Transcript AIDS and Apoptosis2010

Some statistical facts: Till Year 2000
HIV was first identified in 1983.
Virus may have entered the US in late 70s.
Data from Centre for Disease Control and Prevention shows that 774,467
cases of AIDS and 448,060 deaths of AIDS patients by the end of yr. 2000.
Approximately 40,000 new HIV infection per year.
World wide: 36.1 million people living with AIDS by the end of year 2000.
21.8 million adults and 4.3 million children fell victim to HIV/AIDS
associated death.
5.3 million new cases and 3 million deaths occurred in yr 2000.
2008 statistical figures (Global)
http://www.avert.org/worldstats.htm
Estimate
Range
People living with HIV/AIDS
in 2008
33.4 million
31.1-35.8 million
Adults living with HIV/AIDS
in 2008
31.3 million
29.2-33.7 million
Women living with HIV/AIDS
in 2008
15.7 million
14.2-17.2 million
Children living with
HIV/AIDS in 2008
2.1 million
1.2-2.9 million
People newly infected with
HIV in 2008
2.7 million
2.4-3.0 million
Children newly infected with
0.43 million
HIV in 2008
0.24-0.61 million
AIDS deaths in 2008
2.0 million
1.7-2.4 million
Child AIDS deaths in 2008
0.28 million
0.15-0.41 million
USA stat for AIDS
People living with AIDS
At the end of 2007, the CDC
estimates that 468,578 people were
living with AIDS in America, around
20,000 more than 2006.
571,378 people living with HIV/AIDS
in the 39 states and dependent
areas. However, the total number of
people living in the USA with
HIV/AIDS is thought to be around
1.1 million3
Canadian Stat for HIV infection and AIDS
AIDS cases in adults (15 or over) by exposure
category
Positive HIV test reports in adults (15 or over) by
exposure category
Male
Male
Exposure
category
2007
Female
Female
Cumulative
total
until end
December
2007
2007
Cumulative
total
until end
December
2007
Exposure
Category
Cumulative
total
until end
December
2007
2007
Cumulative
total
until end
2007
December
2007
31
13,295
-
-
Men who
have sex
with men
(MSM)
514
17,967
-
-
Men who
have sex
with men
(MSM)
MSM and
injection
drug use
20
738
-
-
MSM and
injection
drug use
0
829
-
-
Injection
drug use
156
3,700
1,824
Injection
drug use
28
1,178
7
432
0
460
0
140
105
Blood/blood
5
products
610
3
207
Blood/bloo
d products
Heterosexu
al contact
120
3,067
167
2,620
Heterosexu
23
al contact
1,780
9
1,147
Other
53
17
247
Other
0
16
1
4
46
529
No
identified
risk
24
932
2
106
4,697
Risk not
reported
84
932
26
100
10,124
Total
190
18,816
45
1,929
No
identified
risk
84
718
2,459
Risk not
reported
749
19,969
Total
1,782
49,228
254
592
Estimated number of people living with HIV/AIDS, 2007
Indian stat
People living with HIV/AIDS
2.31 million
Adult (15 years or above)
HIV prevalence
0.34%
Across India HIV prevalence appears to be low among the general
population, but disproportionately high among high-risk groups, such as
IDUs, female sex workers, men who have sex with men (MSM) and
STD clinic attendees.
The average HIV prevalence among women attending antenatal clinics
in India is 0.48%. Much higher rates are found among people attending
STD clinics (3.6%), female sex workers (5.1%), injecting drug users
(7.2%) and men who have sex with men (7.4%). As the table below
shows, the rates among different groups vary widely between states.
Structure of a generic retrovirus.
The basic structure of Human Immunodeficiency Virus-1, a retrovirus.
Structure of HIV
Stages of Retrovirus Reproduction
Replication of HIV-1
HIV Binding via Cell Surface Receptors
Enzyme Targets of New Anti-HIV Treatments
Major HIV-1 enzymes against which new drug therapies have been targeted.
Presentation of Antigen to T Cells through MHC Class II Molecules of HIV
AIDS Deaths in the United States from January 1986 to June 1998
Drugs Approved for HIV Infection
Nucleoside/Nucleotide Non-nucleoside
RT Inhibitors
RT Inhibitors
•abacavir
•delavirdine
•ddC
•nevirapine
•ddI
•efavirenz
•d4T
zidovudine (AZT),
•3TC
•ZDV
•tenofovir
nucleoside RT inhibitors: zalcitabine (ddC),
didanosine (ddI), stavudine (D4T), and
lamivudine (3TC)
Protease
Inhibitors
•ritonavir
•saquinavir
•indinavir
•amprenavir
•nelfinavir
•lopinavir
The groups of antiretroviral drugs
There are five groups of antiretroviral drugs. Each of these groups attacks HIV in a different way.
Antiretroviral drug class
Nucleoside/Nucleotide
Reverse Transcriptase
Inhibitors
Abbreviations
NRTIs,
nucleoside analogues,
nukes
NNRTIs,
Non-Nucleoside Reverse
non-nucleosides,
Transcriptase Inhibitors
non-nukes
Protease Inhibitors
Fusion or Entry Inhibitors
Integrase Inhibitors
PIs
First approved to treat
HIV
1987
1997
1995
How they attack HIV
NRTIs interfere with the
action of an HIV protein
called reverse
transcriptase, which the
virus needs to make new
copies of itself.
NNRTIs also stop HIV
from replicating within
cells by inhibiting the
reverse transcriptase
protein.
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.
Side effects of AIDS therapeutics
Metabolic changes are occurring in people with chronic HIV infection.
One of these changes causes HIV-associated lipodystrophy syndrome
(HIV-LS). This condition results in abnormal fat distribution and
cholesterol and glucose abnormalities. Gender and HIV infection itself
can influence cell metabolism, making it difficult to distinguish adverse
drug effects from the natural progression of the disease.
Some anti-HIV drugs are toxic to mitochondria. Tissues that require high
levels of energy, like muscles and nerves, are most susceptible to the
affects of damaged mitochondria.
A decrease in the mitochondrial energy supply can result in muscle
wasting, heart failure, peripheral nerve damage causing numbness and
pain.
Other symptoms include low blood cell counts, swelling and fatty
degeneration of the liver, and inflammation of the pancreas. Other more
general signs include fatigue, depression, and high lactic acid levels in
the blood.
Cutting edge developments in AIDS therapeutics
•New protease inhibitors and more potent, less toxic RT inhibitors.
•Fusion inhibitors -- drugs that interfere with HIV's ability to enter a cell
•Integrase inhibitors -- drugs that interfere with HIV's ability to insert its genes
into a cell's normal DNA.
•Therapeutic vaccines are also being evaluated for this purpose and could help
reduce the number of anti-HIV drugs needed or the duration of treatment.
•Therapeutic immune boosters
•Lysozyme and RNase therapy
http://www.iavi.org/Lists/IAVIPublications/attachments/9ba3a2c4-2232-48c5-a08e5532cb32b836/IAVI_Sankalp_December_2009_ENG.pdf
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