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Retroviruses
HTLVs (Human T-cell Lymphotrophic Viruses)
Single stranded RNA viruses, converted to DNA by reverse transcriptase and integrated into host chromosome
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HTVL III
- HIV 1-primary human pathogen, causes AIDS
- HIV 2-mild illness
HIV high mutation rate, multiple subtypes (Clades)
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HIV Epidemiology
- Highest in Africa
- Transmitted via sex, percutaneous, mother to infant
- Affected by stage, source, amount, and susceptibility
- Casual contact not a risk
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Pathophysiology
- Rapid turnover
- Rapid production of virus
- Profound immune response
- Attaches to soluble receptors (CCR and CD4)
- Destroys cells (CD4)
- Early infection mostly in lymph nodes
- Affects immune system (impairs cell mediated immunity and altered production of antibodies)
- Viral replication linked to cell function
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Clinical manifestation
- Acute infection
- Asymptomatic infection
- Early advanced active infection
- Late advanced active infection
- AIDS
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Diagnosis
- Serology
- Direct detection
- culture
- amplification
- major ramifications
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Treatment
- antiretrovirals (controls viral replication)
- Nucleoside analog reverse transcriptase inhibitors
- Nonnucleoside reverse transcriptase inhibitors
- Nucleotide analog reverse trascriptase inhibitor
- Protease inhibitors
- Drugs given in combination
- Drug therapy determined by "viral load"
- Immune reconstitution
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Prevention
- General population (safe sex)
- Health care workers (blood borne pathogen, consider everything bio-hazard, do not get cut, report injury ASAP)
- Prevention is better than treatment
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