Abstract

Etiology, transmission and protection: Transmission of HIV, the causative agent of AIDS, occurs predominantly through bodily fluids. Factors that significantly alter the risk of HIV transmission include male circumcision, condom use, high viral load, and the presence of other sexually transmitted diseases. Pathology/Symptomatology: HIV infects preferentially CD4+ T lymphocytes, and Monocytes. Because of their central role in regulating the immune response, depletion of CD4+ T cells renders the infected individual incapable of adequately responding to microorganisms otherwise inconsequential. Epidemiology, incidence and prevalence: New HIV infections affect predominantly young heterosexual women and homosexual men. While the mortality rates of AIDS related causes have decreased globally in recent years due to the use of highly active antiretroviral therapy (HAART) treatment, a vaccine remains an elusive goal. Treatment and curability: For those afflicted HIV infection remains a serious illness. Nonetheless, the use of advanced therapeutics have transformed a dire scenario into a chronic condition with near average life spans. When to apply those remedies appears to be as important as the remedies themselves. The high rate of HIV replication and the ability to generate variants are central to the viral survival strategy and major barriers to be overcome. Molecular mechanisms of infection: In this review, we assemble new details on the molecular events from the attachment of the virus, to the assembly and release of the viral progeny. Yet, much remains to be learned as understanding of the molecular mechanisms used in viral replication and the measures engaged in the evasion of immune surveillance will be important to develop effective interventions to address the global HIV pandemic.

Highlights

  • EPIDEMIOLOGY, INCIDENCE AND PREVALENCE Acquired immunodeficiency syndrome (AIDS), caused by chronic infection with the human immunodeficiency virus1 (HIV-1), is one of the most devastating pandemics ever recorded in human history [1]

  • Subtype C predominates in the actual HIV-1 pandemic with a prevalence of almost 50% followed by subtype A (12%), subtype B (11%), CRF02_AG (8%), CRF01_AE (5%), subtype G (5%) and subtype D (2%)

  • Additional genetic diversity is introduced as a result of recombination that takes place during HIV replication when the host cell is infected with multiple HIV-1 subtypes, known as coinfection or super-infection [13]

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Summary

Introduction

A retrospective cohort study conducted in South Africa revealed that TB doubled within the first year after HIV infection [27], thereafter the incidence increased as immunity decreased, and reached a very high prevalence of 25.7 per 100 person-years in patients with CD4 T-cell counts lower than 50 cells per μL [28]. Very recent “on-demand PrEP” study conducted in men who have unprotected anal sex with men revealed that a combination of TFV and emtricitabine, taken before and after sexual activity, provided notable protection against HIV acquisition with a relative reduction of 86% in the risk of HIV-1 infection [87].

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