviral Therapy’ and Immuno
Stimulative therapy which bring some hope that even then no specific treatment has been
found so for and morality form is virtually 100%. So only prevention in the test medicine
care

OBSERVATION

AIDS immersed as pandemic disease. It is nondurable. It is more common in developing

countries. Now every day 1000 peoples are going to become HIV infected in world. This is
mainly due to blood transfusion & Sexual contact. In whole world about 3 crore 30 lakhs
people are HIV positive & in India 3 lakh 70 thousands are HIV positive. The number of HIV
positive persons are higher in Tamil Nadu, Bombay, Calcutta and Kerala and Manipur.
PROBLEMS FOR PATIENTS

HIV weakens the immune system by destroying CD4+ T cells, a type of white blood cell that
is important for fighting off infections. The loss of these cells means that people living with
HIV are more vulnerable to other infections and diseases.

HIV causes significant inflammation in the body. This inflammation can cause neurological
complications by damaging the spinal cord and brain, which form the central nervous system.

Despite effective ART, people with HIV are still at risk for central nervous system diseases
associated with HIV. These diseases can be neurological (affecting the nervous system) or
neurocognitive (affecting cognition or mental processing).

Severe neurological impairments such as dementia, brain atrophy, and encephalitis

(inflammation of the brain) are less common in people who use ART, compared to people
with HIV who are not on ART. However, there are still less severe forms of central nervous
system diseases associated with HIV.

BIBLIOGRAPHY

Biology Textbook Class 12 (NCERT)

www.ncbi.nlm.nih.gov

web.stanford.edu

www.healthline.com

www.hiv.gov

www.sciencedirect.com

www.immunology.org