HIV–thebasicfactsmadesimple.docVIP

HIV – the basic facts made simple Prof Thorkild Tyllesk?r, Centre for International Health, University of Bergen, NO-5021 Bergen, Norway. Email: Thokild.Tylleskar@cih.uib.no This paper is presenting the some basic facts needed to understand the determinants for transmission of the Human Immunodeficiency Virus (HIV) to infants. We are briefly going to look at the immune system, the HIV virus and the infection, HIV tests and the HIV infection of infants. The human immune system The immune system has two components: the antibody-mediated defence and the cell-mediated defence. The two play together but the first is important for killing bacteria and the second is important for overcoming viral infections, tuberculosis, mycoses and parasites. As viruses infect cells, the cell-mediated defence attack by killing the infected cells to clear the infection. A very central cell in the immune system is the so-called CD4 T-lymphocyte. The CD4 cell is the coordinator of all the efforts, like an officer of the “soldiers”. The cell-mediated defence is more dependent on its good functioning. The HIV virus and the infection An HIV virion (particle) consists of an outer envelope with glycoprotein buds called gp120. Inside there is a core with the genetic code in the form of RNA and three enzymes: 1) reverse transcriptase, 2) protease and 3) integrase. The HIV virus has a very low infectivity. It needs help to get “under the skin” in order to infect anybody. Blood transfusion is such a help, sexual relations is another one. When the virus gets into the body, it will infect many of the body’s cells. But the gp120 buds on the virus envelope fit onto a receptor on the CD4 T-lymphocytes and therefore the CD4 cells become the prime target of the infection. The virus attaches to the receptor and fuses with the cell membrane and inside the cell the content of the core is released and the reverse transcriptase will now start to make a DNA copy of the RNA. This is the reverse of the usual pr