HIV DIVERSITY

& HUMAN RESPONSE TO

INFECTION
Presented to : Dr. Himender Bharti
Presented by : Vivek Kumar, Roll no.-20521037

MSc Zoology(sem1)
HIV
Definition: Human Immunodeficiency Virus is a specific type of
virus (a retrovirus), which invades Helper T cells to replicate
itself.

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 HIV DIVERSITY
HIV is one of the most genetically diverse pathogens due to its :
a) high-mutation and recombination rates,
b) large population size and rapid replication rate.
This rapid evolutionary process has resulted in
several HIV subtypes that are heterogeneously globally distributed.

Discovery of HIV
 By Luc Antoine Montagnier (French virologist at Pasteur Institute, Paris) and Robert
Charles Gallo (American physician-scientist at National Cancer Institute, Maryland) (1937).
 In India –By Dr. Suniti Solomon and her student Dr. Sellappan Nirmala amongst
six female sex workers in Chennai, Tamil Nadu, (1986). 

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• Origin of HIV-2 was resolved first.

• Origin of HIV-1 from nonhuman primates traced to a simian

virus (SIVcpz), which infected several geographically isolated
chimpanzee communities in southern Cameroon.

• This HIV-1 progenitor probably was passed from chimpanzees

to human hunters through bloodborne transmission.

• Phylogenetic analysis of HIV-1 and related viruses from

nonhuman primates suggests that three independent
transmission events early in the 20th century spawned three
HIV-1 groups: major (M, between 1915 and 1941), outlier (O),
and nonmajor and nonoutlier (N).

• M and N from chimpanzees, evidence suggests that group O

HIV-1 may have originated in gorillas
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Diagram. Hypothesis : Three assumptions for M, N, O groups of HIV-1 Origin and zoonosis. 5
ORIGIN of HIV cases in
Kinshasa, Congo.

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• 1884-1924 : SIV transfer to human as HIV.
• H1920s : Spread of HIV from chimpanzees to humans.
(first case in Kinshasa, Democratic Republic of Congo)
• 1968 : Earliest case of AIDS appears in the Midwest.
• 1980s : Start of the epidemic in U.S.
 HIV-1: Chimpanzee (Pan troglodytes)
origin (first reported in 1989)
.From Cameroon, Congo CAR
.More Virulent(Pandemic)
 HIV-2: Sooty Mangabey (Cercocebus
atys)
.Monkey
.Less Virulent(West Africa)

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 HIV-1 ( newest strain L)

HIV-1 and HIV-2

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 CLASSIFICATION & MOLECULAR
EPIDEMIOLOGY OF HIV :
2 main types : HIV-1 and HIV-2.
Groups N, O, and P
Groups of HIV-1
The smaller HIV-1 groups are rare outside of west central Africa, specifically Cameroon. They are:
HIV-1 has four groups -- 1 large one and 3
N (New, Not-M, or Not O group): This form of the virus has onlyN,
Groups been seenPin:a small group of people
O, and
much smaller ones.
in Cameroon. Researchers haven't named any strainsThese for this groupare
groups because there are
rare outside so few
of west cases
central
of it. Africa, specifically Cameroon.
Group M (Major) :
O (Outlier group): This group has almost as many variations as the M group. However, researchers
• N (New, Not-M, or Not O group): Only seen
• Responsible for: HIV epidemic, nearly 90%
haven't identified its separate strains yet because it's so in
rare.
a small group of people in Cameroon. Few
of all HIV-1 cases.
P group: This is the newest group of HIV-1. It was given cases,
its ownUnidentified.
name because of how different it is
• Group has 9 strains:
from the M, N, and O strains. A, B, C, D, F, G, H, J,
• O (Outlier group): O group has almost as
and K.
many variations as M group. Unidentified
• B strain : Most common in U.S. Worldwide:
strains, rare.
Americas, Western Europe and Australasia.
• P group: Newest group of HIV-1. Different
• C strain: Most common- southern Africa
from the M, N, and O clades.
and India (50%) HIV-1 cases.

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HIV-2
HIV-1 and HIV-2 belong to family Retroviruses and genus Lentiviruses.

• Distribution : HIV-2 infection is predominantly found in West African nations, such as

Guinea-Bissau, The Gambia, Senegal, Cape Verde, Cote d'Ivoire, Mali, Sierra Leone,
and Nigeria. In the late 1980s, each of these countries had a reported prevalence of
>1% of the national population. In World, parts of Africa, Europe, India and the US.

• Rare : In the U.S., it makes up only 0.01% of all HIV cases, and those are primarily
people from West Africa.

• Infection : It's harder to transmit HIV-2 from person to person, and it takes longer for
the infection to turn into AIDS.

Both HIV-1 and HIV-2 have multiple groups: subtypes, or strains.

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Global Distribution of HIV-1 11
 HIV infection reports in worldwide (2019):
GLOBAL HIV STATISTICS(= global epidemic)
• 38.0 million [31.6 million–44.5 million] people globally were living with HIV in 2019.
• Out of 38 million : 36.2 million are adults, 1.8million are children (<15 years old).
• 1.7 million [1.2 million–2.2 million] people became newly infected with HIV in 2019.
• 690 000 [500 000–970 000] people died from AIDS-related illnesses in 2019.
GLOBAL HIV STATISTICS
INDIA
38.0 million HIV
[31.6 prevalence(epidemic)
million–44.5 3rdwere
million] people globally rank
living with HIV in 2019. 1.7 million [1.2
million–2.2 million]cases:
• 2.349million people0.396
became newly infected
in Maharashtra, with HIV in
0.314 2019.
in Andhra 690 000
Pradesh, [500in000–970
0.269 000]
Karnataka..
people died from AIDS-related illnesses in 2019.
HIV most prevalence
• South Africa has the highest number of people living with HIV in the world (7.5 million).
• Eswatini (formerly known as Swaziland) has the highest prevalence in the world (27%).
• Western and Central Africa. An estimated 4.9 million people are living with HIV in Western
and Central Africa.

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HUMAN RESPONSE TO
INFECTION :
Modes of transmission:

75%

15%

HIV is obligate virus, cannot survive for very long outside of human body.
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HIV(1 or 2) infection results in:
• AIDS( Acquired Immunodeficiency Syndrome)
• Opportunistic diseases - Pneumocystis pneumonia (PCP).
Tuberculosis (TB).
Cytomegalovirus.
Cryptococcal meningitis.
Toxoplasmosis.
Neurological diseases, etc.
AIDS-related cancers: Cervical cancer
h
Kaposi sarcoma
Lymphomas
Oral and periodontal manifestations: Candidiasis (thrush).
Oral hairy leukoplakia.
Kaposi`s sarcoma & other malignancies.
Bacillary (epithelioid) angiomatosis
Oral hyperpigmentation
Atypical ulcers
…People suffering from STDs are more likely to get infected during sex with infected person.

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Diagram. HIV Infection in body cells. 15
Stages of Infection – (assuming no treatment)

There are four stages of HIV and infection rate on the individual depends on a
number of factors like: general health, lifestyle, diet etc.

Stage 1: Infection phase

• HIV quickly replicates in body after infection.

• Some people develop short lived flu-like symptoms for example: headaches,
fever, sore throat and a rash within days to weeks after infection.
• During this time, the immune system reacts and produce antibodies – this is
referred to as ‘sero-conversion’.

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MAJOR COMPETITORS
Stage 2: Asymptomatic phase

• As the name suggests, this phase show no outward signs or symptoms. A person may look
and feelContoso
well but HIV–is10continuing
Suites MILE to weaken their immune system.
• This stage may
Started lastinseveral
practicing 2002. Mainyears (an
market is average
primarily businessof 8 to 10in years) and without a HIV test many
executives
the downtown financial district. Not very competitive on pricing. Standard
people business
do nothours
know they are infected.
from 9:00AM to 5:00PM Mon-Fri.

Stage 3: Symptomatic phase

Fabrikam, Inc.
• Over time thepracticing
Started immune system
in 2005. becomes
Very innovative damaged
in technology and weakened by HIV and symptoms
and service
develop. offerings. Pricing standard to market. Practices pediatrics as well as
general dentistry. Offers a “kids’ corner” for parents.
• Initially they can be mild but they do worsen, symptoms include fatigue, weight loss, mouth
ulcers, thrush and severe diarrhea.
• The symptoms are opportunistic infections(so called because they take advantage of a
person’s Lamna
weakenedHealthcare Company
immune system).
Chain company. Standard hours. Reviews reveal customer service is
• Some opportunistic
lacking. Main targetinfections example
market is geared are PCP,
towards seniors toxoplasmosis, TB and Kaposi sarcoma.
and office
specializes in dental implants and surgeries.

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 Stage 4: AIDS/Progression of HIV to AIDS

• There is no single test for AIDS; doctors will look at a variety of symptoms
including the CD4 count, the viral load and the presence of opportunistic
infections in order to make an AIDS diagnosis.

SYMPTOMS : Stage 4: AIDS/Progression of HIV to AIDS

Acute HIV Infection
There is no2 single
Within test forafter
to 4 weeks AIDS;infection
doctors will
withlook at a
HIV, variety
about of symptoms
two-thirds including
of people the this
have CD4 is
count,
the viral load and the presence of opportunistic infections in order to make an AIDS diagnosis
the body’s natural response to HIV infection. 
Flu-like symptoms can include:

Fever Chills Fatigue Swollen lymph nodes

Mouth ulcers Rash Night sweats
Muscle aches Sore throat

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• Rapid weight loss
• Recurring fever or profuse night sweats
• Extreme and unexplained tiredness
• Prolonged swelling of the lymph glands in the armpits, groin, or neck
• 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

Symptoms can last from a few days to several weeks. But some people do not
have any symptoms in early stage of HIV.

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 A period of 4-6 weeks after HIV exposure, when
antibodies against HIV infection are not detectable in blood.

Recommended : a person at high risk of HIV infection, if initially tested –ve should
be retested at 3 months to confirm diagnosis.

3 HIV diagnostic tests : nucleic acid tests (NAT), antigen/antibody tests, and
antibody tests.
1. NATs (Nucleic Acid Tests) -
Detect actual virus in the blood.
• Very expensive and valid for person with high-risk exposure or a possible
exposure with early symptoms of HIV infection.
• NAT can usually detect HIV infection 10 to 33 days after an exposure.

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2. Antigen/antibody tests -
Detect both antibodies to HIV and HIV antigens in blood.
• Antibodies- produced by your immune system. Antigens are foreign substances.
• If you have HIV, an antigen called p24 is produced even before antibodies
develop.
• Recommended for testing done in labs with blood sample.
• Detect HIV infection within 18 to 45 days after an exposure.
• Also rapid Antigen/antibody tests done with blood from a finger prick, but can take
longer to detect HIV (18 to 90 days after an exposure).

3. Antibody tests -
Detect antibodies to HIV in your blood or oral fluid.
• Antibody tests detect HIV infection within 23 to 90 days after an exposure.
• Most rapid tests and the only FDA-approved HIV self-test 
• Blood from a vein- fast HIV detection .
• blood test from a finger prick or with oral fluid – slower HIV detection.

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HIV Test : CD4 count
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Preventions :
HIV can’t spread through air, water or insect bites.
No vaccine to prevent HIV infection and no cure for AIDS.

• Use treatment as prevention (TasP).

• Use post-exposure prophylaxis (PEP) if you've been exposed to HIV-
within 72 hours and continue dose for 28 days after infection.
• Use a new condom every time you have sex.
• Consider pre-exposure prophylaxis (PrEP)- Combination of drugs
emtricitabine + tenofovir (Truvada) and emtricitabine + tenofovir alafenamide
(Descovy) can reduce the risk of HIV infection by sex.
• Tell your sexual partners if you have HIV .
• Use a clean needle.
• If you're pregnant, get medical care right away.
• Consider male circumcision (removal of the foreskin from the human penis).

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 You cannot get HIV from…
• Someone who has an undetectable viral load
• Someone who doesn’t have HIV
• Touch, Kissing
• Sweat, tears, urine or faeces of someone who
has HIV
• Mutual masturbation
• Used condoms
• Air, water
• Coughs, sneezes or spit
• Food, drink and cooking utensils
• Toilet seats, tables, door handles, cutlery,
sharing towel
• Insects, animals
• New or sterilized needles
• Musical instruments
• Tattoos and piercings

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Let`s join hands…
To fight…
To protect…
To give…
Our loved ones a
healthy tomorrow.

WORLD AIDS DAY:

1 December

Thank you!!
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