SUY GIM MIN DCH DO HIV

SVTH: NHM VIII GVBM: Ths. Nguyn Th Lan

NHM VIII H Th Ngc nh Nguyn Th Thy Nguyn Th Thy Nguyn Th M Tin Nguyn Th Thu H Phm Quc Cng Th Hu inh Cng Phc

Ni dung
1 HIV

Nguyn nhn gy min dch HIV

Con ng ly lan v phng php chun on

HIV
Cu to

HIV

c tnh

Ngun gc

HIV
Human Insuffisance Virus L virus gy hi chng suy gim min dch ngi HIV c dng hnh cu Kch thc rt nh Khng nhn thy c bng knh hin vi thng thng

Cu to

Enzyme phin m ngc

1
2 3

Gy nhim trng chm pht trin

RNA si n hoc si i B gen c kch thc 10kb Sao chp ngc mRNA thnh DNA Tnh di truyn rt cao Sng m thm v rt lu Protein c tnh cht khng nguyn C i lc vi lympho bo

c tnh

4 5 6 7

Ngun gc
Nm 1930, gii khoa hc cho l ly truyn t loi kh sang con ngi v chnh thc tha nhn vo nm 1981. Nghin cu trng i hc Arizona (M) kt lun xut hin cch y 100 nm

Phn tch mu t bo bo qun nm 1959, bc s CHDC Congo th ly lan sang ngi trong khong thi gian 18841924. Cng ng l u tin bit n vo nm 1981 Cn bnh ny git cht 25 triu ngi v 33 triu ngi khc ang mang virus HIV

Ngun gc
Virus HIV ly lan rt chm qua con ng tnh dc nhng nh qa trnh th ha m pht sinh thnh dch Theo gi thuyt, c mt con tinh tinh b nhim virus cn vo ngi, sau n b bt v bn git tht. T , virus HIV i vo mu ngi thng qua nhng vt t trn tay trong qu trnh lm tht con vt. Khi nhng thnh ph ny pht trin mnh, ko theo s n r ca nn mi dm, to iu kin cho virus c c hi ly lan nhanh chng.

Nguyn nhn gy min dch HIV

C ch xm nhp vo t bo vt ch

Nguyn nhn dn n s suy gim min dch

C ch xm nhp

Bc 1: Virus HIV gn kt vo t bo

Bc 2: Phin m RNA ca virus thnh DNA si n nh enzyme phin m ngc

Bc 3: Qu trnh tng hp DNA si i t DNA si n

Bc 4: S gn DNA retrovirus vo genome t bo ch

Bc 5: S phin m DNA retrovirus to thnh mRNA virus v RNA genome virus

Bc 6: Tng hp v protein virus Sau th lp rp RNA genome virus vo v protein gii phng virus khi t bo

Nguyn nhn
Hot ng ca HIV
Git trc tip t bo S tng tc ca HIV vi phn t CD4 Gn vi th th CD4

Hot ng ca HIV lm suy gim min dch

Virus HIV tn cng vo cc t bo lympho lm mt kh nng min dch ca h min dch mt kh nng tiu dit virus pht sinh nhiu bnh nhim virus c hi (giang mai, lao ) Virus xm nhp vo t bo mang cm t bo CD4, HIV s nhn ln hng lot virus mi lm gim cc lympho CD4 (thiu ht min dch mc phi)

Gn vi th th CD4

120 ca HIV gn ln th th t bo lympho T4 lm ri lon t bo (tb T gim chc nng min dch) c ch sinh sn tb lympho

HIV gn vi th th CD4 gp

Khi nhim HIV th siu KN tng tc v gn vo T-CD4 CD4 b cm ng khng p ng min dch t bo T cht

H lympho gim c v s lng v cht lng + Ngi bnh thng: 4501280 lympho T/ l mu + AIDS: 200 lympho T/ l mu

Tng tc ca HIV vi phn t CD4

Khi HIV xm nhp vo t bo, thnh phn gp120 ca phc hp glucoprotein ca virus c i lc vi b mt ca tb CD4 glucoprotein ko virus vo tb CD4, tb tua, i thc bo v nhng tb biu hin th th CD4 c th lin kt vi virus nhng thp hn tb lympho T-CD4 Gp120 ca virus phi gn vi coreceptor trn mng tb ch, mt s phn t khc hot ng nh coreceptor cho HIV i vo, hu ht l cc th th chemokine

 Chemokine quan trng tng tc vi HIV l CCR5 biu hin tb tua, i thc bo v t bo T-CD4 CXR4 biu hin tb T c hot ha

Git t bo trc tip

HIV tn cng vo T-CD4 sinh si ph hy mng t

bo, ph v b my trong t bo) git t bo HIV gn vo T-CD4 hng lot T-CD8 gy c git t bo nhim t bo lympho T gim

Cc con ng ly lan HIV

ng mu

ng tnh dc

ng truyn t m sang con

Thi k m tnh
2

Trong mu cha xut hin khng th c hiu vi virus m tnh di hay ngn ty thuc vo con ng ly nhim

Trong mu xut hin khng th c hiu vi HIV

Khng th ny khng c kh nng bo v c th

Thi k xt nghim dng tnh vi HIV

Khng nh nhim HIV v c kh nng ly lan sang ngi khc Khng th to thnh c ngha v mt chun on

Cc phng php chun on

90

Chun on huyt thanh hc

27.4

20.4

1st Qtr

2nd Qtr

3rd Qtr
63

50

Phn lp virus HIV

1st Qtr

32.5

2nd Qtr

3rd Qtr

Quy trnh
2008 2007 2006 2005 2004

Vn + tnh th xc nhn bng Western blot hoc xt nghim min dch hunh quang

Nu + tnh th ELISA c lm li

2003

2002 2001 2000

Sng lc ban u: xt nghim hp th min dch lin kt enzyme (ELISA)

* Test huyt thanh dng tnh xut hin sau 3 thng k t khi b ly nhim. xc nh nhim HIV ngi ta tin hnh xt nghim nh sau:

Xt nghim trc tip

Xt nghim khng nguyn Nui cy HIV Xt nghim a. nucleic ca tb lympho mu ngoi vi Phn ng chui polymerase

Xt nghim mu
m t bo T CD4+ v CD8+ Tc mu lng m tb mu ton phn Xt nghim bnh ly qua ng tnh dc v nhim trng c hi nh: giang mai, vim gan B, lao H tr chun on v gip ng gi mc suy gim min dch

Pht hin chnh bn thn khng nguyn

Chun on bng phn lp virus

Kt qu chc chn nhng phc tp, gi thnh t

Tin hnh trong cc trung tm nghin cu vi mc ch nghin cu hn l chun on bnh