HIV and AIDS Rough Draft Reading Abbas pages

HIV and AIDS Rough Draft Reading: Abbas, pages 258 -266 Flaherty, pages 225 -233 The internal structure of HIV Parham Chapter 3 cover page

Learning Objectives for Vaccine lecture part I • Describe the devastating impact that HIV-1 and HIV-2 have had throughout the world. • Describe the viral proteins, receptors and co-receptors involved in HIV entry into cells • List and describe the different steps associated with the life cycle of HIV • Explain the clinical significance of the high mutation rates associated with retroviruses • Compare and contrast latency with HIV reproduction

Learning Objectives for Vaccine lecture part II • Describe the pathogenesis and clinical course of HIV disease • Describe how opportunistic infections result from AIDS • Describe the mechanism of action for the six classes of antiretroviral drugs used to treat HIV infections • List the prototype for each of the six classes of antiretroviral drugs used to treat HIV • Describe the importance of combinational therapy (HAART) in treating HIV infections • Explain the difficulties associated with developing an effective vaccine for HIV

Acquired (secondary) immunodeficiencies Abbas Fig. 12 -6

Transmission of HIV Infection Table 61 -4. Murray Medical Microbiology 4 th Edition.

Structure of HIV Abbas Fig 12– 7 A. Structure of HIV.

Genome of HIV Presence of overlapping genes is common in viruses, which tend to have small and compact genomes

Attachment and membrane fusion of HIV Flaherty Fig 26 -3

Life cycle of HIV

TEM of both budding and released HIV-1 Photo by Alyne Harrison, Erskine Palmer, Paul Feorino (1984)

High mutation rate of HIV is due to permissive nature of reverse transcriptase -antigenic variation of gp 120 & gp 41 compromises ability -to make effective vaccine -ability of antibodies to limit spread of virus

Means of HIV Escape from the Immune System Murray’s Medical Microbiology, 4 th Edition. Table 61 -3

Pathogenesis of AIDS

Clinical course of HIV disease

Magnitude and kinetics of immune responses (shown in relatively arbitrary units) Abbas Fig. 12– 10.

Opportunistic pathogens associated with AIDS

HAART (Highly active anti-retroviral therapy) - strategy of utilizing combinations of drugs to inhibit viral replication at different steps. Raltegravir is the prototype integrase inhibitor (not included in table on right) Table 49 -2 Katzung & Trevor’s Pharmacology Examination & Board review 10 th Ed.

Steps in HIV life cycle targeted by therapeutics Maraviroc prevents attachment Enfuvirtide prevents membrane fusion. Fig. 49 -3 Katzung & Trevor Basic & Clinical Pharmacology 13 th Ed.

Steps in HIV life cycle targeted by therapeutics Raltegravir is an integrase inhibitor Fig. 49 -3 Katzung & Trevor Basic & Clinical Pharmacology 13 th Ed.

Zidovudine (AZT) -an example of a NRTI

Indinavir-prototype protease inhibitor Protease inhibitors interfere with the proper maturation of HIV virions Murray Medical Microbiology, Fig. 61 -5. HIV protease is required for proper maturation of the HIV virion