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Health and medicine
Course: Health and medicine > Unit 13
Lesson 7: HIV and AIDS- What is HIV/AIDS?
- What is HIV and AIDS?
- Transmission of HIV
- How HIV infects us: Mucous membranes, dendritic cells, and lymph nodes
- How HIV infects us: CD4 (T-helper) lymphocyte infection
- How HIV kills so many CD4 T cells
- Diagnosing HIV - Concepts and tests
- Treating HIV: Antiretroviral drugs
- HAART treatment for HIV - Who, what, why, when, and how
- Defining AIDS and AIDS defining illnesses
- Immune reconstitution inflammatory syndrome (IRIS) in AIDS
- Preventing an HIV infection
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What is HIV and AIDS?
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Want to join the conversation?
- what is function of lymph nodes(5 votes)
- Lymph nodes contain lymphocytes and receive lymph from the surrounding tissue. Lymphocytes act like the body's army of defense. Lymph nodes are places the army is stationed around the body. The lymphocytes, such as T helper cells, are activated when certain antigens are presented to them as they flow through the lymph node. T helper cells defend the body by multiplying themselves and getting other lymphocytes to multiply. For example, our lymph nodes swell with these cells when we have a sore throat and stop the bacteria causing the sore throat. HIV infects those t helper cells and other white blood cells which kills them so we have no police or army protecting our body.(8 votes)
- At, he said T-lymphocites make copies of HIV. But why do they do that? 3:16(5 votes)
- https://www.khanacademy.org/science/biology/biology-of-viruses/virus-biology/a/intro-to-viruses
https://www.khanacademy.org/science/biology/biology-of-viruses/virus-biology/v/viruses
Viruses are infective particles that have one purpose, to make more of themselves. They have a couple of ways they do this. Basically, they take over the normal cell and order it to make more copies of the virus. An analogy might be something like this; imagine a factory that makes robots is taken over by a bad robot that gives the factory directions to make more dangerous robots that can hurt people, destroy buildings etc. The factory, or cell, would make the scary robots, which when activated, would destroy the factory (cell) they were made in and move into new factories to repeat the process of making more dangerous robots. I know this sounds like the plot to a science fiction movie, but it is the reality of how viruses work. Cells normally make materials that a cell needs using little factories inside the cell that follow instructions. The virus has a set of instructions that cause the cell to make parts for the virus, not parts for the cell. People are working to understand how to help the T lymphocytes and other cells so they will not automatically allow HIV to do take over, make more HIV viruses that eventually destroy the person.
https://m.youtube.com/watch?v=_x13XDNr39o(5 votes)
- When CD4 count is droping, shouldn't you first get pneumonia by S.pneumoniae or H.influenzae (more common and stronger bacteria?), not P. jirovecii and others (weaker bacteria)?(4 votes)
- Yes, you could also get infected by other stronger bacteria, but since they are stronger, people with a functioning immune system (who are not immunocompromised) could also get these infections. So you wouldn't have to have AIDS in order to get S. pneumoniae or H. influenzae.
In this video, I think they were giving examples of specific AIDS defining illnesses that someone with a CD4+ count of over 200 cells per microliter of blood wouldn't get.(4 votes)
- what are types of lymphoid cells
please can anyone answer(3 votes)- There are T-cells, which can send out transmitters to activate other cells and attack infectet cells. B-cells can produce antibodies after they diferenciate to plasma cells. Natural killer cells (NK-cells) can attack cells of your own body.(3 votes)
- If the CD4 cell count decreases, shouldn't the viral load also start decreasing at some point because there are less CD4 cells that they can use to replicate?(3 votes)
- While this may be true on a small scale, the biggest problem facing a patient with a low CD4 count is the risk of opportunistic infection. Most AIDS patients do not die of the virus itself, but rather a superimposed infection that their immune system cannot fight. By decreasing the viral load with antiretroviral therapy, we can give the immune system a chance to produce new CD4 cells to help fight off the infections that our body faces every day.
If we cannot control viral replication, then the virus will attack any freshly made lymphocytes they find in the blood.(1 vote)
- can we induce passive immunity in case of aids by extracting antibodies from the body of infected person and introducing it to a healthy person ?(2 votes)
- Well, we could try that, but here's the problem. Just in case you forgot, antibodies are only made after a person fights off an illness. And for that to happen, the body would have to become sick, and the immune system would realize the problem and produce antibodies to combat it. But remember, HIV attacks nothing other than the immune system. So even if the immune system realized the issue, it won't work. One, it'll be an all out war, with the risk of death for white blood cells, and two, antibodies won't always work since HIV can mutate. So, antibodies for HIV won't be possible unless a person manages to fight it off, which is virtually impossible. If someone does manage to do so, then yes, your question will work, but I doubt that will happen.
Sorry 'bout the long response, but hope this helps!(2 votes)
- what is the fullform of CD4 cells and what is the function of lymphoid and the t lymphocytes and b lymphocytes(2 votes)
- how are glial and microglial cells succeptible to hiv though they do not have CD4 antigens on their surface?(1 vote)
- I'm not sure but I think the virus genom can enter those cells through phagocytosis. Microglialcells (micro-phagocytes) are not related ro glial cells, because they enter the nervous system later and are not produced with it unlike glial cells. However, infectet mikroglial cells produce neurotxins, which are harmfull to your neurons.(2 votes)
- HIV short term effects 1-2 years and also the long term effects from 2016-2026 and beyond? how will this affect Australia but also Globally in the future??(1 vote)
- With the current therapeutic drugs available, most individuals with HIV whom are living in developed countries are now able to manage and live with relatively normal lifespans. In the United States, as a consequence, the leading epidemic no longer is HIV as reflected by the 80's and 90's scare, but rather metabolic disorders. While the commitment to cure HIV hasn't waned by the CDC, aggressive funding injection has been stagnant for a relative number of years when compared to research funding in cancer and metabolic disorders (i.e. obesity). And that makes sense - HIV isn't enemy number one. I would speculate that Australia has a similar stance.
Individuals in less developed countries will suffer the most as often drugs are out of reach for populations that are most vulnerable and HIV is much more of a prominent and immediate risk.(1 vote)
- How Aids related to Blood Circulation?(1 vote)
Video transcript
- [Voiceover] What is
HIV, and what is AIDS? Well, let's first look at HIV. HIV is a virus that
attacks our immune system, and if we expand this out, we can see that that's reflected in its name: Human Immunodeficiency Virus. So this implies that it
does something to our immune system somehow, and we'll actually explore that a little bit later on. And if we don't treat HIV,
it'll eventually cause AIDS in the infected person. Acquired Immune Deficiency Syndrome. So right away you already get a sense that HIV attacks your immune
system so destructively, that you end up acquiring
an immune deficiency system. It puts you into a state
of immune-system failure, so you end up not being able to fight off even the most basic infections. And this immune-less state,
is what we call AIDS. So let's explore this a
little bit further now. Let's actually use the help of a graph, this might be helpful. So here's our graph, and
we'll put time down here on our X-axis, and actually
just to make this extra useful, we'll put weeks in this
beginning part here, and then we'll transition
to years here, and you'll see how this is relevant in
a few more minutes here so, on the Y-axis here, we'll
put CD4 T-lymphocyte count. T-lymphocytes are a
really really important type of immune system cell. And CD4 just refers to a
type of protein that's stuck through their cell membranes,
that's kinda how we like to identify them, by this
protein on their membranes. And the reason they get a
special spot on an entire axis of our graph here is
because they're super important in the progression from
HIV infection to AIDS. Because as you might have
suspected, it turns out that HIV preferentially
loves to infect these CD4 cells of our immune system. And why is this so bad? Well, these CD4 cells,
also called helper T cells, play a huge role in signalling
your other immune cells to come and destroy every
given infectious particle that our body discovers. Like maybe strep throat
bacteria, or flu viruses, or even HIV viruses, for that matter. So these CD4 cells are kinda central. They're almost like little
amplifiers of our immune system. So because HIV loves to
infect and kill these cells, it completely disrupts how
our immune systems function, and renders it essentially useless. So let's say you acquire HIV in your body, either in your bloodstream
or your tissues, maybe through unprotected
sex with an infected partner, that would be the most
common method of becoming infected with HIV, in adults at least. What happens? Well, the main thing is that
the virus really quickly gets into your white blood cells, so these T-helper cells, the
CD4 cells we've talked about. But also some other white blood cells, like your macrophages and so on. And from inside a white blood
cell, it can do two things. One, it can sorta hijack
your cell's machinery, so it manages to insert
its genetic material into your own cell's DNA. And from there it starts to
make lots and lots and lots of copies of itself, lots
of new HIV particles. Actually that's really really important, so let's put that on our
graph too, let's say, "viral load" here on another Y-axis here. Viral load referring to the amount of HIV in your bloodstream. So we can see that after
our primary infection here, the viral load starts to increase. It's hijacked our T helper cells, and now new HIV particles
are being churned out, and our viral load is
majorly on the upswing. And you'll notice that the
viral load is starting to rise at around the two to three week mark, and that's just 'cause it
takes a bit of time for the HIV virus production to start sort of ramping up within our bodies. And of course a major
concern here is well, the more HIV there is in your bloodstream, the more CD4 cells get
infected, get hijacked, right? But the biggest problem
here, thing number two here, is that HIV infection of your CD4 cells, triggers a self-destruct
sequence within these cells. So you end up losing these CD4 cells. And even worse, the
self-destruct sequence doesn't just destroy the infected
cells, it even destroys nearby immune cells that
maybe have come into the area to try to help out. So I won't go into the
mechanism in this video, but you do end up losing
lots more immune cells than just the infected
ones, and that's part of why you see this massive dropoff
here, this line representing our CD4 T-cell numbers has this
really steep downward slope, we're losing lots of T-cells. While at the same time our
HIV viral load is going up and causing more and more
infection of our cells. The other thing I wanna point
out here is you can see this massive rise in viral load
and this pretty massive drop in CD4 levels, and this
huge viral load means that this time period right,
early on in an infection, is when someone with HIV
has the highest risk of transmitting it to someone else. I guess one good thing
here is that eventually, maybe a month or so in,
your immune system gets somewhat of a handle on the virus, and it starts to make
anti-HIV antibodies, right? Those are just antibodies against HIV. So they start to fight off
the virus to some extent. And this is called seroconversion,
when you make antibodies to something, so now we've
seroconverted to HIV. So now the antibodies
get to work on helping to destroy the viral particles. And that's why we see this decrease here in viral load in the bloodstream. Because our immune system
is starting to control the viral levels to some degree. And this also gives our CD4
cells a chance to recover, to some extent, because there's less virus around to infect them. So you might be wondering, how
you're gonna feel during all of this, with this massive
battle going on inside your body? Well, you're gonna feel
sick, you're probably gonna feel like you're having the
worst flu you've ever had. So about here, about a month
or so in, at seroconversion, you start to fight the infection. And as a result, most
people get some serious flu-like symptoms, so things
like headache, and fever, and sore throat, muscle
pains, joint pains, some people get swollen glands, just sort of fatigue and feeling unwell. Some people get a rash, some people get some open sores in their mouth. These are some of the more common symptoms of an acute infection with HIV. And this flu-like illness
that people experience is referred to as Acute HIV Syndrome. And the reason for a lot of
these symptoms is because well, when immune system
cells get really active, or when they die off, both
of which are happening here of course, they tend
to release these little chemical signals that cause inflammation, sort of all throughout your
body, and so this is what underlies a lot of these symptoms here. So back to our graph,
the immune system can't completely kill off the
HIV, even though we have antibodies now, right? And that's because A, remember the rate of immune system killing is
roughly matching up with the rate of new viral
particles being produced. And B, because the virus has
sort of taken up residence in some really really hard-to-reach
reservoirs in our body. Like within the brain and
within our bone marrow, and within our genital tract. Because of these two
reasons, these curves tend to sort of stabilize at some
point, they reach a set point, where again, our immune
system is killing off HIV at a pretty similar rate to
which HIV is replicating. So the curves start to
come together a bit more and stabilize somewhat. So this period here is
thought of as the start of the second phase of HIV
infection, what's called the latency period, or Chronic HIV. This acute infection back
here being phase one. So in this latency period, we
don't tend to see any clinical signs of HIV illness, the
person is often asymptomatic. They're still infectious, but
there are few or no symptoms during this phase, and without treatment, this phase will last on
average about 10 years. And I said that our curves
here stabilized, right? But it turns out that
HIV's actually replicating, killing our immune cells
just a teensy little bit more than our CD4s are recovering. So over this long period
of time, phase two, eventually, again, without treatment, HIV will start to overwhelm
our immune system, and we'll start to see symptoms again. So things like fever or muscle
pains or swollen glands, really similar to the
acute infection, and again, much for the same reasons as before. And many people at this
stage of the illness experience significant weight loss. HIV causes you to use
more energy than usual, and also prevents you
from absorbing nutrients from your food as well
as you normally would. So we often see some
significant weight loss for these and a few other reasons as well. Eventually, if our CD4 cells
get to a critically-low number, and result in our having no
functional immune system, that's what AIDS is. Essentially a state of being
where we have no immune system. So at this point, this
is when certain bugs, bacteria and viruses that
would never stand a chance against even a
minimally-effective immune system, these things start to infect the person. And we refer to these
specific infections as AIDS-defining illnesses,
because we just know that if somebody has
one of these illnesses, they just cannot have a
functioning immune system, it just wouldn't happen,
or at least it would be really really unusual. So there's a high suspicion
of this person having AIDS and not just an HIV infection anymore if they have any of these
AIDS-defining illnesses. Two examples of
AIDS-defining illnesses are two fungal pneumonias, one
called pneumocystis pneumonia, and one called cryptococcal pneumonia. These are two common
AIDS-defining illnesses. And again, these aren't the
types of infections that you get when your immune system
works even a little bit. So actually one of two
criteria has to be met before we can say someone has AIDS. Either they have to have
extremely low amounts of CD4 cells in their blood,
and to get a little bit technical here, it's if they
have less than 200 CD4 cells per microliter of blood,
with the normal count, the normal CD4 count in
this amount of blood, it should be around
1000 to 1100 CD4 cells. Or, regardless of CD4 count, if they have any of the
AIDS-defining illnesses, like either of these, for example, then we can say that
they have developed AIDS. And so you might have suspected
this, but it's actually the overwhelming impact,
and the complications of serious infections that you pick up because of the immune deficiency in AIDS that actually results in
the death of the person. So from HIV infection to
eventually an incredibly high amount of viral particles,
and low amount of CD4 cells in the bloodstream, to
development of a completely non-functional immune system in AIDS, very quickly leading to
overwhelming infection by essentially every infectious
pathogen from A to Z. And because of this, death results.