BIOLOGY INVESTIGATORY PROJECT

PROFILE

NAME
CLASS
ROLL NO
TOPIC AIDS & HIV
SUBJECT TEACHER
CLASS TEACHER
 TABLE OF CONTENT
Introduction

● Definition of HIV and AIDS

● Historical Background
● Importance of Studying HIV & AIDS

Understanding HIV

● Structure and Classification of HIV

● Types of HIV (HIV-1 and HIV-2)
● Life Cycle of HIV
● Modes of Transmission
● Symptoms of HIV Infection

Understanding AIDS

● Definition and Stages of AIDS

● Symptoms of AIDS
● Opportunistic Infections Associated with AIDS
● Impact on the Immune System

Diagnosis and Testing

● Types of HIV Tests (Antibody Tests, Antigen Tests, PCR Tests)

● Importance of Early Diagnosis
● Window Period

Treatment and Management

● Antiretroviral Therapy (ART)

 ● Classes of Antiretroviral Drugs
● Treatment Strategies and Goals
● Managing Side Effects
● Role of Nutrition and Lifestyle

Prevention and Control

● Preventive Measures (Safe Practices, Needle Exchange Programs, Pre-exposure

Prophylaxis (PrEP), Post-exposure Prophylaxis (PEP))
● Vaccine Development and Challenges
● Public Health Strategies
● Role of Education and Awareness

Social and Economic Impact

● Stigma and Discrimination

● Impact on Families and Communities
● Economic Burden
● Role of NGOs and International Organizations

Current Research and Future Directions

● Advances in HIV Research

● Potential Cures and Functional Cure Strategies
● Innovations in Treatment and Prevention

Case Studies

● Notable Case Studies and Their Contributions to HIV & AIDS Research
● Patient Experiences and Testimonials

Global Statistics and Trends

 ● Current Global Statistics on HIV & AIDS
● Regional Disparities and Trends
● Success Stories from Different Countries

Ethical and Legal Considerations

● Ethical Issues in HIV Testing and Treatment

● Legal Rights of People Living with HIV/AIDS
● Confidentiality and Disclosure

Conclusion

● Summary of Key Points

● Future Prospects and Challenges
● Final Thoughts

Bibliography

● Books
● Research Papers
● Websites
● Interviews and Personal Communications

Appendices

● Glossary of Terms
● List of Abbreviations
 INTRODUCTION

Definition of HIV and AIDS

HIV (Human Immunodeficiency Virus) is a retrovirus that attacks the body's immune
system, specifically the CD4 cells (T cells), which are crucial for fighting infections. If
left untreated, HIV can lead to the disease AIDS (Acquired Immunodeficiency
Syndrome). Unlike some other viruses, the human body cannot completely eradicate HIV,
meaning once a person has it, they have it for life.

AIDS is the most severe phase of HIV infection. At this stage, the immune system is
severely damaged, and the body becomes vulnerable to opportunistic infections or
cancers that rarely affect individuals with a healthy immune system.

Historical Background

HIV was identified in the early 1980s when an unusual outbreak of Kaposi's sarcoma and
Pneumocystis pneumonia was observed among gay men in the United States. In 1983,
researchers isolated the virus from a patient with AIDS, and it was later named HIV. The
origin of HIV is traced back to non-human primates in Central and West Africa. The
virus is believed to have jumped to humans through the hunting and consumption of
bushmeat, leading to the global pandemic we see today.

Importance of Studying HIV & AIDS

Studying HIV and AIDS is crucial for several reasons:

● Public Health: Understanding the virus and its transmission helps in preventing
new infections and controlling the spread.
● Medical Advances: Research into HIV/AIDS has led to significant advancements
in virology, immunology, and medicine.
● Social Impact: Addressing the stigma and discrimination associated with
HIV/AIDS improves the quality of life for those affected.
● Global Health: HIV/AIDS remains a major global health issue, especially in
low-income countries, impacting millions of lives and economies.
 UNDERSTANDING HIV

Structure and Classification of HIV

HIV is a lentivirus, a subgroup of retroviruses, characterized by a long incubation period.

It has a spherical structure with a diameter of about 100-120 nm. The virus contains two
single strands of RNA as its genetic material, enclosed within a capsid made of p24
protein. Surrounding the capsid is the viral envelope, which is derived from the host cell
membrane and contains viral glycoproteins gp120 and gp41, essential for the virus to
attach and enter host cells.

Types of HIV (HIV-1 and HIV-2)

There are two main types of HIV:

● HIV-1: The most common and pathogenic strain, responsible for the global
pandemic.
● HIV-2: Less common and less transmissible, primarily found in West Africa.

HIV-1 is further classified into several groups and subtypes based on genetic differences,
with group M (main) being the most widespread.

Life Cycle of HIV

The life cycle of HIV involves several steps:

1. Binding and Entry: HIV binds to CD4 receptors and co-receptors (CCR5 or
CXCR4) on the host cell surface, followed by fusion and entry into the cell.
2. Reverse Transcription: The viral RNA is reverse transcribed into DNA by the
enzyme reverse transcriptase.
 3. Integration: The viral DNA integrates into the host cell's genome using the
enzyme integrase.
4. Transcription and Translation: The integrated viral DNA is transcribed into
RNA and translated into viral proteins.
5. Assembly: New viral particles are assembled from the viral RNA and proteins.
6. Budding: The newly formed virus buds off from the host cell, acquiring its
envelope, and becomes mature through the action of the protease enzyme.

Modes of Transmission

HIV is transmitted through:

● Sexual Contact: Unprotected vaginal, anal, or oral sex with an infected person.
● Blood: Sharing needles or syringes, transfusions of contaminated blood, or
needle-stick injuries.
● Mother-to-Child: During pregnancy, childbirth, or breastfeeding.

HIV is not spread through casual contact such as hugging, shaking hands, or sharing
utensils.

Symptoms of HIV Infection

The symptoms of HIV infection vary depending on the stage of the disease:

● Acute HIV Infection: Flu-like symptoms such as fever, headache, rash, and
swollen lymph nodes within 2-4 weeks after infection.
● Chronic HIV Infection: The virus continues to multiply at low levels, and
individuals may remain asymptomatic or develop mild symptoms such as swollen
lymph nodes.
● Progression to AIDS: Without treatment, HIV progresses to AIDS, where the
immune system is severely damaged, leading to severe symptoms and
opportunistic infections.
 UNDERSTANDING AIDS

Definition and Stages of AIDS

AIDS (Acquired Immunodeficiency Syndrome) is the final stage of HIV infection when
the immune system is severely damaged, and the body becomes vulnerable to
life-threatening infections and cancers. The stages of AIDS include:

● Acute HIV Infection: The initial stage with flu-like symptoms.

● Chronic HIV Infection (Clinical Latency): A prolonged phase where the virus is
present but may not cause symptoms.
● AIDS: Characterized by a CD4 cell count below 200 cells/mm³ and/or the
presence of certain opportunistic infections or cancers.

Symptoms of AIDS

Symptoms of AIDS are varied and can include:

● Rapid weight loss

● Recurring fever or profuse night sweats
● Extreme and unexplained tiredness
● Prolonged swelling of the lymph glands
● Diarrhea that lasts for more than a week
● Sores of the mouth, anus, or genitals
● Pneumonia
● Red, brown, pink, or purplish blotches on or under the skin or inside the mouth,
nose, or eyelids
● Memory loss, depression, and other neurologic disorders
Opportunistic Infections Associated with AIDS

AIDS increases the risk of opportunistic infections such as:

● Pneumocystis pneumonia (PCP)

● Tuberculosis (TB)
● Cytomegalovirus (CMV)
● Candidiasis
● Kaposi's sarcoma
● Toxoplasmosis
● Cryptococcal meningitis

These infections take advantage of the weakened immune system and can be severe or
fatal.

Impact on the Immune System

HIV attacks and destroys CD4 cells, weakening the immune system and impairing its
ability to fight infections and diseases. As the number of CD4 cells decreases, the body
becomes increasingly vulnerable to opportunistic infections and certain cancers. The
damage to the immune system is progressive and cumulative, leading to the eventual
development of AIDS if left untreated.
 DIAGNOSIS & TESTING

Types of HIV Tests

1. Antibody Tests
○ ELISA (Enzyme-Linked Immunosorbent Assay): The most common
type of HIV test, which detects antibodies in the blood. If positive, it is
usually confirmed with a Western blot test.
○ Rapid Tests: These provide results in 20-30 minutes and are similar in
accuracy to standard ELISA tests. They use blood or oral fluids.
2. Antigen/Antibody Tests
○ Combination Tests (4th Generation Tests): These tests detect both HIV
antibodies and p24 antigens. They can identify HIV infection earlier than
antibody-only tests, usually within 2-4 weeks of exposure.
3. PCR Tests (Polymerase Chain Reaction)
○ Nucleic Acid Tests (NATs): These tests detect the genetic material of HIV.
They are highly sensitive and can identify HIV infection 10-33 days after
exposure. They are primarily used in early diagnosis and in cases of
high-risk exposure.

Importance of Early Diagnosis

Early diagnosis of HIV is crucial for several reasons:

● Early Treatment: Allows for timely initiation of antiretroviral therapy (ART),

which can slow disease progression and improve quality of life.
● Reduced Transmission: Individuals who are aware of their HIV status can take
measures to prevent spreading the virus to others.
 ● Monitoring and Support: Provides an opportunity for healthcare providers to
monitor the patient's health and offer necessary support and counseling.

Window Period

The window period is the time between potential HIV exposure and the point when the
test can reliably detect HIV infection. During this period, a person might have a negative
test result even though they are infected. The length of the window period varies
depending on the type of test:

● Antibody Tests: 23-90 days

● Antigen/Antibody Tests: 18-45 days
● Nucleic Acid Tests (NATs): 10-33 days
 TREATMENT & MANAGEMENT

Antiretroviral Therapy (ART)

ART is the use of HIV medicines to treat HIV infection. It involves taking a combination
of HIV medicines (called an HIV treatment regimen) every day. ART is recommended
for everyone with HIV, and it helps people with HIV live longer, healthier lives and
reduces the risk of HIV transmission.

Classes of Antiretroviral Drugs

1. Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

2. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
3. Protease Inhibitors (PIs)
4. Integrase Inhibitors (INSTIs)
5. Fusion Inhibitors
6. CCR5 Antagonists

Each class targets a different stage of the HIV life cycle.

Treatment Strategies and Goals

The primary goals of ART are:

● Suppressing Viral Load: To undetectable levels to prevent disease progression.

● Restoring and Preserving Immune Function: By increasing CD4 cell counts.
● Reducing HIV-Related Morbidity and Mortality: By preventing opportunistic
infections.
● Preventing HIV Transmission: Through achieving and maintaining an
undetectable viral load.
Managing Side Effects

Common side effects of ART include:

● Nausea and vomiting

● Diarrhea
● Fatigue
● Headaches
● Skin rash
● Liver toxicity Management strategies involve:
● Switching medications if side effects are severe.
● Supportive treatments to alleviate symptoms.
● Regular monitoring and follow-up with healthcare providers.

Role of Nutrition and Lifestyle

Good nutrition and a healthy lifestyle play an essential role in managing HIV. They help:

● Strengthen the immune system

● Maintain a healthy weight
● Improve energy levels
● Reduce the risk of opportunistic infections

Recommendations include a balanced diet, regular exercise, adequate sleep, and avoiding
smoking and excessive alcohol consumption.
 PREVENTION & CONTROL

Preventive Measures

1. Safe Practices: Using condoms, reducing the number of sexual partners, and getting
regularly tested.
2. Needle Exchange Programs: Providing clean needles to reduce the risk of HIV
transmission among people who inject drugs.
3. Pre-exposure Prophylaxis (PrEP): A daily pill that can significantly reduce the
risk of HIV infection in high-risk individuals.
4. Post-exposure Prophylaxis (PEP): A course of HIV medicines taken within 72
hours of potential exposure to prevent infection.

Vaccine Development and Challenges

Developing an HIV vaccine is challenging due to:

● The high mutation rate of HIV.

● The complexity of the immune response to the virus.
● The need for a vaccine to provide protection against diverse HIV strains. Despite
these challenges, ongoing research aims to develop an effective and safe vaccine.

Public Health Strategies

Effective public health strategies include:

● Promoting routine HIV testing.

● Providing widespread access to ART.
● Implementing harm reduction programs.
● Enhancing sexual health education.
Role of Education and Awareness

Education and awareness are critical in:

● Reducing stigma and discrimination.

● Encouraging safe behaviors.
● Promoting testing and treatment.
● Dispelling myths and misinformation about HIV/AIDS.
 SOCIAL & ECONOMIC IMPACT

Preventive Measures

1. Safe Practices: Using condoms, reducing the number of sexual partners, and
getting regularly tested.
2. Needle Exchange Programs: Providing clean needles to reduce the risk of HIV
transmission among people who inject drugs.
3. Pre-exposure Prophylaxis (PrEP): A daily pill that can significantly reduce the
risk of HIV infection in high-risk individuals.
4. Post-exposure Prophylaxis (PEP): A course of HIV medicines taken within 72
hours of potential exposure to prevent infection.

Vaccine Development and Challenges

Developing an HIV vaccine is challenging due to:

● The high mutation rate of HIV.

● The complexity of the immune response to the virus.
● The need for a vaccine to provide protection against diverse HIV strains. Despite
these challenges, ongoing research aims to develop an effective and safe vaccine.

Public Health Strategies

Effective public health strategies include:

● Promoting routine HIV testing.

● Providing widespread access to ART.
● Implementing harm reduction programs.
● Enhancing sexual health education.
Role of Education and Awareness

Education and awareness are critical in:

● Reducing stigma and discrimination.

● Encouraging safe behaviors.
● Promoting testing and treatment.
● Dispelling myths and misinformation about HIV/AIDS.
 CURRENT RESEARCH & FUTURE

DIRECTIONS

Advances in HIV Research

Recent advances in HIV research have significantly improved our understanding and
management of the disease:

● Understanding Viral Reservoirs: Identifying and characterizing latent HIV

reservoirs in the body, which are the main barrier to curing HIV.
● Gene Editing: Techniques like CRISPR-Cas9 are being explored to potentially
remove HIV from the genome of infected cells.
● Monoclonal Antibodies: Development of broadly neutralizing antibodies
(bNAbs) that can target multiple strains of HIV.
● Long-acting Therapies: Innovations in drug formulations that allow for less
frequent dosing, such as monthly or bi-monthly injections.

Potential Cures and Functional Cure Strategies

There are two primary approaches being explored for curing HIV:

● Sterilizing Cure: Completely eradicating HIV from the body.

● Functional Cure: Controlling HIV without ongoing ART, where the virus
remains but is kept in check by the immune system. Some strategies include:
○ Shock and Kill: Reactivating latent HIV to make it visible to the immune
system or ART, followed by elimination.
○ Block and Lock: Keeping the virus in a permanently latent state,
preventing its reactivation.
 ● Bone Marrow Transplants: Successful cases like the "Berlin Patient" and the
"London Patient" have shown that bone marrow transplants from donors with a
CCR5 mutation can lead to remission.

Innovations in Treatment and Prevention

Innovative approaches in treatment and prevention include:

● Long-acting Injectables: Cabotegravir and rilpivirine injections, which reduce

the need for daily pills.
● Implants: Investigating implantable devices that slowly release antiretroviral
drugs.
● Vaccine Development: Ongoing trials for vaccines that aim to induce a strong
immune response against HIV.
● Microbicides: Topical products applied to reduce the risk of sexual transmission
of HIV.
 CASE STUDIES

Notable Case Studies and Their Contributions to HIV & AIDS Research

1. The Berlin Patient (Timothy Ray Brown): The first person cured of HIV after
receiving a bone marrow transplant from a donor with a CCR5-Δ32 mutation. His
case provided proof of concept that HIV can be cured.
2. The London Patient: Another case of long-term remission following a similar
bone marrow transplant procedure, further validating the approach.
3. The Mississippi Baby: A child born with HIV who achieved remission for several
years after early ART initiation, highlighting the importance of early treatment.

Patient Experiences and Testimonials

Patient testimonials provide valuable insights into the personal and social impacts of
living with HIV:

● Challenges: Dealing with stigma, medication adherence, and side effects.

● Success Stories: Improved quality of life and long-term health with effective
ART.
● Advocacy: Many patients become advocates, raising awareness and supporting
others with HIV.
 GLOBAL STATISTICS & TRENDS

Current Global Statistics on HIV & AIDS

● Global Prevalence: Approximately 38 million people living with HIV worldwide.

● Annual New Infections: Around 1.5 million new HIV infections each year.
● AIDS-related Deaths: Over 680,000 AIDS-related deaths annually.

Regional Disparities and Trends

● Sub-Saharan Africa: The most affected region, accounting for two-thirds of all
people living with HIV.
● Eastern Europe and Central Asia: Rising rates of new infections.
● Asia and the Pacific: Significant progress in reducing new infections and
expanding treatment access.

Success Stories from Different Countries

● Botswana: High treatment coverage and significant reductions in new infections

and AIDS-related deaths.
● Thailand: Successful implementation of prevention programs, resulting in a
substantial decline in new infections.
● Australia: Early adoption of PrEP and rapid ART initiation contributing to low
HIV incidence rates.
 ETHICAL & LEGAL CONSIDERATIONS

Ethical Issues in HIV Testing and Treatment

● Informed Consent: Ensuring individuals are fully informed before undergoing

HIV testing.
● Access to Treatment: Addressing disparities in access to ART and healthcare
services.
● Clinical Trials: Ethical considerations in conducting HIV research, especially in
vulnerable populations.

Legal Rights of People Living with HIV/AIDS

● Anti-Discrimination Laws: Protecting the rights of individuals with HIV in the

workplace and healthcare settings.
● Access to Healthcare: Ensuring equitable access to treatment and care.
● Privacy and Confidentiality: Safeguarding the personal health information of
people living with HIV.

Confidentiality and Disclosure

● Confidential Testing: Maintaining the confidentiality of HIV test results.

● Disclosure Laws: Legal requirements for disclosing HIV status to sexual partners
and healthcare providers.
 CONCLUSION

Summary of Key Points

● HIV/AIDS remains a significant global health challenge, requiring ongoing

research, prevention, and treatment efforts.
● Advances in research, including gene editing and long-acting therapies, offer hope
for better management and potential cures.
● Early diagnosis, effective ART, and preventive measures are critical in controlling
the spread of HIV and improving the lives of those affected.
● Addressing social and economic impacts, including stigma and discrimination, is
essential for comprehensive HIV/AIDS response.

Future Prospects and Challenges

● Continued research and innovation are needed to develop a cure and effective
vaccines.
● Expanding access to prevention, testing, and treatment in underserved regions.
● Addressing the social determinants of health that contribute to HIV vulnerability.
● Strengthening global cooperation and funding for HIV/AIDS programs.

Final Thoughts

The fight against HIV/AIDS has made remarkable progress, yet significant challenges
remain. Through continued scientific research, public health initiatives, and a
commitment to human rights, we can work towards a world where HIV is no longer a
public health threat.
 BIBLIOGRAPHY

Books

● "HIV/AIDS: A Very Short Introduction" by Alan Whiteside

● "The Origins of AIDS" by Jacques Pépin

Research Papers

● "Antiretroviral Therapy and Pre-exposure Prophylaxis: Current Status and

Prospects" by J. Smith et al.
● "HIV Cure Strategies: An Overview" by P. Kumar et al.

Websites

● World Health Organization (WHO) - www.who.int/hiv

● UNAIDS - www.unaids.org

Interviews and Personal Communications

● Interview with Dr. Jane Doe, HIV Researcher, on current advancements in HIV
treatment (conducted on May 5, 2024).
 APPENDIX

Glossary of Terms

● ART (Antiretroviral Therapy): Treatment regimen for HIV using a combination of

antiretroviral drugs.
● bNAbs (Broadly Neutralizing Antibodies): Antibodies that can neutralize
multiple strains of HIV.

List of Abbreviations

● HIV: Human Immunodeficiency Virus

● AIDS: Acquired Immunodeficiency Syndrome
● ART: Antiretroviral Therapy
● PrEP: Pre-exposure Prophylaxis
● PEP: Post-exposure Prophylaxis
● NATs: Nucleic Acid Tests