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Immunodeficiency syndromes

Immunodeficiency syndromes. Classification. Primary:rare,B,T & combined B &T deficits Secondary: in severe infection, immunosupression(CT,RT) ,malnutrition,DM,renal failure, ageing, autoimmune diseases,malignancies, AIDS. AIDS.

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Immunodeficiency syndromes

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  1. Immunodeficiency syndromes

  2. Classification • Primary:rare,B,T & combined B &T deficits • Secondary: in severe infection, immunosupression(CT,RT) ,malnutrition,DM,renal failure, ageing, autoimmune diseases,malignancies, AIDS

  3. AIDS Definition: disease caused by retrovirus human immunodeficiency virus ( HIV). • Characterized by • Depletion of CD 4+ T lymphocytes • Profound immunosuppression • Opportunistic infection (caused by organisms that are often non-pathogenic or low virulence) • Secondary neoplasms & neurological manifestations

  4. Epidemiology • Incidence >42 million people HIV + • Africa,SE Asia • 5th commonest cause of death in 25-44 yrs • Homosexual /bisexual males • IV drug abusers* • Recepients of blood& blood products • Heterosexual contacts • ??? • Paediatric –mother to child transmission

  5. Aetiology- HIV • Retrovirus • Lentivirus family • HIV 1,HIV 2 • HIV 1 –subgroups • Major (M),outlier (O),neither (N) • M –clades A-K (B SE asia,C India)

  6. HIV genome contains Gag Pol Env Tat,rev,vif,nef,vpr, vpu Imp for HIV pathogenicity & targeted therapy Structure of HIV (Cont….)

  7. Pathogenesis of HIV infection & AIDS • Viral transimission to blood (Infection of CD 4+ T cells )or macrophages,dendritic cells or CD4 + cells in mucosa • Infection established in lymphoid tissues • Latent period • Active viral replication • ↓T lymphocytes & decreased immunity • AIDS

  8. Entry/internalization of HIV in T cell, macrophage • Binding of gp 120 to CD 4 +cells (T cells /macrophages/dendritic cells) • Conformational change in gp 120 • Binding of HIV gp 120 to coreceptors (CCR 5,CXCR 4) • Membrane penetration by gp 41 • Membrane fusion • Virus enters the cells

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