Lecture 10

Question 1

First case of AIDS

Answer 1

• jan 1981 UCLA Hospital
• Dr Gottlieb sees very ill 31 year old gay man
• fever, wasting, viral infections, fungal infection

Question 2

AIDS complications

Answer 2

• Pneumonia
• Tuberculosis
• Cytomegalovirus
• Salmonellosis
• Candidiasis
• Crytopcooccal Meningtisis

Question 3

AIDS complications and tumors

Answer 3

- kaposis sarcoma:
 Tumour of blood vessel walls
 Appears as pink or red lesions
on the skin and mouth.
 Also affects GI-tract and
lungs.
- lymphomas:
Originates in white blood cells
and the lymph nodes
 Involves swellings within neck,
armpit or groin

Question 4

Other AIDS complications

Answer 4

• wasting syndrome

- AIDS dementia

Question 5

Where did AIDS orginate from

Answer 5

• simian virus trasnfer from primates

- 1959 earliest seropostive human blood (congo)

Question 6

How many people are living with hiv

Answer 6

38 million

Question 7

what factors increased the spread of HIV

Answer 7

- Migration of carriers into
cities
- Poverty, prostitution
- International travel
- Risky sexual behaviour
- Intravenous drug use
- Receipt of blood and
blood products

Question 8

what is retrovirus

Answer 8

• Members of Retroviridae family
• Related retroviruses infect
  sheep, horses, goats, cats,
  cows, etc
• All retroviruses express
  Reverse Transcriptase
• RT converts RNA genome into DNA within infected cells
• DNA enters nucleus and
  integrates into genome

Question 9

how does HIV damage the immune system

Answer 9

• HIV kills T cells & macrophages which express CD4 glycoprotein on cell surface (“CD4+”)
• Slow depletion of Thelper lymphocytes causes ‘immune
  deficiency’
• Loss of T-cells means body can’t fight off otherwise rare
  infections (“opportunistic infections”)
• Persistent replication of virus throughout body
• Also impaired tumour immunosurveillance

Question 10

what was the first effective AIDS drug

Answer 10

• Zidovudine
• 1985 first successful trial in normal subjects
• 1987 FDA approved

Question 11

Limitations of Zidovudine

Answer 11

• drug is not entirley selective for HIV reverse transcriptase
• resistance is a major problm

Question 12

what are the four types of protein inhibitiors

Answer 12

1- RTIs - reverse transcriptase inhibitors
2- PIs - protease inhibitors
3- INIs - integrase inhibitors
4- FIs - fusion inhibitors

Question 13

what did Dr Ho discover

Answer 13

• Anti HIV drug cocktails

- HAART: highly active anti retroviral therapy

Question 14

what is HAART highly active antiretroviral therapy

Answer 14

• cocktail of HIV drugs
• HIV now manageable as a chronic disease
  problems:
• poor compliance ( emergence of drug resistant HIV strains)

Question 15

Clinical Consequences of Drug Resistance in HIV Antiviral Therapy

Answer 15

• Loss of treatment effectiveness
• Cross-resistance to other drugs
• Increased risk of death (mortality)
• Need to switch to drugs that are more toxic, more expensive, more complex

Question 16

what is covid 19

Answer 16

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first reported in Wuhan, December 2019
• ssRNA genome encapsulated by a membrane envelope
  SARS-CoV-2 targets ACE2 for cell entry - exopeptidase on epithelial cells of respiratory tract
  • Very often only mild flu-like symptoms
  • BUT in vulnerable patients, can contribute to multiple organ failure, affecting heart,
  liver, kidney, CNS and GI-tract

Question 17

what are antiviral drugs in relation to the covid pandemic

Answer 17

• may limit impact of epidemic until vaccines are available
  issues:
• viral load may peak before symptoms
• drug screening in vitro may find drugs that dont work well in patients
• a few drugs seem promising but large clinical trials are on going