Human Immunodeficiency Virus (HIV) Patient Radiographic Results Patient Human Immunodeficiency Virus (HIV)

Human Immunodeficiency Virus (HIV) Patient Radiographic Results Patient Human Immunodeficiency Virus (HIV) www.phwiki.com

Human Immunodeficiency Virus (HIV) Patient Radiographic Results Patient Human Immunodeficiency Virus (HIV)

Sauceda, Mike, Executive Producer has reference to this Academic Journal, PHwiki organized this Journal Human Immunodeficiency Virus (HIV) Gayane Arutunyan Monica Brown David Yang Patient 28 year old male Bad case of thrush (oral c in addition to idiasis) Low grade fever Lost 20 pounds in the last year without dieting Serious bouts of diarrhea Stool Sample tested positive as long as Giardia lamblia. Difficulty breathing Radiographic examination showed bilateral infiltrate (characteristic of Pneumocystosis carinii pneumonia) Radiographic Results (A.D.A.M., 2006)

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Patient 28 year old male Bad case of thrush (oral c in addition to idiasis) Low grade fever Lost 20 pounds in the last year without dieting Serious bouts of diarrhea Stool Sample tested positive as long as Giardia lamblia. Difficulty breathing Radiographic examination showed bilateral infiltrate (characteristic of Pneumocystosis carinii pneumonia) Heroin addict in addition to admits to sharing needles at a “shooting gallery” Human Immunodeficiency Virus (HIV) Icosahedral or Wedge-shaped Nucleocapsid Reverse Transcriptase Lipid Membrane single str in addition to ed (+) sense RNA gp120 gp41 gp160 (NIH, 2005) HIV genome Two copies (+) ss RNA (Dimmock, et. al, 2007)

Types of HIV Two species of HIV infect humans: HIV-1 More virulent, relatively easy to transmit Majority of HIV infections globally 3 types of HIV-1: (based on alterations in env gene) Clades M, N, in addition to O HIV-2 Less transmittable Largely confined to West Africa (Gao, et. al; 1999) (Keele, et. al; 2006) (Reeves, et. al; 2002) (Thompson, et. al; 2002) Laboratory Tests Enzyme Linked Immunosorbent Assay (ELISA) Direct : Tests as long as the virus Indirect : Tests as long as antibodies to the virus Enzyme Linked Immunosorbent Assay (ELISA) Direct : Tests as long as the virus Indirect : Tests as long as antibodies to the virus

Indirect ELISA HIV Antigen Patient’s serum Enzyme-labeled antihuman IgG Laboratory Tests Enzyme Linked Immunosorbent Assay (ELISA) Direct : Tests as long as the virus Indirect : Tests as long as antibodies to the virus Western Blot Analysis Direct : analyze samples as long as specific protein(s) Indirect : analyze samples as long as antibodies against a specific protein(s) Enzyme Linked Immunosorbent Assay (ELISA) Direct : Tests as long as the virus Indirect : Tests as long as antibodies to the virus Western Blot Analysis Direct : analyze samples as long as specific protein(s) Indirect : analyze samples as long as antibodies against a specific protein(s) Indirect Western Blot Analysis

HIV – Western Blot Results gp160 = viral envelope precursor (env) gp120 = viral envelope protein binds to CD4 p31 = reverse transcriptase (pol) p24 = viral core protein (gag) HIV (+) serum HIV (-) serum (Univ. of Arizona, 1996) Patient Risk Assessment High Risk Behaviors: Sharing of infected drug injection needles/syringes Accidental needle stick (healthcare professionals) Unprotected sex with infected individual Blood transfusions/Organ transplants Rare, only occurs in underdeveloped countries with inadequate blood donor testing programs Transmission from infected mother-to-fetus during pregnancy or delivery Transmission from breast milk of infected mother to her baby

Prevention of HIV Infection Known Methods of Preventing HIV Infection: Avoid sexual contact with infected individuals Avoid sharing needles/syringes that could be contaminated with HIV Avoid any type of contact with the bodily fluid of an infected individual New Methods as long as Prevention of HIV: Intravaginal lime or lemon juice to kill the HIV virus be as long as e entry Intravaginal oestrogen: Karotinizing the vagina with estrogen Male circumcision: Removal of the inner as long as eskin removes the main site of HIV entry into the penis, resulting in a sevenfold reduction in susceptibility to infection Post-coital penile hygiene: Wiping the penis immediately after intercourse with lime or lemon juice or vinegar should kill the virus be as long as e it has had a chance to infect. Prevention of HIV Infection Immunological Basis as long as Opportunistic Infection HIV targets cells that express CD4 in addition to can infect macrophages, dendritic cells, in addition to activated T cells During the non-symptomatic phase of HIV infection, HIV has a low affinity towards T cells in addition to higher affinity towards macrophages slow death rate of T cells Once the virus becomes lymphotropic, it begins to infect activated T cells far more efficiently due to increased affinity as long as CD4 Functional T cell levels begin to decrease, eventually to a point where the T cell population is too small to recognize the full range of Ags that could potentially be detected The lack of full Ag recognition core symptoms of acquired immune deficiency syndrome (AIDS). CD4 T cell depletion during AIDS allows various pathogens to escape T cell recognition, thus allowing opportunistic infections that would normally elicit a helper T cell response to bypass the immune system

Immunological Basis as long as Opportunistic Infection Nef protein – advances the endocytosis in addition to degradation of cell surface proteins, including CD4 in addition to MHC proteins Downregulates expression of host CD4 Downregulates expression of host MHC class I molecules MHC class I molecules function to present peptide fragments to cytotoxic T cells to destroy virally infected cells. Induces phosphorylation of MA proteins to increase viral infectivity (increased viral replication) MA in addition to Vpr proteins aid in facilitating the transport of HIV pre-integration complex across nuclear membrane. Alter T cell signaling to promote viral replication. Opportunistic Infections CD4 Count Diseases 200-500/L Pneumonia (usually caused by bacteria) Tuberculosis in the lungs Oral or vaginal yeast infections Shingles (viral skin infection) Oral hairy leukoplakia Kaposi’s sarcoma 100-200/L All of the above plus: Pneumoniadue to Pneumocystis carinii (PCP) Chronic diarrhea 50-100/ L All of the above plus: Encephalitis (usually due to toxoplasmosis) Esophagitis due to yeast or viruses Meningitis (usually due to cryptococcus) Opportunistic Infections CD4 Count Diseases (50-100/µL Tuberculosis outside the lungs Continued) Chronic herpes simples virus (HSV infection) Primary brain lymphoma <50 /µL All of the above, plus: Widespread infection due to Mycobacterium avium complex Retinitis, diarrhea, encephalitis due to cytomegalovirus Epidemiology The virus was first successfully identified in addition to classified in 1981. The appearance of rare diseases amongst HIV infected persons first alerted scientists to the then unknown virus. At end of 2003 in the U.S. 1,039,000 - 1,185,000 persons infected with HIV/AIDS Global (2006 statistics): 39.5 million infected with HIV/AIDS 4.3 million new infections in 2006; 2.8 million (65%) of these were in sub-Saharan Africa Increases in Eastern Europe in addition to Central Asia, where there may have been a more than 50% rise in infection rates since 2004 In 2006, 2.9 million deaths due to AIDS-related illnesses 2003 HIV in addition to Disease Human Immunodeficiency Virus (HIV) has an incubation period of about 10 years in addition to eventually leads to Acquired Immunodeficiency Syndrome (AIDS), resulting in the impairment of the immune system. This can lead to death from infections, secondary diseases from opportunistic bacteria in addition to /or viruses that are usually harmless to people, or many different types of cancers. Common diseases associated with HIV infection: Kaposi's sarcoma (KS) Pneumocystis carinii pneumonia (PCP) Mycobacterium avium complex (MAC) Early Symptoms: Most don’t exhibit symptoms when first infected However, may have flu-like symptoms (fever, headache, tired, enlarged lymph nodes) 1-2 months after exposure Very infectious during this period Sauceda, Mike Horizon - KAET-TV Executive Producer www.phwiki.com

Later Symptoms: More sever symptoms may not appear until after 10yrs, however this varies with each individual Decline in number of CD4 + T cells The most advanced stage of AIDS is classified as having < 200 CD4+ T cells/cubic millimeter of blood (in healthy adults CD4+ T-cell counts = 1,000+) Onset of AIDS is characterized by: weight loss, fevers/sweats, fatigue rashes/flaky skin, persistent yeast infections, Pelvic inflammatory disease in women will not respond to treatments, short-term memory loss, frequent in addition to severe herpes infections, shingles coma deaths HIV in addition to Disease Precautions Treatments Reverse Transcriptase (RT) Inhibitors – interrupt early stage of viral replication to slow spread of HIV in body in addition to delay start of opportunistic infections Nucleoside/nucleotide RT inhibitors Insert faulty DNA building blocks into HIV genome Prevents completion of DNA chain no replication Non-nucleoside RT inhibitors Bind to reverse transcriptase in addition to prevents reverse transcription May slow the spread of HIV in the body in addition to delay the start of opportunistic infections. Protease Inhibitors – interrupt late stage of viral replication in the HIV life cycle Side Effects: nausea, diarrhea, gastrointestinal symptoms, serious effects from interaction with other drugs Fusion Inhibitors – new class of drugs Fuzeon (enfuvirtide or T-20) interferes with HIV-1’s ability to enter the cell by blocking fusion of the virus to the host cell membrane HIV cannot enter in addition to infect immune cells Designed to be used in combination with other anti-HIV treatments reduces the level of HIV infection in blood may be effective against HIV resistant to current antiviral treatments Side Effects: pneumonia, trouble breathing, low bp, chills/fever, skin rash, blood in urine, vomiting Treatments HAART Treatment has significantly reduced number of deaths from AIDS in the U.S. Reduces the amount of virus circulating in blood to nearly undetectable levels, although HIV is still present by hiding places such as the brain, lymph nodes, testes, & retina of the eye Side Effects: severe; decrease in RBCs or WBCs, inflammation of pancreas, painful nerve damage, even death in some cases Treatments Picture references Dimmock, N.J., Easton, A.J., in addition to K.N. Leppard. Introduction to Modern Virology, 6th Edition. Blackwell publishing Ltd. 2007. http://wildiris3.securesites.net/cms-prod/files/course/192/WAHIV4-2007-fig1.jpg http://www.eduwhere.com/images/lab-goggles.jpg http://www.osha.gov/needlesticks/biohazard-sample2.jpg http://www1.istockphoto.com/file-thumbview-approve/2209865/2/istockphoto-2209865-hiv-negative.jpg http://www.inmarkinc.com/images/hinew02.jpg http://www.ipngos.org/images/vaccine.jpg http://www.who.int/hiv/facts/en/hiv-global2003.jpg http://www.stan as long as d.edu/group/virus/retro/2005gongishmail/hiv2.jpg http://pathmicro.med.sc.edu/images/global.gif http://www.metrokc.gov/HEALTH/apu/healthed/background/global.gif http://www.niaid.nih.gov/factsheets/howhiv.htm http://www.biology.arizona.edu/immunology/activities/western-blot/west2.html Questions

Sauceda, Mike Executive Producer

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