传染病学教学（重庆医科大学）THE SECOND AFFILIATED HOSPITAL CQUMS.pptVIP

周智 Definition AIDS is a fatal chronic infectious disease caused by the Human Immunodeficiency Virus(HIV), transmitted mainly through sexual contacts and body fluids, characterized pathologically by selective depletion of helper T(CD4+) lymphocytes and impairment of cell-mediated immunity, and clinically by severe opportunistic infections and malignancies.  Classification: HIV-1 and HIV-2, belong to family Retroviridae, subfamily Lentivirus, and were discovered in 1983 and 1985, respectively. HIV genome Nine genes, 3 structure genes , 3 regulatory genes and 3 unknown function genes . (l) GAG (group antigen) gene encodes main core protein p24; (2) pol (polymerase) gene encodes reverse transcriptase; (3) ENV gene encodes surface proteins gp 120 and gp 41. Tropism: High affinity of the viral gp 120 envelope protein for the CD4 molecule (receptor), which is normally on the surface of helper T lymphocytes, 10%-20% of blood monocytes and macrophages, 5% of B cells, neuroglia, neurons of central nervous system, Langerhans cells in skin and colorectal epithelial cells are also know to express small amounts of CD4 on their surfaces. Initial Reports Other Early Developments 1 1982: Term “AIDS” coined First cases in women reported First transfusion and vertically transmitted cases reported 1983: Isolation of a retrovirus from a patient with AIDS by Montagnier’s group 1984: Detection of HTLV-III in pts with and at risk for AIDS (Gallo) Other Early Developments 2 1985: FDA approves first commercial HIV antibody test 1986: NIH establishes the AIDS Clinical Trials Group 1987: AZT = first antiretroviral approved by FDA Epidemiology First case repoted in mid-1981 from USA； 80，000，000 Infected person all over the word； Over 24, 800, 000 AIDS patients died； Newly Increased 50,000,000 per year, 16000 patients every day,11 cases every minute. Africa AmericaAsiaEurope； At least 1,000,000 infected person in China. HIV epidemic in China Since the firs