Topics Discussed: acquired immunodeficiency syndrome; aids, pediatric; hiv; hiv and pregnancy; hiv infection; hiv-1; hiv-1 infection; hiv-2; immunology; infectious diseases.
Excerpt:"I. Definition. HIV is an enveloped RNA virus that is a member of the lentivirus subfamily of retroviruses. Infection is most commonly secondary to HIV-1. HIV-2 is rare in the United States but more common in West Africa. HIV results in a broad spectrum of disease, with AIDS representing the most severe end of the clinical spectrum.
II. Incidence. The Joint United Nations Program on HIV/AIDS approximated that 33.2 million people worldwide were infected with HIV-1 at the end of 2007. More than 95% of the total cases reside in developing countries. Every day, > 6800 persons become infected with HIV and >5700 persons die from AIDS, mostly because of inadequate access to HIV prevention and treatment services. An estimated 1200 children become infected with HIV every day, mostly acquiring infection vertically from their mothers. The mother-to-child transmission (MTCT) of HIV-1 has been reduced significantly over the past 10–15 years in developed countries; however, transmission rate in developing countries is still high at ~26%.
III. Pathophysiology. HIV-1 is particularly tropic for CD4+ T cells and cells of monocyte or macrophage lineage. After infection of the cell, viral RNA is uncoated and a double-strand DNA transcript is made. This DNA is transported to the nucleus and integrated into the host genome DNA. There is eventual destruction of both the cellular and humoral arms of the immune system. As well, HIV-1 gene products or cytokines elaborated by..."
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