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Today, tens of millions of people around the world are going to die young

because they are infected by HIV, the virus that causes AIDS. The primary AIDS

virus is HIV-1, which can be spread via sexual intercourse or drug use

(activities, which result in body fluid exchange like blood and semen). HIV can

also be passed from mother to child and can also be acquired during blood

transfusions. AIDS, Acquired Immune Deficiency Syndrome, is a virus that causes

a loss of protection against disease causing microorganisms. People who are

infected by AIDS usually have a decline in the number of T-cells that are

responsible for their immune system. Because the virus reproduces by a reversed

transcriptase enzyme, it can quickly make a copy of its virus and so, it is

difficult to treat with its infinite reproductions. However, scientists have now

came up with a combination of drug called "cocktail drugs" to slow

down the development of the virus in different life cycles. Introduction HIV,

the Human Immunodeficiency Virus, is a disease that merits international

concern, study, and research. The diseases that infect individuals over the

world are causing theme to lose the functionality of their immune system and

finally succumb to one or more opportunistic diseases. AIDS viruses are

unbelievably small particles, invisible under an ordinary microscope, but

observable with an electron microscope. All the viruses are tiny packets of

genetic material, composed of either DNA or RNA and are surrounded by a

protective envelope of protein. HIV belongs to a group of especially tricky

viruses called retrovirus. It reverses the usual flow of genetic information

within the host cell. Retroviral RNA is copied, using its reverse transcriptase

enzyme, into a complementary single strand of DNA. This single-strand retroviral

DNA is then copied into double-stranded retroviral DNA inside the cell’s

cytoplasm. This retroviral DNA migrates into the host cell’s nucleus and becomes

integrated into the host cell DNA. It is then a provirus. (Hyde & Forsyth,

1996) 1.0 Retroviruses 1.1 History There are two strains of HIV, HIV-1 and

HIV-2. HIV-1 is the more prevalent form and also the one that causes the greater

pathology. HIV-2 is a lesser found strain that is endemic to countries in West

Africa. Presently, the majority of those infected with HIV are infected with the

HIV-1 strain. When the infection progresses, the patient is diagnosed with

acquired immunodeficiency syndrome (AIDS). The first well-documented case of

AIDS was found in San Francisco and New York in 1981. A young gay man in San

Francisco was found to be suffering from a severe fungal infection to which he

had little immune reaction. In fact, his immune system did not appear to respond

to any disease. Then he developed Pneunocystis carinii pneumonia (PCP), a type

of pneumonia that is caused by parasite. This disease is usually found only

among severely malnourished individuals or people whose immune systems have been

impaired by drugs such as those used in the treatment of cancer or in connection

with organ transplants. The young man died by the end of the year. Retroviruses

are classified into many different categories, but Lentivirus is responsible for

human immunodeficiency virus (HIV-1). (Armstrong, 1990) 1.2 T-Cells A

characteristic feature of AIDS is the progressive decline in the number of

circulating CD4 T lymphocytes . Various strains of HIV are cytopathic for cells

from cultured CD4 cell lines suggesting that direct killing, among other

mechanisms, may contribute to depletion of CD4 T-cells in HIV-infected persons.

Cell killing may also be involved in other aspects of HIV pathogenesis,

including the induction of neurological dysfunctions. The molecular events that

mediate HIV-induced cytopathology have not yet been elucidated, although env

gene products have been implicated by many lines of evidence. Studies funded in

the previous years of this grant indicate that HIV, like several other cytolytic

viruses, mediates changes in plasma membrane-associated ion transport systems.

Scientists proposed studies focus on defining HIV proteins, which mediate the

changes in ion flux. Their study found out that one of the HIV proteins may be

involved is the transmembrane protein (TM). Among the regions of TM, there are

carboxyl terminal sequences involved. These sequences have the potential to form

a strongly amphipathic helix enriched in arginine, a motif shared with

monovalent cation channels. HIV also have affects the potassium and sodium ion

transport systems. (Armstrong,1990) 1.3 Structure of AIDS virus There is

considerable diversity between various types of retrovirus; the following is a

generalized description of the particle. There is a universal nomenclature for

retrovirus proteins: Protein Function Matrix matrix protein (gag gene); lines

envelope Capsid capsid protein (gag gene); protects the core; most abundant

protein in virus particle Nucleocapsid capsid protein (gag gene); protects the

genome; forms the core Protease Essential for gag protein cleavage during

maturation Integrase Encoded by the pol gene; needed for integration of the

provirus Surface glycoprotein The outer envelope glycoprotein; major virus

antigen Transmembrane protein The inner component of the mature envelope

glycoprotein Reverse transcriptase Reverse transcribes the RNA genome; also has

RNAseH activity Retroviruses have enveloped particles and vary in sizes and

shapes, but are usually 100nm in diameter. The envelope carries a virus-encoded

glycoprotein, which forms spikes in the membrane. There are certain

structural/functional similarities between the envelope glycoprotein and the

influenza haemagglutinin. The mature protein is cleaved into 2 polypeptides:

 The outer envelope glycoprotein is the major antigen of the virus,

responsible for receptor binding, linked by disulphide bonds to:  The

trans-membrane glycoprotein holds the SU protein in the envelope, responsible

for membrane fusion. Inside the membrane is the matrix protein, rather

amorphous. Capsid is the most abundant protein in the particle making 33 per

cent of the total weight. Inside the capsid is the core, which contains RNA,

genome+NC and protein+RT+IN. All retrovirus genomes consist of two molecules of

RNA, a 5′ cap and a 3′ poly-A (equivalent to mRNA). Retrovirus genomes have 4

unique features:  They are viruses that are truly diploid.  They

are the only RNA viruses whose genome is produced by cellular transcriptional

machinery, that is, without any participation by a virus-encoded polymerase.

 They are the only viruses whose genome requires a specific cellular RNA

(tRNA) for replication.  They are the only RNA viruses whose genome does

not serve directly as mRNA immediately after infection. These two molecules are

physically linked by hydrogen bonds. (Retroviruses [Online]) 1.4 Replication

Shortly after infection, only low amounts of parental infectious material can be

identified, this is the so-called eclipse phase. At this stage, genome

replication has been initiated but progeny viruses are not yet released. There

is then a maturation phase when viral material accumulates exponentially in the

cell or surrounding medium. After a few hours cells infected with lytic viruses

become metabolically disordered and viral production ceases. Titres then slowly

drop. Cells infected with non-lytic viruses can continue to produce viral

particles indefinitely. Infection of a cell may be:  productive, the

cells are permissive for viral replication and virion progeny are released.

 abortive, the cells are non permissive for a viral function and virion

particles not produced.  restrictive, the cell is transiently permissive

and a few virus are produced. Viral production then ceases but the genome

persists. This is one of the reasons why some people do not develop AIDS. The

replication cycle of HIV is shown: Source: "Retrovirus" (Online) There

are several steps involved in the HIV cycle: Source: "AIDS fact sheet"

(Online)  Attachment Virus attachment consists of specific binding of a

viral attachment protein (VAP) to a cellular receptor. Receptor molecules can be

proteins (glycoproteins), or the sugar residues present on glycoproteins or

glycolipids. Some complex viruses, for example, Poxviruses and Herpesviruses may

have more than one receptor-binding protein, therefore, there may be alternative

routes of uptake into cells. The expression or absence of receptors on the

surface of cells largely determines the tropism of most viruses, that is, the

type of cell in which they are able to replicate.  Penetration Unlike

attachment, viral penetration is an energy-dependent process; that is, the cell

must be metabolically active for this to occur. Three mechanisms may be

involved:  Translocation of the entire virion across the cell membrane

 Endocytosis of the virus into intracellular vacuoles.  Fusion

of the viral envelope with the cell membrane, which requires the presence of a

viral fusion protein in the virus envelop.  Uncoating A general term for

the events which occur after penetration, in which the capsid is removed and the

virus genome exposed, usually in the form of a nucleoprotein complex. This can

happen when retrovirus cores are highly ordered nucleoprotein complexes which

contain, in addition to the diploid RNA genome, the reverse transcriptase enzyme

responsible for converting the viral RNA genome into the DNA provirus. This

process occurs inside the core particle. For viruses that replicate in the

cytoplasm, the genome is simply released into the cell, but for viruses that

replicate in the nucleus, often with associated nucleoproteins, must be

transported through the nuclear membrane. This is achieved by interactions of

the nucleoproteins or capsid with the cytoskeleton. At the nuclear pores, the

capsid is stripped off, and the genome passes into the nucleus.  Gene

Expression Control of viral replication is achieved by tight regulation of gene

expression and the methods used depend on nature of the virus genome/replication

strategy. One advantage of monocistronic mRNAs is that various proteins can be

produced in different amounts, rather than in a constant ratio. Non-segmented

genomes tend to produce polycistronic mRNA, which is translated to form a

polyprotein, processed by proteolytic cleavage to form the mature gene products.

To utilize the cellular machinery, viral mRNAs must contain control signals

which are recognized by the cell.  Assembly This involves the assembly

of all the components necessary for the formation of the mature virion at a

particular site in the cell. During this process, the basic structure of the

virus is formed.  Release For lytic viruses, release is a simple process

- the cell breaks open and releases the virus. Enveloped viruses acquire the

lipid membrane as the virus buds out through the cell membrane. Virion envelope

proteins are picked up during this process as the virus is extruded. Budding may

or may not kill the cell, but is controlled by the virus – the physical

interaction of the capsid proteins on the inner surface of the cell membrane

forces the particle out through the membrane:  Maturation The stage of

the life cycle at which the virus becomes infectious. Usually involves

structural changes in the particle, often resulting from specific cleavage of

capsid proteins to form the mature products, which frequently leads to a

conformational change in the capsid, or the condensation of nucleoproteins with

the genome. For some viruses, assembly and maturation are inseparable, whereas

for others, maturation may occur after the virus particle has left the cell.

(Retroviruses [Online]) 2.0 Transcription The transcription of RNA in AIDS is

caused by reverse transcriptase enzyme. This enzyme changes HIV’s genetic

material (RNA) into the form of DNA. This step has to occur before HIV’s genetic

code gets combined with an infected cell’s own genetic codes. Within the host

cell nucleus, proviral DNA, when activated, produces new strands of RNA. Some

RNA is used as mRNA to produce proteins for making HIV. Other RNA becomes

encased within the viral core proteins to become the new viruses. The RNA

strands that are splices become the mRNA strands used in protein synthesis. The

unspliced RNA strands serve as new viral strands that are encased in their

protein coats (capsids) to become new viruses that bud out of the cell. Source:

"Retrovirus – Transcription" (Online) There are two distinct phases of

transcription follow the HIV infection of an individual cell. Firstly, the RNA

strands produced in the cell’s nucleus are snipped into multiple copies of

shorter sequences by cellular splicing enzymes. When they reach the cytoplasm

they are only about 2,000 nucleotides in length. These early-phase short

transcripts encode only the virus’ regulatory proteins. The regulatory proteins

and the structural genes that constitute the rest of the genome are among parts

that are left behind. In the second, or late phase, two new size classes of RNA

move out of the nucleus and into the cytoplasm. (Cozic & Swisher, 1991) 3.0

Treatment Although scientists have not came up with sufficient treatments for

AIDS, researchers have found several ways to suppress HIV reproductions: 3.1 Tat

Toxoid Robert Gallo, a co-discoverer of HIV has published significant findings

using an experimental vaccine for an AIDS-like illness in rhesus macaques

(monkeys). The vaccine did not prevent infection, but did weaken the disease

with undetectable viral loads, CD4 counts that remained within normal limits,

and other parameters, when compared to control animals. Tat is a protein

produced by HIV that has been linked with several components of HIV disease. In

laboratory tests, immune cells treated with Tat have a lesser response to new,

foreign antigens (infections) and can enhance HIV growth in those cells. Tat

also increases levels of fas ligand on immune mononuclear cells, a precursor to

apoptosis (programmed cell death). This is thought to be one possible component

that leads to decreased CD4 counts. Lastly, Tat increases the number of

chemokine (intercellular "messengers") receptors on immune cells that

HIV partly uses to enter them. Scientists found out that among those monkeys,

who developed both types of immune responses to Tat, "88% were protected

against high level virus replication." It should be emphasized, however,

that the vaccine did not protect against infection, but led to viral load levels

that were attenuated in many animals. (Drugs and AIDS, 1994) 3.2 Chinese Herbal

Medicines The Chinese herbal medicine is known as an energy balancing treatment

for people with unbalanced "yin" and "yang". Chinese herbs

do not cure HIV infection. However, many people believed that the herbs have

helped them to improve their overall energy, or deal with the side effects of

antiviral medications. Some people have used herbs to reduce the upset stomach

or diarrhea caused by their medications. The reason for this is because Chinese

herbs generally strengthen the immune system and therefore eliminate the chance

of getting sick of an AIDS infected person. (Drugs and AIDS, 1994) 3.3 Cocktail

Drugs Cocktail drugs are known as a combination of a variety of protease

inhibitor Invirase, Nucleoside Analogues and Hivid ?, which can all help to

reduce the time to disease progression or death by more than 50 percent. These

drugs combine to attack and slow down the replication and transcription of the

RNA in the virus. Therefore, the patient can live longer because the drugs are

slowing down the speed of disease development. (Protease Works [Online])

Conclusion The true impact of AIDS is now fully known for many years for it

produced profound changes in society. Although there are still questions in the

minds of some individuals about whether AIDS should be treated as a medical or a

moral problem, an increasing number are asking what can be done to best serve

the dignity, liberty, and health of those who are infected, as well as to

prevent new infections in the name of public health. While it is the duty of the

infected not to spread the virus, it is the responsibility of the community to

provide education, compassion, and support.


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