Biochemistry

-
og -
AIDS d HN

Transmission :

About so %
by sexually transmitted disease ( STDs )
°

About blood
by
°

15% -

About 5%
by Mother to
fetus ( of infants to
•

-
n 30% born HIV +

mothers
may get the
infection )
Course :

klindowenod -
When virus enters the
body .
it is
multiplied in the

body cell but it cannot be detected

,
easily .

. The Virus
capsid antigen p 24 can be detected in blood .

Few months later antibodies

Sewposikvestage -

, are seen in circulation

This is sew
positivity .

this period in but carrier

During normal
°

person a .

3rd
•
About to %
g Seropositive individual
progress
to
stage
within 5
years
.

About so t within to
yrs
• .
.

About within not treated )

yrs ( if
°
90% 15

AIDS Disease
Third
stage when the clinical
manifestations
-

-
in

start
By this time immune
system di
.

o Commensal microbes IT

Patients die within after 3rd

2
stage
•

years .

°
Some
infections by -

fungi : Candida
Cryptococcus
&

Virus :
cytomegalovirus Herpes simplex &

Parasites :
Pneumocystis carinii

Bacteria :
Mycobacterium & Salmonella
 •
Cancers associated with AIDS an
Kaposi sarcoma and

NHL ( non -

Hodgkin 's lymphoma )

•

Cognitive impairment due to meningitis Neuropathies .

and
Neuropsychiatric manifestations .

Clianifestakons :

lymphadenopathy be 2nd
o and Fever
may
seen
by end
of stage .

related
• AIDS
symptoms ( Ars ) are wide .

. Since
immunity Hi in
,
non -

pathogenic microorganisms enter into

the
body and produce lesions in skin ,
GIT .
lungs .
Urinary tract .

brain etc .

•
Gastroenteritis & Tuberculosis are
predominant in AIDS in India .

Laboratory Analysis :

cis
by ELISA test .

ciii tales fern bolt

-

( confirmatory )
( iii , T -

helper count ( L 300 Camm ) ( Normal -

400 cumin )

( Ivi 24 A
p
cut RTPCK ( real time PCR) -
To detect Hiv
particles in blood .

Value copies 1mL of blood

I 5000 in
good prognosis .

> I lakh 1mi blood in bad

g
prognosis .

His HAT ( Nucleic acid testing )

I,

Involves
amplification and detection of one or more
specific
located
target sequences
in
specific Hiv
genes
.

Detection limit to 400

200
copies 1mL
o =
.
 Virus
Human
#
Immunodeficiency #
:

structure :
-

cis Hiv
belongs to the retrovirus groups RNA containing .

viruses that
replicate with the help of transcriptase ( reverse RT ) or RMA

dependent DNA
polymerase .

iii , Virus has

cylindrical
a core ,

containing two copies

of ss RNA .

Protein
ciii ,
components are named after
its molecular wt .

civl Core contains Reverse transcriptase

( p 66 &
p
55 ) ,
endonuclease
(p 32)

Nucleocapsid ( pg )
protease ( p lo )

Major capsid Antigen ( pm) -

About
copies
200
.

Outer shell
Myn 's to ligated Protein
-

(P 17 )

[ About
pies D
p ]
24
 Virus
Entry :

l " The
binding of Hiv with
target cell in
through a
receptor mechanism

The
envelope with bind with
ciii
gp
120
of vines
specifically CD4

molecule on the
surface of target cell .

CD4 acts as a
receptor for
tins
present
.

molecules
(
iii , The CD4 are on
surface of T -

helper cells &

therefore helper cells receive the maximum attack of Hiv .

and
entering receptors
HIV chemokines
(im uses CD4 as .

[ Replicating de ]
 Immunology of AIDS

ii. The CD4 (T helper) lymphocytes decreased number

leading
-

are in
,

to
immunodeficiency .

unit attach with molecules present

• The
gp
120
surface CD4 on

the
surface of T -

helper cells .

• Hiv
preferentially enters into T -

helper cells and they analysed .

act
ciii
Macrophages and
monocytes as the reservoir
of Hiv
infection .

which disseminate the virus to various

organs .
including CMS .

In turn , macrophage de

1400 blood
ciii , T -

helper ( CD4 ) =
cumin g
.

interleukin
Civ , Lymphokines such as
interferon ,
-
2 etc are lowered .

ANTI -
HIV
Drugs :

inhibitors
- -

① RT

anti Inhibitors
o G - classes og
-
HH
drugs .
② Integrase
[ 4 described
-

③ Protease inhibitors ④
Entry
here
] Inhibitors
④

①
②
 ( is Reverse transcriptase ( RT ) inhibitors :

cis AZT ( di deoxy thymidine azidothymidine .

,
Zidovudine )
Iiis dd I ( di
deoxy inosine ,
did anosine .
Lida no sine )
ciiis ddc ( di deoxy cytidine Zala ta bine )
'

civ , das ( stave dine )

HI 37C ( Lami vaccine )

Il
Aba caviar
''
(

Inhibitors Raltegrayir
ciis
Integrase : cis

ciis
Elvitegrauir
ciii , Dolce te
gravis

( iii , Protease Inhibitors : cis Iopinaneir

dis Indinaniir
( iii , Mel
financier
( in
Ampnnaneir
( is Rito navis
( vis Darien aviv & Atacama .ir ( first line
choice )
( in
Entry Inhibitors : Ma ravine 4 En
fair tide
- .

Prevention :

• Since there in no cure

for AIDS ,
and vaccines are not present ,

public education to limit

awareness &
only means
.

am

° Use
protections .

Using disposable syringes

•
.

inactivate the
•

Boiling for to mins will virus .

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