NEW ADVANCES IN HIV MANAGEMENT

1. NOVEL APPROACHES IN
HIV_AIDS
By . . ,
DR CH.PAVAN KUMAR
MBBS

2.  NOVEL UDERSTANDING OF EPIDEMIOLOGY.
 APPLICATIONS.

3. EPIDEMIOLOGY
HIV VIRUS
ENVIRONMENT
HOST
AIDS
HOST
ENVIRONMENTAGENT

4. HIV VIRUS
V1/V2
env
mannose
cholesterol
CD 59

5. HIV VIRUS
“env” is the most used target for the
production for vaccines.
In 2012,
An anti-SIVSME543 vaccine obligately
including “env “protein antigens prevented
SIV in rhesus monkeys.

6. HIV hides inside coat rich in mannose.
 pradimicin A
1.Freezes HIV's molecular
machinery for entering and infecting its host's
healthy cells.
2.The virus responds by reducing
the mannose in its coat thereby revealing
itself to the immune system, which can then
attack.
Contd..,

7. The antibody binding site, called the V1/V2
region, represents a suitable HIV vaccine
target.
CD59 protien of human origin will be kept in
capsid of HIV thereby escaping the
immune mechanism.
Contd….,

8. HIV rotates and flattens, exposing more of
the gp41 proteins in the middle during
attachment.
 Probably allowing the gp41
protein to get closer to the cell membrane
so it can lock on.
Exposes an area of the virus that would
be vulnerable to attack by the immune
system.
Contd….,

9. HIV
CD4
+ CELL
Vulnerable area
HIV
CD4
+ CELL

10. ENVIRONMENT
The LENTIVIRAL VECTOR has only been
tested in culture dishes and has resulted in
the destruction of about 35 percent of
existing HIV cells.
Breast milk antibodies. . ,
Nearly half of the 350,000 new infant HIV
infections occurring annually are transmitted via
breast milk .
(can it kept here or to be shifted to the host).

11.  The human body can produce powerful
antibodies that shield cells in the laboratory
against infection by an array of HIV strains.
 Antibody-dependent cell-mediated cytotoxicity
is important.
 Appearing only after a person has been
infected with HIV for at least one year.
 IL 7 seem to be important.
HOST

12. CD4+ T cells with the α4β7 receptor play an
role in the sexual transmission of HIV.
Cofilin , a protein used to cut through a cell's
outer layer, or cytoskeleton -- is involved in HIV
infection.
LIM domain kinase, triggers a cell to move, like
a propeller. This cell movement is essential for
HIV infection.
Contd….,

13. A sugar-binding protein called galectin-9
traps PDI (protein disulfide isomerase)on T-
cells.
PDI helps,
Change the shape of the surface
envelope protein of the virus .
Enabling the virus to interact optimally
with receptors as the CD4 molecule.
Contd….,

14. • In certain monkeys TRIM5,cellular protein,
– Recognizes this lattice structure,
– Specifically attaches itself to it,
Stimulates the protein to produce signal
molecules known as polyubiquitin chains in the
cell.
These chains immediately trigger an anti-viral
reaction.
The "alerted" cell can then start eliminating cells
infected with HIV by releasing messenger
substances (cytokines).
Contd….,

15.  Protein named SAMHD1 was able to prevent HIV_1
,
– is able to degrade deoxynucleotides(dNTP) ,
which are the building blocks required for
replication of the virus.
 Alarmins ,
Ex: Interleukin 33.
Create the foreign look and presented by dentritc
cells to t cells.
IL-33 could be used to artificially increase the T
killer cell army, which was generated in response
to vaccination.
Contd….,

16. Capsid protein, acting like a key, binds to
Nup358, a protein on the nuclear pore
complex gain access to nucleus.
Gene TLR7 allows the antibody generating
B cells.
 To detect the presence of a retrovirus.
 Germinal centre reaction.
Contd….,

17. Human Endogenous RetroViruses (HERV’s),
Are genetic fossils of retro viruses with HIV
activates HERVs that lie inside HIV-infected cells
in some individuals.
The activated HERVs produce proteins that attract
immune system T cells to the HIV-infected cells.
HLA alleles [critical immune system components]
that are associated with protection from HIV-1
disease progression.
Proteins produced by the HERV genes can act
as target.
Contd….,

18. Elite suppressors (0.5 percent of all HIV-
infected individuals)infected with the virus,
(more effective killer T cells,) are naturally able
to control infection in the absence of
antiretroviral therapy, or HAART.
Levels of HIV integrated into immune
cells are much lower.
Cells that contain the integrated form of
HIV DNA and are metabolically less
active.
Contd….,

19. A transdermal patch which releases more
than 96 percent of the hiv medication over
the course of seven days.
Economic advantage.
With an estimated 15 million people living
with HIV in developing countries and only
5.3 million people with access to treatment.
More..,

20. HVTN 505 is testing the safety and efficacy of
a TWO-PART HIV VACCINE REGIMEN.
– Prime the immune system.
– Boost the immune response.
A major HIV vaccine RV144 trial trial in
Thailand showed for the first time that a
vaccine can generate modest protection
against HIV infection in humans.
Gene Therapy, to insert genetically mutated
viruses into living cells.
Contd….,