infeção por hiv-1

7/24/2019 Infeo Por HIV-1

1/31

INFEO POR HIV-1VS. HIV-2Unidade Curricular:Virologiaur!a "

Fili#a Oli$eira%Ri&a S' (i!a


2/31

+ ,e*coer&a de u! no$o$ru*

No&cia ada#&ada de )&://ne0*.c.co.u/2/)i/)eal&)/113452.*&! - acedido e! 13.43.241
http://news.bbc.co.uk/2/hi/health/1154082.stmhttp://news.bbc.co.uk/2/hi/health/1154082.stmhttp://news.bbc.co.uk/2/hi/health/1154082.stmhttp://news.bbc.co.uk/2/hi/health/1154082.stm


3/31

HIV &i!eline


4/31

+da#&ado de: )&://000.unaid*.org/*i&e*/de6aul&/7le*/!edia8a**e&/UN+I,S89a#8r
http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdfhttp://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdfhttp://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdfhttp://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdfhttp://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdf


5/31

Cla**i7ca;o

Fa!lia: Retroviridae

9i#o 1 e i#o 2?

HIV-1 e HIV-2 co! 4@ de )o!ologia genA!ica

&://#&.0ii#edia.org/0ii/V@CB@+,ru*8da8i!unode7ci=ncia8)u!ana- acedido e! 2B.43.241
http://pt.wikipedia.org/wiki/V%C3%ADrus_da_imunodefici%C3%AAncia_humanahttp://pt.wikipedia.org/wiki/V%C3%ADrus_da_imunodefici%C3%AAncia_humanahttp://pt.wikipedia.org/wiki/V%C3%ADrus_da_imunodefici%C3%AAncia_humanahttp://pt.wikipedia.org/wiki/V%C3%ADrus_da_imunodefici%C3%AAncia_humana


6/31

Orige! HIV-1

V'ria* e*#c)i!#an


7/31

Orige! HIV-2

Gaior *e!el)ana co! oSIV* >*oo&L !angaeL*? gru#o* + a I. 1

Cercocebus a

age! re&irada* de 9oogle.co! Pee&er* G. et al. J Origin and Diversity of Human Retro


8/31

,i*&riui;o 9eogr'7ca

O gru#o G do HIV1 < o Mnico co! di*&riui;o MUNDIAL.

E

O

Pee&er* G. et al. J Origin and Diversity of Human Retro


9/31

,i*&riui;o 9eogr'7ca

+da#&ado de: )&://000.a$er&.org/euro#ean-)i$-aid*-*&a&i*&ic
http://www.avert.org/european-hiv-aids-statistics.htmhttp://www.avert.org/european-hiv-aids-statistics.htmhttp://www.avert.org/european-hiv-aids-statistics.htmhttp://www.avert.org/european-hiv-aids-statistics.htmhttp://www.avert.org/european-hiv-aids-statistics.htm


10/31

Pre$al=ncia

Valore* 244" >1-3 ano*?

Pa*e* co!)i*&Aria colonial:Frana e Por&ugal

9uerra ci$il e!igra;o

i!#ac&o na#ro#aga;o doHIV 2

a&ada de: )&://000.n)*)i*&orL.ne&/aid*da&a.#d6- acedido e! 2".43.241er Q. et al.; British H! "ssociation guidelines for antirretroviral teatment of H!#$#%ositive individualsJ P'g.

K11-K1J +ugu*& 2414
http://www.nhshistory.net/aidsdata.pdfhttp://www.nhshistory.net/aidsdata.pdfhttp://www.nhshistory.net/aidsdata.pdfhttp://www.nhshistory.net/aidsdata.pdfhttp://www.nhshistory.net/aidsdata.pdf


11/31

Gor6ologia HIV-1

Protenas do envelope SU g#124G g#31Outras protenas estruturaisG+ #1" C+ #23NC #"Enzimas: P #11 R/RNa*eH #KK/#1 IN #B2

Vru* en$elo#adoD e*6


12/31

9eno!a HIV-1Re&ro$ru* co!#leo:

gagD #olD en$ K gene* ace**Ario*ou reguladore*

& al.J HIV-1 en$elo#e glLco#ro&ein *&ruc&ure. Curr O#in S&ruc& iol. 241B +#ril J Page* 2K52"K


13/31

Diferenas EstruturaisI!"# !s I!"$

A %li&oprotena 'U ( &onstituida p+ipervaraveis, !# a !), rodeadas &onstantes, -# a -)U! e*&udo de co!#ara;o de*&a* regie* de!on*&rou ue:

HIV-1 gene&ica!en&e !ai* di$er*o na* CB

+o con&r'rio do ue ocorre #ara o HIV-1e! C2 e CB &e! u! e6ei&o nega&i$o na ana *ua &ran*!i**;o

arro*o H. et al.J &volutionary and 'tructural (eatures of the C$) !* and C* &nvelo%e Regions +nderlying the Di,erences in HnfectionJ Volu!e KD I**ue 1D Page* 1-12 QanuarL 2411


14/31

O loo# VB e*&' We*condidoX no HIV-2D enuan&o ue no HIV-e*&' e! e#o*&oD ou *eYaD e*&a regi;o n;o < i!unodo!inaHIV-2 #acien&e* n;o #rodue! an&i-cor#o* con&ra e*&a !a* *i! con&ra ou&ra* regie* >C2D V1D V2D V3 e C?D &orna#rodu;o de an&icor#o* !ai* e6e&i$a.

Estes fa&tores epli&am as diferenas na evolu/o &linna transmiss/o dos dois tipos de vrus, sendo 0ue o

evolui mais lentamente e transmite"se de forma mee1&az.

arro*o H. et al.J &volutionary and 'tructural (eatures of the C$) !* and C* &nvelo%e Regions +nderlying the Di,erencand nfectionJ QanuarL 2411D Volu!e KD I**ue 1


15/31

Gani6e*&ae* e E$olu;oClnica

+* di6erena* en&re a HIV-1 e HIV-2 *;o #ouco *igni7ca&i$a*D ndi re*#ei&o Z* !ani6e*&ae* clnica* e! doen&e* co! HIV

uando co!#arada* co! a* de doen&e* co! HIV-1.

Ndour G. et al.J"D' caused by H!- and H!$ infection are there clinical di,erences/Results of "D' surveillance -012#03 at (ann Hos%ital in Da4ar) 'enegalJ ro#icalGedicine and In&erna&ional Heal&)D Oc&oerD 2444D Vol. D n[ 14D ##. K5"-K1.


16/31

Re#lica;o $iral

#.Adsor/o e penetra/o

Rece&ore* de ci&ocina*: CCR !acrA6ago* e

!onAci&o*D c2444? I!!unological Re$ie0*.


17/31

Re#lica;o $iral

$.2epli&a/o do %enoma viral

Co!#leo #rCPI?

! RN+ >$iral e celular?

In&egra;o do ,N+ #ro$iral no geno!acelular

ran*#or&ado a&< ao nMcleo

Eni!a* celulare*

INEni!a*

celulare*

3. Monta%em, li4erta/o e matura/o; Co#rece%tor use by H! and inhibition of H! infection by chemo4ine rece%tor ligands. >2444? I!!unological Re$ie0*.


18/31

ran*!i**;o HIV-2 < !eno* in6ecio*a

HIV-2

+ &ran*!i**;o ocorre &al

!a* de u!a 6or!a a#ena* #or con&ac&o ]udo* co! #e**oa*end

!ias: He&ero**eual Ver&ical a**ociada a

in6e;o #ri!'ria #or HIV 2duran&e a gra$ide

ran*6u*;o de *angue Ho!o**eual

Pee&er* G. et al. J Origin and Diversity of Human Retro


19/31

Virul=ncia

HIV-2 < !eno* in6eccio*o ue HIV-1 e &e! u!a localia!ai* re*&ri&aD #or&an&oD a !aioria do* ca*o* de$er' ea**ociado ao HIV-1 >gru#o G?.H1I

56 MIL7E' DE-A'O' EM

8ODO O MUNDO

Pee&er* G. et al. J Origin and Diversity of Human RetrovirusesJ +I,S Re$ie0*D Vol.1KD Page* 2B-B3D 2413


20/31

In6e;o ,u#laIn6e;o #or HIV2 n;o #ro&ege con&ra in6e;o #or HIV1

E*&udo* no E*&e de 6rica in6e;o du#la !ai* co!u! e!!ul)ere* ido*a*

Pre$al=ncia: 4DB-1D4@ >E*&e de 6rica?

Sinergia en&reo* doi* $ru*re*ul&a nu!

agra$a!en&oda in6e;o^

Gecaninii&Arre*#oi!u

a&enucur*oin6e

Sil$aD IJ et al. >2414? Dual infection 5ith H!#- and H!#$ Double 6rouble ou Destructive nerference/
http://www.medscape.com/viewarticle/723256


21/31

Imunoensaios 9tria%em

1[ 9era;o ,e&ec&a a#ena* Ig9. QI grande a&< 2 !e*e*. Pe e*#ec7co*. Eli*a indirec&o

2[ 9era;o Eli*a indirec&oD de&e&a algun* an&igIgGD Ig9D Ig+D Igdia*.

3[ 9era;o ,e&e&a o +9 #23 e &oda* a* Ig* an&i-HIV. QI de 18estes r;pidos

I!unocro!a&ogra7aD I!unoconcen&ra;o Varia! c/ 6arican&e. Re*ul&ad+$alia! HIV 1 e 2. QI a&< B !e

Ensaios &omplementares

_e*&ern lo&D I!uno lo&.. ,e*#i*&e de 6al*o* #o*i&i$o*.

>n;o de&e&a! IgG e #23?. Cu*

Dete/o direta do I!

Pe*ui*a de co!#onen&e* do $irM* P23D RN+D ,N+ #ro-$iral.

IPOS ,E ESE


22/31

e*&e* R'#ido* ca*o de e*&udo

8estes a

9enie II

I!!unoHIV2

S, ioli-ontrolo: INNO-(I+ HIV `

O4


23/31

=enie IIIHIV-1/HIV-2Immuno>o?

HIV1-HIV2 'D @iolineHIV-1/2 B.4

HongeD . et al; Performance of * ra%id tests for discrimination bet5een H!#- and H!#$ in Guinea#Bissau) 7est "frica;Qourna,e7ciencL SLndro!e*D Vol. KD Nu!er 1D Page* 5" 4D QanuarL 2413.


24/31

PREVENO

=uidelines

UNI-EPreven/

o I!

Progra!a*de +gul)a*e Seringa*

Circ!a*

U*ocorrec&o erecorren&e

do#er*e$a&i$o!a*culino

U*o do *eu#rA#rio!a&erial

inYec&'$el Educa;o*ani&'ria

+con*eln&o e &e*$olun&'r

con7den.

&ran*!i**;o #elo*angue

+co!#an)a!en&o dege*&an&e*de ri*co

)&://000.unice6.org/#re*crier/#or&8
http://www.unicef.org/prescriber/port_p16.pdfhttp://www.unicef.org/prescriber/port_p16.pdf


25/31

PRO9R+G+ N+CION+( ,E PREVENO E CONRO(O,+ INFECO VIH E SI,+ $6##"$6#)

)&://000.!in-*aude.#&/NR/rdonlLre*/3"CCCE-F1C,-32C3-51C-2,3K32,K+/4/PRO9R+G+8N+CION+(82411241.#d
http://www.min-saude.pt/NR/rdonlyres/479CC5CE-F1CD-42C4-81CB-92D4642D695A/0/PROGRAMA_NACIONAL_20112015.pdfhttp://www.min-saude.pt/NR/rdonlyres/479CC5CE-F1CD-42C4-81CB-92D4642D695A/0/PROGRAMA_NACIONAL_20112015.pdfhttp://www.min-saude.pt/NR/rdonlyres/479CC5CE-F1CD-42C4-81CB-92D4642D695A/0/PROGRAMA_NACIONAL_20112015.pdfhttp://www.min-saude.pt/NR/rdonlyres/479CC5CE-F1CD-42C4-81CB-92D4642D695A/0/PROGRAMA_NACIONAL_20112015.pdf


26/31

era#=u&ica +n&i-Re&ro$iral HIV-1

Ini4idores da trans&riptase reversa+n'logo* do* NucleA*ido* >id

N;o an'logo* do* nucleA*ido* ,ela$irdina?

Ini4idores da protease viral Sauina$irD Ri&ona$irD i#rana$

,aruna$ir

Ini4idor da entrada na &(lula+ospedeira

Iniidore* da 6u*;o >En6u$ir&ide

+n&agoni*&a do co-rece&or CCR

Ini4idor da inte%rase Ral&egra$ir

2 NR

2NRI*


27/31

ra&a!en&o HIV-2

Perodo de la&=ncia a**in&o!'&ico 1

,e#le;o de lin6Aci&o* C,3 !ai*Genor carga $iral

Pode le$ar a SI,+ clnica e !or&e

E*&udo* e! #a*e* de*en$ol$ido* re*#o*&a #ore ao &ra&a!en&o e! HIV-2

reuer Q. et al.; British H! "ssociation guidelines for antirretroviral teatment of H!#$#%ositive in


28/31

E*&udo* IN VIRO

N28Is

+&i$o* con&ra HIV-2

G+S: #oli!or7*!o da &ran*crido$udine < nece**'rio e! c!ai* ele$ada*

Gu&a;o G153V e b11G encindi$duo* no urina Fa*o na&ural ou re*i*&=ncia*

PIs

+&i$o* con&ra HIV-2

G+S: #oli!or7*!o da #ro&ea

(o#ina$irD *auina$irD &i#rana!ai* #o&en&e*

NN28Is e Enfuvirtide 9ini4idor da fus/o NO de$e! *er u*ado*

Anta%onistas do --2) Po&=ncia inde&er!inada HIV$'rio* co-rece&ore* >C\CR3D CCa!#ell-e*u6uD OJ et al.; +%date on Human mmunode8ciency !irus 9H!:#$J Clinical In6e


29/31

E! #acien&e* co!de$e *er con*iderano en&an&oD de$e-ao con*iderar ualu&iliar e! #acien

#ara asse%ura&ontra am4os

reduzir o rdesenvolvim

resistBn

buando iniciar o&ra&a!en&o^

,e$e *er con&age! de

e*&ado

HIV-2

Carga$iral

indica#rogre**

;o dain6e;o

ra&a!en&oinicia-*e

!ai* cedodo ue e!indi$duo*co! HIV-1>C,3 B4-

44c


30/31

Co! o ue iniciar o&ra&a!en&o^

OM' B NRI*Re*#o*&a in6erior da* C,3

Co!ina;o de claGoni&oriar carga

2 NRI*PI*

Pro$ada e7c'cia co! K4@ dere*#o*&a

reuer Q. et al.; British H! "ssociation guidelines for antirretroviral teatment of H!#$#%ositive individualsJ +go*&o 2414J P'g. K


31/31

CONC(US+O^

infeção por hiv-1

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