HIV and AIDS
After this unit, students should be able to: 1. To know the main characteristics of the Retroviridae family, including the specificities of human retroviruses and related pathologies. 2. Describe the human immunodeficiency virus (HIV) and understand the different steps of its replication cycle. 3. Interpret the phylogenetic relationships among immunodeficiency viruses from Primates and infer about the biological origin of HIV-1/HIV-2. 4. Recognize the biological mechanisms generating genetic variability in retroviruses and their consequences. 5. Describe the natural history of HIV infection, relating to the host immune response and understanding the immunopathogenic mechanisms of infection. 6. Interpret the different algorithms for diagnostics/laboratory monitoring of HIV infection and select the tests to be carried out according to different objectives. 7. Select and apply screening enzyme immunoassays (ELISA and rapid tests) and confirmatory tests (Western blot) in the diagnostics of HIV-1/-2 infection.
Weekly - 8
Total - 20
• Alexander TS (2016). Human immunodeficiency virus diagnostic testing: 30 years of evolution. Clin. Vaccine Immunol., 23:249-53. • Brun-Vézinet F, Charpentier C (2013). Update on the human immunodeficiency virus. Méd. Mal. Infect., 43:177-84. • Cortez KJ, Maldarelli F (2011). Clinical management of HIV drug resistance. Viruses, 3:347-78. • Hemelaar J (2012). The origin and diversity of the HIV-1 pandemic. Trends Mol. Med.,18:182-92. • Hurt CB, et al. (2017). Selecting an HIV test: a narrative review for clinicians and researchers. Sex. Transm. Dis., 44:739-46. • Kuritzkes DR, Walker BD (2007). HIV-1 pathogenesis, clinical manifestations and treatment. in “Fields Virology”, pp. 2187-2214. Knipe DM et al. (eds.), Wolters Kluwer Health e Lippincott Williams and Wilkins, Philadelphia, EUA, 5ª Ed. • Okulicz JF (2012). Elite controllers and long-term nonprogressors: models for HIV vaccine development? J. AIDS Clinic. Res., 3:139. doi:10.4172/2155-6113.1000139. • Peeters M, et al. (2013). The origin and molecular epidemiology of HIV. Expert Rev. Anti Infect. Ther., 11:885-96. • Pépin J (2011). The origins of AIDS. Cambridge University Press, Cambridge, Reino Unido. • Sharp PM, Hahn BH (2011). Origins of HIV and the AIDS pandemic. Cold Spring Harb. Perspect. Med., 1:a006841. • Sierra S, et al. (2005). Basics of the virology of HIV-1 and its replication. J. Clin. Virol., 34:233-44. • Tebit DM, Arts EJ (2011). Tracking a century of global expansion and evolution of HIV to drive understanding and to combat disease. Lancet Infect. Dis., 11:45-56.
The total contact hours will be distributed by four lectures, theoretical and practical sessions, a class of laboratory practice and a tutorial (2 hrs.).
The final assessment will be conducted through a written exam (2 hrs.), consisting of 20 varied questions, e.g. multiple choice, true/false, fill-in the spaces, subtitling, essay questions (100% of the final grade).
I. Family Retroviridae. Human retroviruses and associated pathologies. Morphology and genome organization. Replication cycle. The human immunodeficiency virus (HIV). II. Biological origin and phylogenetic relationships of HIV-1/HI V-2 to Primate lentiviruses. Zoonotic-like transmission. III. Genetic variation and molecular epidemiology. Biological mechanisms of variability. Quasispecies. Types, groups, subtypes and sub-subtypes of HIV. Mosaic viruses, unique recombinant forms and circulating recombinant forms. IV. Natural history of infection. Host immune response. Infection immunopathogenesis. Acute infection, chronic infection and AIDS. Opportunistic infections. V. Diagnostics in HIV infection. WHO and CDC algorithms. Special cases: direct detection ofthe virus (PCR, RT-PCR, p24 antigenaemia, virus isolation). VI. Therapy and resistance to antiretrovirals. Infection monitoring. Genotypic and phenotypic tests of resistance.