Abstract
The HIV/AIDS epidemic is now in its third decade since the discovery of the virus responsible for the disease in 1981. While the first cases of AIDS were first recognized in young men who have sex with men in the United States and Europe in the 1980s, it soon became clear that the virus could be spread through contaminated blood products and heterosexual sex. At the time of its discovery, acquired immunodeficiency syndrome (AIDS) was a new disease with high mortality, and the discovery of a new human virus as its cause in 1983 created new challenges for prevention, treatment, and vaccine efforts, many of which remain unmet today. Human immunodeficiency virus type 1 (HIV-1), as the causative agent of AIDS, has been the subject of intense research over the past three decades, in an effort to understand the biological properties of this new virus, its relatedness to other known retroviruses, characterize its epidemiology, and discover drugs and vaccines to control the epidemic.
This chapter, which has been modified slightly for the purposes of this volume, was originally published as part of the Encyclopedia of Sustainability Science and Technology edited by Robert A. Meyers. DOI:10.1007/978-1-4419-0851-3
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Abbreviations
- Acquired immunodeficiency syndrome (AIDS):
-
A clinical syndrome caused by the human immunodeficiency virus (HIV). Its pathogenesis is related to a qualitative and quantitative impairment of the immune system, particularly a reduction of the CD4+ helper T lymphocyte cell count (surrogate marker of the disease). After an average of 10 years, if untreated, HIV + individuals can develop opportunistic diseases (i.e., infections and cancers rarely detected in people with normal immune systems). The natural history of the disease can be dramatically modified with administration of combination therapy composed of antiretroviral (ARV) drugs.
- CCR-5:
-
A cell membrane protein expressed on several cell types including peripheral blood-derived dendritic cells, CD34+ hematopoietic progenitor cells, and certain activated/memory Th1 lymphocytes. This receptor is well defined as a major coreceptor in conjunction with CD4+, implicated in susceptibility to HIV-1 infection.
- CD4+:
-
A large glycoprotein that is found on the surface of helper T lymphocyte cells, regulatory T cells, monocytes, and dendritic cells. Its natural function is as a coreceptor that assists the T cell receptor (TCR) to activate its T cell following an interaction with an antigen-presenting cell. CD4+ is a primary receptor used by HIV-1 to gain entry into host T cells.
- CD4+ T cell:
-
An immune cell, lymphocyte (white blood cell) characterized by the CD4+ antigen (protein) on its surface. This is a T lymphocyte considered to have a “helper” function to enhance the cellular immune response. The CD4+ is the primary receptor for the HIV virus, and upon infection, the virus can destroy the CD4+ cell. In HIV-infected people, the drop in CD4+ T lymphocyte cells is a major determinant of the progression of HIV infection to AIDS.
- Coreceptor (CCR-5 or CXCR-4):
-
Protein molecules on the surface of lymphocytes or monocytes that bind to the gp120 protein of HIV and facilitate, with CD4, binding, fusion, and entry of the virus into the susceptible cell.
- CXCR-4:
-
An alpha-chemokine receptor specific for stromal-derived factor-1 (SDF-1 also called CXCL12), a molecule endowed with potent chemotactic activity for lymphocytes. This coreceptor is one of several chemokine receptors that HIV isolates can use to specifically infect CD4+ T cells.
- DNA (deoxyribonucleic acid):
-
A nucleic acid that contains the molecular basis of heredity for all known living organisms and some viruses and is found in the nuclei and mitochondria of eukaryotes. Chemically, DNA consists of two polymer strands of units called nucleotides made up of one of four possible bases plus sugar and phosphate groups. The polymers are joined at the bases by hydrogen bonds to form a double helix structure.
- Fusion of virus and cell membranes:
-
A merging of cell and virus membranes that permits HIV proteins and nucleic acids to enter the host cell.
- Fusion/entry inhibitors:
-
A class of ART drugs that interferes with the virus’ ability to fuse with the target cell’s outer membrane, thereby blocking entry of the HIV into the host cell.
- gp120:
-
The major HIV envelope glycoprotein having a molecular weight of 120 that protrudes from the outer surface of the virion. This glycoprotein binds to a CD4+ receptor on a T cell to facilitate entry of the virus into the cell.
- Human immunodeficiency virus (HIV):
-
The virus that causes acquired immunodeficiency syndrome (AIDS). It is a lentivirus belonging to Retroviridae family and was discovered in 1983 by Robert Gallo and Luc Montagnier. HIV infects and destroys helper T cells of the immune system causing a marked reduction in their numbers. Loss of CD4 cells leads to generalized failure of the immune system and susceptibility to life-threatening opportunistic infections. It is transmitted mainly through sexual intercourse, exchange of contaminated syringes among intravenous drug users, and contaminated blood transfusion. HIV-1 is the HIV type most frequently detected HIV worldwide and responsible for the global pandemic.
- HIV-1 subtypes or clades:
-
Genetically related HIV strains that are essentially phylogenetically equidistant, generating a starlike phylogeny. Subtypes A, B, C, D, F, G, H, J, and K are currently known subtypes A, B, C, and D are highly prevalent others have low prevalence and limited geographic distributions.
- HIV-2:
-
The second HIV virus discovered in West Africa in 1984, the virus is more closely related to the simian immunodeficiency virus of primates. Although HIV-2 can cause AIDS, it has a distinct epidemiology, lower rate of transmission, and slower progression to disease.
- Incidence:
-
Rate describing the number of new cases of disease occurring within a given time period, expressed as new cases per person-time.
- Integrase:
-
An enzyme found in retroviruses including HIV that permits the reverse transcribed viral DNA to be integrated into the infected cell’s DNA. Integrase is an enzyme encoded by the polymerase gene of HIV.
- Integrase inhibitors:
-
A class of ART drugs that blocks the viral integrase the enzyme HIV uses to integrate its genetic material into its target host cell DNA.
- Nucleus:
-
A membrane-enclosed central compartment of a cell that functions to contain the genomic DNA and to regulate gene expression.
- Prevalence:
-
Number of cases of disease in a defined population at a specific point in time it is often expressed as a percentage.
- Protease:
-
An enzyme that hydrolyzes or cleaves the polyproteins into proteins and is important in the final steps of HIV maturation. In HIV, the protease enzyme is encoded by the polymerase gene.
- Protease inhibitors:
-
A class of ART drugs that interferes with the viral protease enzyme of HIV by inhibiting the viral polyproteins from being cleaved, which would allow the individual viral proteins to produce infectious viral particles.
- Reverse transcriptase:
-
An enzyme found in HIV that creates double-stranded DNA using viral RNA as a template and host tRNA as primers. The reverse transcriptase enzyme is encoded by the polymerase gene of HIV.
- Reverse transcriptase (RT) inhibitors:
-
A class of ART drugs that interfere with the reverse transcription step during the HIV life cycle. During this step, the HIV enzyme RT converts HIV RNA to HIV DNA. There are two main classes of RT inhibitors that are used as ART drugs.
Nucleoside/nucleotide RT inhibitors (NRTI) are faulty DNA building blocks. When these faulty pieces are incorporated into the HIV DNA (during the process when HIV RNA is converted to HIV DNA), the DNA chain cannot be completed, thereby blocking HIV from replicating in a cell.
Nonnucleoside RT inhibitors (NNRTI) bind to RT, interfering with its ability to convert the HIV RNA into HIV DNA.
- RNA (ribonucleic acid):
-
A universal form of genetic material typically transcribed from DNA, it differs from DNA in that it contains ribose and uracil as structural components. In retroviruses like HIV, RNA is their primary genetic material and is found in a mature virus particle.
- T-lymphotropic:
-
A characteristic of a virus that infects and replicates in T lymphocytes, a type of immune cell. This was the descriptor of the human T cell leukemia virus (HTLV), a human retrovirus that causes T cell leukemia and lymphoma and is T-lymphotropic like HIV. HIV was originally called human T-lymphotropic virus type III (HTLV-III) by Gallo and colleagues.
- Tuberculosis:
-
The infectious disease caused by Mycobacterium tuberculosis. It usually involves the lungs (pulmonary tuberculosis) but can also affect other organs (i.e., kidneys, central nervous system, lymph nodes, bones, etc.; extrapulmonary tuberculosis). Pulmonary tuberculosis, which is the most frequent clinical form, can be classified as smear positive or smear negative according to the result of the sputum bacteriological examination. The former is a major public health problem being highly contagious. Only a few individuals develop tuberculosis after a mycobacterial infection, and most of them soon after infection: it is estimated that the lifetime risk is 5–10% in HIV negatives and 5–15% yearly in HIV positives.
- Virion:
-
A single and complete extracellular infective form of a virus that consists of an RNA or DNA core and in the case of HIV with a glycoprotein coat or “envelope.”
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Kanki, P.J. (2013). HIV/AIDS Global Epidemic. In: Kanki, P., Grimes, D. (eds) Infectious Diseases. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5719-0_3
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