HEAVE

human Immunodeficiency virus
rear virus (diagram)
systematics
Richly: Viruses
Baltimore K. (RNA Retroviren) VI
family: Retroviridae
Unterfamilie: Orthoretrovirinae
kind: Lentivirus
Untergattung: Primate lentivirus group
kind: Human immunodeficiency virus
scientific name
human one immunodeficiency virus

HEAVE (H uman I mmunodeficiency V irus, English for: Human immune weakness virus) is the name for a virus, which causes the illness AIDS. It belongs to the class of the Retroviren. A complete distance of the rear virus from the human body is not possible, since Retroviren are able, to build their genetic code into the hereditary property of the landlord. An infection leads after a Inkubationsphase of different lengths and usually of several years to AIDS, an incurable immunodeficiency illness. With a minority (< 5 %)- the so-called Long term Non Progressors - the illness breaks out only after decades or possibly never.

Rear viruses divided into the trunk HIV-1 with the Subtypen A to I as well as O, and the trunk HIV-2, occurring world-wide. During HIV-1in the meantime, occurs HIV-2 is world-wide common mainly in west Africa . Both types resemble each other regarding the clinical infection process and the ill-making characteristics and look under the electron microscope equal. They differ however in the molecular weight of the proteins and in thatArrangement of the genes.

In Germany live approximately 45,000 humans with HEAVE, among them about 34,000 men, approximately 10,500 women and zirka 400 children. Each year comes it at present to on the average 2,400 new infections. In Austria infected themselves in the year 2005 altogether453 humans with HEAVE.

This article describes HEAVES and its characteristics. Detailed to AIDS (symptoms, investigation, process, therapy, Vorbeugung etc.) is to be found in the article AIDS.

Table of contents

structure and structure of the rear virus

structure of the HIV Virons

HEAVE is belonged a spherical Retrovirus and to the family of the Lentiviren. Infections with Lentiviren run usually chronically, with long clinical latency and under participationthe nervous system.

Viruspartikel has a diameter of approximately 100 Nm and is surrounded by a Lipoproteinhülle. Into this covering 72 about 10 Nm large env Glykoproteinkomplexe, those are embedded from an external portion (gp120) and a Transmembranprotein (gp41)exist. Gp120 is for the connection of the virus to the CD4-Rezeptoren of the goal cells of crucial importance. Since the covering of the rear virus from the diaphragm of the landlord cell develops, likewise different proteins of the landlord cell, z are in it. B. HLA classI and II molecules as well as adhesion proteins. The HIV-RNA lies in two copies in virus-cape-simmers forwards. Here are the enzymes reverse Transkriptase (blank ), Integrase and Protease necessary for the Vermehrung.

The Genom of the rear virus is clearly more complex than the other one Retroviren. Beside the three usual retroviralen genes (gag, pole, env) the rear virus possesses six additional (accessory) genes (vif, vpu, vpr, did, rev, nef), which possess mainly regulatorische functions.

transmission

the rear virus becomes with the body fluids blood, Sperm, Vaginalsekret, Liquor and mother's milk transfer. Potential entrance gates are fresh, still bleeding wounds in mucous membranes (binding skin, mouth, nose, Vaginal and Analschleimhaut) and/or. not sufficiently verhornte, easily verletzliche places of the outer skin (acorn, inside of the foreskin). As most frequent infection waysto call if the Vaginal is - or Analverkehr without use of condoms, then also oral traffic and the use of unsteriler syringes with the intravenous drug consumption. In particular homosexual men are considered as group of risks, there frequent partner changes and Analverkehr in the sceneare far common. As high the risk is with the sexual intercourse, depends particularly on the virus load in the seed liquid, in the sheath secretion and in the blood . This is high immediately after the infection, before anti-bodies formed, particularly, takesthen however first off and rises in late stages of the illness.

Blood transfusions are likewise a possible source of infection, which has meaning however today in Germany by the 1985 introduced routine investigations of the blood donors hardly still. In addition, is here inRisk available, since between infection of the donor and the demonstrability in the HIV test up to three months can elapse.

The risk of an infection of a child by an HIV infected nut/mother during the pregnancy or during the birth becomes on 15 to 30Per cent estimated. With well-known HIV infection the nut/mother the risk of a transmission can on the child by the gift of antiretroviraler medicines and the birth by Kaiserschnitt on approx. 2% to be decreased. A transmission of the virus when satisfying is likewise possible.

The so-called CHAT Survey study of the Swiss federal office for health service (BAG) - a Nachbefragung of humans, who received positive HIV tests in the process of a yearly - it resulted in that 49% of all newinfected received the infection from their firm Sexualpartner; 38% became from oneadmitted, but not firm opportunity partner infects. The large majority of the again-infected people knew already before that their partner was HIV positive. Were infected only 13 per cent of the heterosexual with anonymous sexual meetings. With homosexual ones the firm partners play with infectionsa smaller role; anonymous Sexualkontakte constituted 26% of the infections.[1]

The risk to be infected by tongue kisses can be excluded, if no bleeding wounds, so for example injuries of the gums, are present in the mouth. The HIV concentration in tears, sweat and Saliva is not sufficient for an infection after today's knowledge level likewise. In addition AIDS epidemiology lets an infection appear extremely improbable by insect bites or by droplet infection.

Humans, who were exposed to an acute infection danger, should as soon as possible (ideal-proves within twoHours!) visit a physician, in order to leave themselves advised and a Postexpositionelle prophylaxis (PEP) accomplish if necessary. At expiration of 72 hours a medicamentous PEP is not than meaningfully judged any more.

Regarding the probabilities of infection see detailed under AIDS

Cyclecycle cycle HEAVE

for the Vermehrung needs the virus landlord cells, which carry the CD4-Rezeptor on the surface. These are above all the CD4-tragenden T-Lymphozyten (T4-Zellen), which is responsible for the cellular immune defense in such a way specified with humans and which support anti-body formation. BesideT-Lymphozyten possess also Monozyten, macro phages and dendritische cells CD4-Rezeptoren.

with the landlord cell over

with the landlord cell to merge to be able, the surface proteins GP120 bind fusion to the CD4 receptors. By the connection it comesa Konformationsänderung in the Transmembranprotein GP41, a mechanism, which resembles one „Schnappfeder “or one „Mausefalle “. The again developed active substance T20 is a Peptid, which blocks the Konformationsänderung and thus attaching the virus difficult more difficult (see below).

Beside the CD4 receptors are further CO receptors in the connection of the rear virus to the cell takes part. The Chemokin receptor CCR5 cells and CXCR4 receptors at T-cells, monozytären on, is involved in the connection. The different development of these receptors affects the process of the rear infection and the probability of infection.Molecules, which are to block the CCR5 receptors, are tested to time. Since the meaning of these receptors for the organism is however not yet exactly clarified, it is ready for the market one still another far way up to. Important it is to be mentioned that the rear viruswithin the first months after the infection (after a short initial phase with CXCR4-Tropismus) an extraordinary preference of cells with the CCR5-Korezeptor shows usually. This leads to a predominant infection of cells of the monozytären/makrophagozytären system and less the so-called.T-Helferzellen. With the help of the monozytären cells the virus arrives into later Kompartimente of the body with difficulty accessible for the antiretrovirale therapy, like e.g. the testicles and the brain. Also regarding the heavy brain damage, those becomes important the virus with onePart the infected one already early to cause can.

PMID 8649511 PMID 8674120 PMID 8649512 PMID 8629022 PMID 9108481 PMID 8791690 PMID 9430590 PMID 9334379 PMID 9334378 PMID 9634238

installation of the rear virus gene COM into the landlord cell

structure and Vermehrung of theHEAVE

HEAVE builds for Vermehrung his RNA Genom after the reversen Transkription in such a way specified into doppelsträngige DNA into the Genom the landlord cell. The transformation of viraler RNA into provirale DNA in the Cytoplasma the landlord cell by the enzyme Reverse Transkriptasea crucial step is in the reproduction cycle of the Retroviren. This procedure does not occur otherwise in human cells. Therefore the enzyme Reverse Transkriptase is an important goal of therapeutic intervention and starting point of two pharmakologischer Wirkstoffklassen. After reverser Transkription closes the integrationthe virus gene COM into the human hereditary property by a further virales enzyme, the Integrase, on. In newer work it was shown that the virale DNA is already read off before the integration and virale proteins are formed. Therefore the HIV-DNA lies asintegrated and non-integrated form forwards. Also circular letters forms of HIV-DNA exist. As first virale proteins the virale Transaktivator act and the Nef protein were proven. Nef is essential, in order to be able to infect T-cells productively, while act adjusts the virale Transkription. ThoseSynthesis of viraler proteins is modulated through alternative splices and virale control of the RNA export by the Rev protein.

The virus in infected and resting CD4-positiven T-cells extracts itself from the attack by antiviral medicines and the immune system. To an activation of these immune cellsit comes to antigen contact, for example in the framework more usually or a opportunistischen infection. While the cell wants to proceed against another pathogen, it begins to produce virus proteins and set new viruses free. These infect then again different cells.

Which thatRear virus makes, is its transformation ability better said so unusually survivable or, its fast evolution rate. Of the influenza - viruses (flu) for example develop in the same time in the whole world not even half as many new subspecies as ofRear virus in an individual infected one.

The long incubation period of ten years is a problem, since many infected ones infect perhaps still for many years different persons, before their infection is recognized or noticed by them.

[CCF+97]

process thatHIV infection

rear virus, from an immune cell extracts itself

an untreated HIV infection usually runs in several stages. 3 to 6 weeks after the infection it comes usually to an acute HIV infection. This is by fever, reducingness, skin excursions, oral Ulcerations, or Arthralgie characterized. Because of the similarity with grippalen infections the acute HIV infection remains mostly unidentified. An early diagnosis is however important. Further infections cannot only be prevented by it by Sexualpartnern. First studies at patients, duringthe acute HIV infection it was antivirally treated and according to some time the therapy set off, showed that the HIV specific immune answer of the patients could be strengthened. The acute infection persists rarely more than 4 weeks.[2] PMID 11029005 PMID 11148221

in thatno physical symptoms arise to the following , latency phase usually of several years. Afterwards it comes often to first illnesses, which are to due to a moderately severe weakened immune system, however not yet as AIDS-defining applies (to CDC classification B, see AIDS). In the median after 8to 10 years after the Erstinfektion comes it to a heavy immune defect (< 200 CD4 - Cells/micro litres). This usually leads to AIDS-defining illnesses (CDC classification C, see AIDS). Among these rank opportunistische infections, those by viruses, bacteria, Mushrooms or parasites are conditioned, as well as other illnesses, like Kaposi Sarkom, malignant lymphoma, HEAVING Enzephalopathie and the Wasting syndrome. After individually different time these lead untreatedly usually to death. A heavy immune defect does not mean however that AIDS arises immediately.The longer a heavy immune defect is present, the more largely is the probability to get AIDS.

HEAVING Enzephalopathie

under HEAVING Enzephalopathie (HEAVE briefly) one understands one by HEAVES caused brain damage. It steps only with a part of the AIDS patientsup. That HEAVE strikes thereby the Fresszellen in the brain. Although the nerve cells directly of DO NOT HEAVE are stricken, it comes nevertheless to nerve cell damage. One explains oneself this indirect damage by the influence of the infected Fresszellen of the environment. ThatArise HEAVE with AIDS patients is since introduction SHEDS (see therapy) clearly declining.

Symptoms HEAVE:

  • Thoughts disturbance (memory, concentration, language disturbances)
  • disturbances of movement control (slowing down, co-ordination disturbances, course uncertainty)
  • change of behavior (apathy, Libidoverlust, social retreat)

with heavy processes knows itselfa dementia develop.

Of HEAVE to define are brain damage, which appears as consequence of medicine side effects , infections or lymphomas.

it points genetic

factors the fact that individuals have often very different disease processes despite same source of infection, to a strong influenceof landlord factors on the process of the infection. Apart from the training of the immune system also some genetic factors seem to play a role. So homozygote individuals with a genetic defect at the CCR5-Rezeptor (CCR5delta32) are to a large extent resistant to HIV infections. This receptor servesas CO receptor with the fusion of the virus with the landlord cell. Only few individuals were found, who have an infection despite receptor defect. They infected themselves with rear viruses, which use other CO receptors, like the CXCR4 receptors at T-cells. Homozygote gene carrier of theseDeletion make approx. 1% of the population out, heterozygote gene carriers about 20%. Heterozygote have clearly less CCR5 receptors and to seem after infection hardly a longer middle survival period to have.

The AIDS researcher J.J. Bouyao has in Nairobi (Kenya) it examines 600 prostitutes and with the fact stated that 24 of them is obviously immune to the rear virus. The reason for it seems to be genetically conditioned in opinion of researchers. An anomaly of gene is responsible obviously for which the virus prevents from it,to penetrate and spread into the cells.

[DPS+77], [LPC+96], [DCW+96]

history

HEAVE is the designation recommended by internationally the Committee OF Taxonomy OF Viruses 1986, the earlier designations like Lymphadenopathie associated virus (LAV), human T-cell-leukaemia-virus III (HTLV III)or AIDS-associated Retrovirus (ARV) replaces. HEAVE type 1 became 1983 for the first time from Robert Gallo, the director/conductor of the tumor virus laboratory at the NIH and Luc Montagnier, which described director Institut of the Pasteur in Paris. There both the Erstentdeckung forstress themselves, followed a law case for many years, with which it concerned also the patent for the again developed HIV test. HIV-2 was discovered 1986.

PMID 6189183 PMID 6601823

bibliography

[CCF+97] „Quantification OF latently tissue of reservoir and totally bodyviral load in HIV-1 infection. “: Chun powerplant, Carruth L, Finzi D et. aluminium: Nature. 1997 May 8; 387 (6629): 183-8.: PubMed PMID9144289

[DPS+77] „The amino acid patterns into the blood RK the onset OF haemorrhagic shock into the advice “: Daniel PM, Pratt OE,Spargo E, Taylor DE.: J Physiol. 1977 August; 270 (1): 71P-72P.: PubMed PMID915816

[LPC+96] „Homozygous defect in HIV-1 coreceptor accounts for resistance OF some multiply exposed individuals tons of HIV-1 infection “: Liu R, Paxton WA, Choe S et. aluminium: Cell. 1996 August 9; 86 (3): 367-77.: PubMed PMID8756719

[DCW+96] „genetics restriction OF HIV-1 infection and progression ton of AIDS by A deletion alleles OF the CKR5 structural genes. Hemophilia Growth and development Study, multi-center AIDS Cohort Study, multi-center Hemophilia Cohort Study, San Francisco town center Cohort, ALIVE Study. “: Dean M,Carrington M, Winkler C et. aluminium: Science. 1996 September 27; 273 (5283): 1856-62. : PubMed PMID8791590

see also

Wiktionary: HEAVE - word origin, synonyms and translations

Web on the left of (German)

probability of infection

answering the institute for Robert cook on the AIDS criticism

Web on the left of (English)


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