GROUP 3

HIV
Introduction
Life cycles of HIV
Immunotheraphy

What is HIV ???

HIV (human immunodeficiency virus) is a
virus that attacks the immune system, the
body's natural defense system.
Without a strong immune system, the body
has trouble fighting off disease. Both the
virus and the infection it causes are called
HIV.
But having HIV doesn't mean you have
AIDS. Even without treatment, it takes a
long time for HIV to progress to AIDS
usually 10 to 12 years.

HISTORY OF HIV
AIDS is caused by the human immunodeficiency
virus (HIV), which originated in nonhumanprimatesinSub-Saharan Africa.
While various sub-groups of the virus acquired
human infectivity at different times, the global
pandemic had its origins in the emergence of
one specific strain HIV-1 subgroup M
inLopoldvillein theBelgian Congo(now
Kinshasa in theDemocratic Republic of the
Congo) in the 1920s.

Types of HIV
HIV -1

HIV-1 is more virulent, is

more easily transmitted and
is the cause of the vast
majority of HIV infections
globally.
The pandemic strain of HIV-1
is closely related to a virus
found in thechimpanzeesof
the subspeciesPan
troglodytes troglodytes,
which live in the forests of
the Central African nations
ofCameroon,Equatorial
Guinea,Gabon,Republic of
Congo(or Congo-Brazzaville),
andCentral African Republic

HIV-2

HIV-2 is less transmittable

and is largely confined to
West Africa, along with its
closest relative, a virus of
thesooty
mangabey(Cercocebus atys
atys), an Old World monkey
inhabiting
southernSenegal,GuineaBissau,Guinea,Sierra
Leone,Liberia, and
westernIvory Coast.

Causes And Symptoms

TheHIVinfection is caused by the human
immunodeficiency virus (HIV).
After HIV is in the body, it starts to destroyCD4+
cells, which are white bloodcells that help the
body fight infection and disease.
HIV is spread when blood, semen, or vaginal
fluids from an infected person enter another
person's body, usually through sexual contact,
from sharing needles when injectingdrugs, or
from mother to baby during birth.

HIV (Human Immunodeficiency Virus)

Infection - Symptoms
Belly cramps, nausea, or vomiting.
Diarrhea.
Enlargedlymph nodesin the neck, armpits, and
groin.
Fever.
Headache.
Muscle aches and joint pain.
Skin rash.
Sore throat.
Weight loss.

EARLY HIV
RASH

HIV RASH ON FACE

HERPES SIMPLEX RASH AROUND THE

MOUTH

HERPES ZOSTER RASH

KAPOSIS SARCOMA

SKIN RASH DUE TO ANTI HIV DRUG

LAMIVUDINE

WHO

Data and statistics from

Statistic In Malaysia

Statistic In Indonesia

The HIV Life Cycle

BINDING

The HIV attaches to the immune cell when

the gp120 protein of the HIV virus binds with
the CD4 molecule/receptor of the T-helper
cell. The viral core enters the T-helper cell
and the virion's protein membrane fuses with
the cell membrane.This fusion allows the
virus to get inside of the immune cell with its
genetic material.

Reverse Transcription
Within the cells of the human body, our genetic material
is in the form of a molecule called deoxyribonucleic
acid, or DNA. HIVs genetic material is the form of
ribonucleic acid (RNA) instead of DNA.
To take over a human immune cell, the virus has to
convert its RNA to DNA. This process occurs using an
enzyme called reverse transcriptase. The virus
releases this enzyme once it has entered the T-helper
cell so it can begin the conversion process, called
reverse transcription.

Integration: Taking Over the DNA

Once reverse transcription is complete
and the virus has its genetic material in
the form of DNA, it can enter the cells
nucleus. This is where the cell keeps its
DNA. Inside the nucleus, the virus joins its
DNA to the cells DNA. In other words, it
integrates its genetic material into that of
the host cell. The HIV uses an enzyme
called integrase to do this.HIV DNA is
called a provirus.

Transcription and Translation: Building HIV Proteins

Transcription- The viral DNA in the

nucleus separates and
createsmessenger RNA(mRNA),using
the cell's own enzymes.The mRNA
contains the instructions for making new
viral proteins.
Translation- The mRNA is carried back out
of the nucleus by the cell's enzymes.The
virus then uses the cell's natural proteinmaking mechanisms to make long chains
of viral proteins and enzymes.

Assembly and Budding: The Infection

Progresses
Assembly- RNA and viral enzymes
gather at the edge of the cell. An
enzyme, calledprotease, cuts the
polypeptides into viral proteins.
Budding- New HIV virus particles pinch
out from the cell membrane and break
away with a piece of the cell membrane
surrounding them. This is how enveloped
viruses leave the cell and infect the other
cells.

VIDEO

IMMUNOTHERAPHY
ANTIRETROVIRAL DRUG
This is the main type of treatment for HIV or AIDS. It is not a
cure, but it can stop people from becoming ill for many years.
The treatment consists of drugs that have to be taken every day
for the rest of a persons life.
The aim of antiretroviral treatment is to keep the amount of HIV
in the body at a low level. This stops any weakening of the
immune system and allows it to recover from any damage that
HIV might have caused already.
The drugs are often referred to as: antiretrovirals, ARVs, antiHIV or anti-AIDS drugs.

COMBINATION
THERAPHY
Taking two or more antiretroviral drugs at a time is
called combination therapy. Taking a combination of
three or more anti-HIV drugs is sometimes referred to
as Highly Active Antiretroviral Therapy (HAART).
If only one drug was taken, HIV would quickly become
resistant to it and the drug would stop working. Taking
two or more antiretrovirals at the same time vastly
reduces the rate at which resistance would develop,
making treatment more effective in the long term.

WHAT DOES COMBINATION

THERAPHY USUALLY CONSIST OF?
The leading recommendations for antiretroviral treatment were published by the
World Health Organisation (WHO) in 2013.For adults and adolescents, they
recommend starting on a first line therapy of two nucleoside reverse-transcriptase
inhibitors (NRTIs) plus a non-nucleoside reverse-transcriptase inhibitor (NNRTI).
The favoured recommendation is a fixed-dose combination (just one pill) of:
- TDF - Tenofovir
- 3TC - Lamivudine or FTC - Emtricitabine
-EFV - Efavirenz
The choice of drugs to take can depend on a number of factors, including the
availability and price of drugs, the number of pills, the side effects of the drugs, the
laboratory monitoring requirements and whether there are co-blister packs or fixed
dose combinations available. Most people living with HIV in the developing world
still have very limited access to antiretroviral treatment and often only receive
treatment for the diseases that occur as a result of a weakened immune system.

FIRST AND SECOND LINE

THERAPHY
At the beginning of treatment, the combination
of drugs that a person is given is called first line
therapy. If after a while HIV becomes resistant
to this combination, or if side effects are
particularly bad, then a change to second line
therapy is usually recommended.
Second line therapy recommendations by WHO
suggest two NRTIs and a ritonavir-boosted
protease inhibitor (PI).

GROUPS OF ANTIRETROVIRAL
DRUGS
Antiretroviral drug class

Abbreviations

Nucleoside/Nucleotide

NRTIs,
nucleoside analogues,
nukes

Reverse Transcriptase
Inhibitors

Non-Nucleoside Reverse
Transcriptase Inhibitors

Protease Inhibitors

Fusion or Entry Inhibitors

Integrase Inhibitors

NNRTIs,
non-nucleosides,
non-nukes

PIs

First approved to treat HIV

How they attack HIV

1987

NRTIs interfere with the action

of an HIV protein called
reverse transcriptase, which
the virus needs to make new
copies of itself.

1997

NNRTIs also stop HIV from

replicating within cells by
inhibiting the reverse
transcriptase protein.

1995

PIs inhibit protease, which is

another protein involved in the
HIV replication process.

2003

Fusion or entry inhibitors

prevent HIV from binding to or
entering human immune cells.

2007

Integrase inhibitors interfere

with the integrase enzyme,
which HIV needs to insert its
genetic material into human
cells.

THANK YOU