Gregory M. was a 22-year-old student at the University of Texas who had been in
ID: 81423 • Letter: G
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Gregory M. was a 22-year-old student at the University of Texas who had been in relatively good health throughout his life. He was a distance runner on the cross-country and track teams at the university. In the early part of January 2002 he developed a mild fever, lymphadenopathy, sore throat, and excessive fatigue, particularly after completing a training session. Although he was already thin yet fit due to his athletic regimen, he began losing weight. He consulted the athletic trainer who believed that his symptoms were simply those of a driven athlete who was under stress due to academics and the pressure of training for highly competitive meets. Gregory was not entirely convinced, so he sought advice from a local clinician. The clinician concluded that the symptoms were indicative of infectious mononucleosis. After three weeks the symptoms went away and Gregory felt considerably better. He excelled in cross-country and track and graduated with honors near the top of his class in the spring of 1985. After graduating, he continued to train as a semi-professional runner, preparing for and participating in international meets and races. Seven years after graduating Gregory noticed several brown papules on the skin of his feet. After consultation with a physician, the raised lesions were diagnosed as malignant and multifocal neoplasm indicative of Kaposi's Sarcoma. ELISA and western blot confirmed infection with HIV. Additionally, he was shown to have a rapid increase in serum levels of IgG and IgA consistent with clinical signs associated with AIDS, which he was diagnosed as having based on symptoms and laboratory findings. Gregory was familiar with HIV infection and its ramifications, but he continued to work out and convinced himself that by doing so the HIV infection and concomitant symptoms of AIDS would go away. Several months after his diagnosis he suffered from a bout of pneumonia. Laboratory analysis confirmed that the pneumonia was caused by Pneumocystis carinii. one of the organisms commonly associated with AIDS. An analysis of his blood at this time indicated that he had 300 CD4+ T lymphocytes per microliter of blood {normal-800-1200 cells/mu L}. Within one month, not fully recovered from pneumonia, Gregory became infected with Mycobacterium tuberculosis and presented with symptoms characteristic of tuberculosis. The organism disseminated throughout his body, also in keeping with AIDS, and he died several weeks later despite exhaustive treatment with antimicrobials for tuberculosis and zidovudine (AZT). dideoxyinosine, and dideoxycytidine for AIDS. At his first consultation for disseminated tuberculosis, blood work showed his CD4+ T lymphocyte count to be 40 cells/mm^3. 1. How is MV transmitted? 2. Are there some individuals who have been infected with HIV for a long time but have not yet progressed to AIDS? 3. What cell types of the human host carry HIV? 4. How does HIV gain access to host cells? 5. AIDS may initially manifest of persistent generalized lymphadenopathy syndrome. What does this mean? 6. How many types of HIV are known to be in existence? 7. Because infection with HIV does not result in elimination of the virus by the immune system, does this mean that the immune system does not respond? 8. As of 2015, what are the statistics in terms of how many people are infected with HIV and mortality associated with the virus?Explanation / Answer
answers:
1) HIV is transmitted to sexual behavior, intravenous needles, blood products, hetersexual partner
2) individuals who do not progessed to AIDS tend to have very low HIV-1 virus. It means that individual effective immune mechanism that keep viral replication below a certain level that would otherwise result in disease, but it is not exactly
3) CD4+ Tcells, dendritic cells and macrophages are all common cell types that carry the virus
4) The glycoprotein gp120 of the virus binds to CD4 molecule present on some T lymphocytes , macrophages, and other cells containing CD4. Similarly gp 41 enables fusion occurs between virus and membrange target cells. CCR5 is the major coreceptor for viral entry of HIV into CD4 lymphocytes and macrophages but not T-cells.
5) Some individuals present with enlarged lymph nodes at multiple site for longer than three months. Those who do are said to have persistent generalized lymphadenopathy syndrome.
6) Most cases of AIDS worldwide caused by HIV-1, HIV-2 is found primarily in west africa and india.
7) No. Initially immune response is strong and involves both the production antibody and generation of CD8+ T lymphocytes
8) 2015 global HIV : it is estimated 36.7 million people were living with HIV (including 1.8 million childrens)
Number of people living with HIV in 2015:
Eastern and southern africa : 19 million
western and central africa : 6.5 million
Asia and pacific : 5.1 million
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