NTA Level 5 • Semester 1 • PST05103

HIV and AIDS

Pharmaceutical Microbiology • Source Session/Topic 30

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Session 30: HIV and AIDS

Total Session Time: 60 minutes

Pre-requisites

• Human anatomy and physiology

Students Learning Tasks

By the end of this session students are expected to be able to:

• Describe HIV and AIDS (causative agents, transmission, signs and

symptoms)

• Describe treatment, prevention and control of HIV and AIDS

Resources Needed:

• Flip charts, marker pens, and masking tape

• Black/white board and chalk/whiteboard markers

SESSION OVERVIEW

SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks and clarify

ASK students if they have any questions before continuing

STEP 2: Cause and Transmission of HIV/AIDS (15 minutes)

• Human immunodeficiency virus (HIV) infection and acquired immune

deficiency syndrome (AIDS) is a spectrum of conditions caused by

infection with the human immunodeficiency virus.

• HIV is a single-stranded positive-sense RNA virus that belongs to the

family retroviridae. It infects HIV infects CD4-bearing cells (T4

lymphocytes and monocyte-macrophages)

• HIV is transmitted through unprotected sexual intercourse with an

infected person, blood to blood contact (e.g. using unsafe skin

piercing instruments and blood transfusion), mother to child

transmission during delivery and breastfeeding

• Inside the host cell, HIV uses its own reverse transcriptase enzyme to

produce DNA from its RNA genome, the reverse of the usual pattern

• The new DNA is then incorporated into the host cell genome by an

integrase enzyme to form viral DNA as part of its own genome,

transcribing and translating the viral genes along with the cell's own

genes, producing the proteins required to assemble new copies of the

virus

• It is difficult to detect the virus until it has infected the host. At

that point, the infection will persist indefinitely

• The Infection may be latent or chronic low level.

• Activation leads to the development of immune dysfunction as a result

of direct and indirect killing of T4 cells and functional impairment

of viable T4 cells.

• Macrophages appear to be the primary target cells in brain infection.

The pathogenic mechanisms of neurologic disease are not known

• A person can be infected with HIV but not have AIDS.

• The virus infects human T-lymphocyte cells

• Infection by the human immunodeficiency virus leads to gradual and

progressive destruction of the cell mediated immune system.

o Failure of the immune system allows life-threatening opportunistic

infections and cancers to thrive

STEP 3: Signs and Symptoms of HIV/AIDS (10 minutes)

|Activity: Buzzing (5 minutes) |

| |

|ASK students to pair up and buzz on the following question for 2 |

|minutes |

| |

|What are the signs and symptoms of HIV/AIDS? |

| |

|ALLOW few pairs to respond and let other pairs to add on points not |

|mentioned |

| |

|WRITE their response on the flip chart/board |

| |

|CLARIFY and SUMMARIZE by using the content below |

• HIV is associated with three presentations;

o Asymptomatic infection

o Acute infection with symptoms

▪ May include fever, sweats, myalgia or arthralgia, sore

throat, lymphadenopathy, nausea, vomiting, diarrhea, persistent

headaches, rash and generalized pruritus

o Acquired immune deficiency syndrome (AIDS)

▪ Characterized by progressive immune deficiency accompanied by

a wide range of opportunistic infections, neoplasms, and

neurologic abnormalities, including progressive dementia and

peripheral neuropathy.

• Most patients, however, present with symptoms due to opportunistic

infections e.g. tuberculosis, candidiasis or pyogenic infections.

STEP 4: Treatment, Prevention and Control of HIV/AIDS (20 minutes)

• Treatment of HIV/AIDS involves use of antiretroviral drugs

• Classes of retroviral drugs used in Tanzania are;

o Nucleotide/Nucleoside reverse transcriptase inhibitors (NRTIs)

▪ Zidovudine (AZT)

▪ Tenofovir (TDF)

▪ Abacavir (ABC)

▪ Lamivudine (3TC)

▪ Emtricitabine (FTC)

▪ Didanosine (DDI)

o Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

▪ Etravirine

▪ Efavirenz

▪ Nevirapine

▪ Etravirine

▪ Delavirdine

o Protease inhibitors (Pls)

▪ Atazanavir

▪ Ritonavir (booster)

▪ Lopinavir

▪ Darunavir

o Integrase strand transfer inhibitors (INSTI)/ Integrase inhibitors

▪ Dolutegravir (DTG)

▪ Raltegravir

o Fusion inhibitors

▪ Enfuvirtide

o Chemokine receptor inhibitors/CCR5 inhibitors

▪ Maraviroc

|Activity: Take home Assignment (10 minutes) |

| |

|DIVIDE students in groups or individual. |

| |

|ASK the students to work on the following assignment |

| |

|What are the regimes (including drug name, dose and dose schedule) |

|of antiretroviral drugs used; |

|In treatment of adults and adolescents without tuberculosis |

|In treatment of adults and adolescents with tuberculosis |

|In pregnancy |

|Drug abusers |

|For post-exposure prophylaxis of medical staff |

|For prevention of mother-to-child transmission |

|In prophylaxis of babies born from infected mothers |

| |

|ALLOCATE time for students to do the assignment and submit |

| |

|REFER students to recommended references |

• Prevention and control of HIV/AIDS

o Safe sex practices e.g. use of condoms

o Post exposure prophylaxis for people at risk e.g. medical staff

o Prevention of mother-to-child transmission

o Avoid sharing skin piercing instruments e.g. needles

o Avoid drug abuse

STEP 5: Key Points (5 minutes)

• HIV is the virus that cause AIDS

• A person may have HIV but not AIDS

• AIDS occur when the body’s immune system is weakened by the virus so

that the body cannot defend against infectious pathogens.

• Treatment of HIV/AIDS involves the use of antiretroviral drugs which

lower viral load and improve the immunity and quality of life in

HIV/AIDS patients

• Prevention of HIV transmission involves wide aspects of behavioural

changes, post exposure prophylaxis and prevention of mother-to-child

transmission

STEP 5: Evaluation (5 minutes)

• What is the difference between HIV and AIDS?

• How is HIV transmitted?

• What are the classes of medications used for treatment of HIV/AIDS?

References

Hugo and Russell (2011), Pharmaceutical Microbiology 8th Edition, Willey-

Blackwel publications

Karen C. Carroll et al (2013); Jawetz, Melnick and Adelberg’s Medical

Microbiology 26th Ed. McGraw Hill Co. Inc.

Greenwood et al (2012); Medical Microbiology, 18th edition Churchill

Livingstone

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