MYCOLOGY-VIROLOGY

Reflection Paper
Journal

Submitted by:

Mostales, Ameryl A.
Miñozo, Xanthe Evitcejda Zemme E.
Resma, Edsel L.
Tamboong, Kimberly A.
Catorce, Mary Grace C.
 May 15, 2018

Journal

HIV (HUMAN IMMUNODEFICIENCY VIRUS)

HIV belongs to a group of a retroviruses called lentiviruses. The genome of retroviruses

is made of RNA, and each virus has two single chains of RNA ,for replication the virus needs a
host cell, and the RNA must first be transcribed in to DNA, which is done with enzyme reverse
transcriptase .The human immunodeficiency viruses are approximately 100 nm in diameter. It
has a lipid envelope, in which are embedded the trimeric transmembrane glycoprotein gp41
to which the surface glycoprotein gp120 is attached. HIV leads to AIDS primarily because the
virus destroys essential immune cells called CD4 T cells, but also to a lesser degree monocytes,
macrophages, and dendritic cells. Once infected, the cell turns in to a HIV replicating cell and
loses its function in human immune system.
HIV/AIDS has not yet caused a widespread epidemic in the Philippines. Rates in all the
usual risk groups (sex workers, men who have sex with men, STD clients, returning overseas
workers, etc.) have remained below 1%, except in a few areas, where they are still only 1-2% in
some risk groups. The low level of HIV may be due in part to the low number of sex worker
clients per night, the relatively low number of full-time sex workers, the low proportion of
injectors among drug users, the early multisectoral response to the epidemic, and the
presence of social hygiene clinics for sex workers. The incidence of STDs, multiple partners,
and injection drug use with needle sharing, however, is increasing, suggesting that an
explosive epidemic could occur if the virus is introduced into the appropriate risk groups. The
Philippine government has confronted the problem of HIV/AIDS aggressively with an action
plan that includes an emphasis on the response of the local government agencies,
involvement and support of nongovernmental organizations (NGOs), incorporation of
HIV/AIDS education into the school curriculum, and laws forbidding discrimination against
persons with HIV/AIDS or belonging to risk groups. Local and international NGOs have been
actively involved in prevention of HIV/AIDS and support of affected individuals. Although the
Philippines is currently experiencing low rates of HIV/AIDS, the country needs to be prepared
for the possibility of an explosive increase in the spread of HIV/AIDS. Vietnam and Indonesia
provide examples of delayed epidemics of HIV/AIDS that could also occur in the Philippines.

Transmission
HIV is transmitted by direct sexual contact, either homosexual or heterosexual; by blood or
blood products; and from an infected mother to infant, either intrapartum, perinatally, or via
breast milk (Fauci and Lane 1991). There is no evidence that HIV can be transmitted by casual
contact or that virus is spread by bites of insects such as mosquitoes.
Although the predominant mode of transmission in the United States and western Europe is
via homosexual contact and sharing of needles during drug use, the vast majority of infections
worldwide, particularly in developing countries, result from heterosexual contact. HIV has
been found in semen both in infected mononuclear cells and as cell-free virus in seminal fluid;
in addition, virus is present in cervical smears and vaginal fluid. There is a strong association
of HIV transmission with receptive anal intercourse. Only a thin and fragile rectal mucosal
membrane separates deposited semen from potential target cells within and beneath the anal
mucosa; in addition, there may be trauma associated with anal intercourse. The vaginal
mucosa is several layers thicker than the rectal mucosa and is less likely to be traumatized
during intercourse; however, it is clear that virus can be transmitted to either partner during
vaginal intercourse (de Vicenzi et al. 1994). It has been estimated that the probability of a
woman becoming infected by an HIV-positive male partner during vaginal intercourse is
probably less than 0.2% per contact. The risk of infection from a woman to a man via vaginal
intercourse appears to be less likely (Holmberg 1997). There is also a clear-cut relationship
between the presence of ulcerative genital lesions due to sexually transmitted disease and
increased susceptibility to HIV infection. This effect may result from an increased chance of
virus entering the bloodstream through such a lesion, or a higher frequency of CD4+ target
cells in the lesion itself. Although oral sex appears to be a much less efficient means of
transmitting HIV, there are rare anecdotal reports of transmission through receptive fellatio
and insertive cunnilingus. Prospective studies have clearly demonstrated that condom use
decreases transmission of HIV (Weller 1993).
Before the identification of HIV as the causative agent of AIDS, one of the principal modes of
transmission was contaminated blood and blood products. Approximately 13,000 cases of
AIDS have occurred among hemophiliacs in the United States, and recipients of blood or
blood products (together, 2% of the total AIDS cases). Two factors have decreased the
numbers of new cases among these risk categories: (1) screening of the blood supply and (2)
preventing recognized at-risk individuals from donating blood. In this regard, the estimated
rate of HIV infection from undetected HIV-infected, seronegative blood donors ranges from 1
in 40,000 to 1 in 250,000. The risk of infection of health care workers by direct inoculation of
blood from an infected individual via a sharp object such as a needle stick is approximately 1
in 300 (Fauci and Lane 1991).
Maternal transmission of HIV accounts for more than 90% of all HIV infections in infants and
children. In the absence of intervention, rates of mother-to-infant HIV transmission range
from 13% to 42%. In the United States, approximately 20–25% of untreated pregnant HIV-
infected women transmit the virus to their infants. An estimated 50–70% of mother-to-child
transmissions occurs late in pregnancy or during birth. It has been hypothesized that HIV is
transmitted when maternal blood enters the fetal circulation, or by mucosal exposure to virus
during labor and delivery. Postnatal HIV infection may occur via breastfeeding, which adds an
estimated 14% additional risk over the risk of HIV infections in utero or at delivery. Recently, it
has been demonstrated that a specific regimen of 5′azidothymidine (AZT) can markedly
reduce the risk of perinatal HIV transmission (Dunn et al. 1992; Connor et al. 1993; Rouzioux et
al. 1993; St. Louis et al. 1993; Scarlatti 1996).
The precise mechanisms of transmission of HIV are not completely understood. Virus must
enter the body as either cell-free virions or infected cells. The mode of transmission (either
through mucosal surfaces or by direct inoculation into the blood) generally determines the
initial cells that the virus encounters. Despite this difference, there is at present no reason to
believe that the route of transmission alters the subsequent course of HIV infection, although
it would be expected (and has been shown experimentally with SIV) that blood-borne
transmission would be much more efficient. Likely targets for initial viral infection in the
mucosa are antigen-presenting cells, particularly macrophage-related cells of the dendritic
cell lineage. Cells residing at the mucosal surfaces are called Langerhans cells; those in the
circulation are known as blood dendritic cells. These cells express CD4 as well as an
appropriate coreceptor and can be infected by HIV. Infected cells are then transported to the
lymphoid tissue where released virus can come into contact with susceptible CD4+ T cells that
predominantly reside in the paracortical areas. Infection is thereby established and the
subsequent burst of viremia seeds virus throughout the lymphoid tissues of the body (Fauci
1993).
Evidence has been presented which suggests that in sexual transmission, HIV-1 variants
present at only low frequency in the donor are passed to the recipient (Zhu et al. 1993). Similar
results have been reported for maternal-infant transmission (Wolinsky et al. 1992). Although
these results need to be confirmed and the mechanisms elucidated, the mucosa may form a
barrier that selects particular HIV variants. It has been suggested that clade-E strains can be
transmitted more efficiently by heterosexual intercourse than clade-B strains and that this
may correlate with increased infectability of dendritic cells for clade-E strains (Soto-Ramirez
et al. 1996). This effect could explain the much more rapid spread of clade-E virus than clade-
B virus in Thailand, where transmission is predominantly heterosexual (Gao et al. 1996).
However, this conclusion is controversial and needs confirmation.
References:
https://www.omicsonline.org/scholarly/hiv-virology-journals-articles-ppts-list.php
https://www.ncbi.nlm.nih.gov/books/NBK19450/
https://www.researchgate.net/publication/8446117_HIVAIDS_in_the_Philippines

Reaction

HIV infection is one of the laboratory acquired infection being transmitted to

the medical practitioners through needle stick injuries. It is a kind of sexually
transmitted disease that can be transmitted through penetration or a blood to blood
contact. Anyone can be transmitted as long as they comply with the 3P’s (Parenteral,
placental, person to person). Even a medical technologist can acquire this infection if
there is a less safety in conducting work in the laboratory. There’s no cure for this
infection because when we think about it, this infection seems like a life-threatening
disease. A virus particle is involved and as far as we know it is more dangerous than
other microorganisms. The staffs in the hospital and medical students, it is considered
as a warning or precaution to be extra cautious of their work in the laboratory
particularly in dealing with clinical specimens. Not only to be cautious of work but also
in selecting your future partner. As the saying goes, “think before you click”. This is
applied when we are making decisions in life but this might also apply in selecting your
partner in engaging marriage. One must be wise enough to be properly protected by
doing sexual intercourse to avoid having sexual transmitted disease such as HIV/AIDS.