HLTH 230b Lecture 2: HIV AIDS
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Department
Global Health Studies
Course
HLTH 230b
Professor
Kristina Talbert- Slagle
Semester
Spring

Description
GLOBAL HEALTH: CHALLENGES AND RESPONSES 1/24/17: HIV/AIDS  ADA caps  Incidence: number of new infections over certain time period 1. Often recorded over 1 year 2. Prevalence: number of existing cases in a population a. 36.7 million: people currently living with HIV b. 300: new cases/class period (1.25 hours) o 105/300 are 15-24 years old c. 157: deaths during class period d. 35 million: deaths in the world so far from AIDS 3. HIV is bloodborne, and also transferred through semen/vaginal fluids, pregnancy and breastfeeding a. Transmission through o female genital tract: 1/200 to 1/2000 probability o Male genital tract: 1/700 – 1/3000 o Intestinal: 1/5 – 1/10 (maternal to fetal transfer) o Placenta: 1/10 – 1/20 o Bloodstream: 95/100 – 1/150 o Majority of transmissions between heterosexual people  Emergence of HIV-1 1. Likely around 1900 in Africa transmitted from primate a. Called simian IV (SIV) in non-human primates 2. Few thousand people living in Africa with HIV in early 1900s 3. Spread through increased interactions, consuming non-human primates, 4. Graphic: a. 22,000 genes/cell b. Central dogma: DNA  RNA  protein c. HIV has 9 genes d. Steps of infection o HIV binds to CD4, then to the cell, then fuses and dumps contents into cell. o Uses reverse transcriptase and its own RNA to make viral DNA  Retrovirus reverses central dogma and uses RNA to make DNA o Virus is error prone: high mutation rate o Cell tries to block reverse transcription, HIV tricks cell into removing its own defense mechanisms that try to block this o Integrase uses cellular stuff to integrate viral DNA into nucleus and cellular DNA  Cell is forever infected with DNA, to rid is to rid the cell  Now uses vDNA to make vRNA and viral proteins  Infects CD4 memory cells, so after another kind of infection like polio, HIV-infected CDH T cells replicate in immune response and increase copies of HIV in body o Immature viral cell created, non-infective  Creates protease which allows cell to mature into virus particle  Produces 10 billion virus particles per day  Coupled with high mutations rate means that HIV greatly mutates its viral DNA everyday  Usually has drug-resistant variants already in body due to high mutation and replication rate e. Many locations where intervention can occur to block HIV infection o AZT tried to block reverse transcriptase but HIV quickly becomes drug
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