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Some statistical facts: Till Year 2000 HIV was first identified in 1983. Virus may have entered the US in late 70s. Data from Centre for Disease Control and Prevention shows that 774,467 cases of AIDS and 448,060 deaths of AIDS patients by the end of yr. 2000. Approximately 40,000 new HIV infection per year. World wide: 36.1 million people living with AIDS by the end of year 2000. 21.8 million adults and 4.3 million children fell victim to HIV/AIDS associated death. 5.3 million new cases and 3 million deaths occurred in yr 2000. 2008 statistical figures (Global) http://www.avert.org/worldstats.htm Estimate Range People living with HIV/AIDS in 2008 33.4 million 31.1-35.8 million Adults living with HIV/AIDS in 2008 31.3 million 29.2-33.7 million Women living with HIV/AIDS in 2008 15.7 million 14.2-17.2 million Children living with HIV/AIDS in 2008 2.1 million 1.2-2.9 million People newly infected with HIV in 2008 2.7 million 2.4-3.0 million Children newly infected with 0.43 million HIV in 2008 0.24-0.61 million AIDS deaths in 2008 2.0 million 1.7-2.4 million Child AIDS deaths in 2008 0.28 million 0.15-0.41 million USA stat for AIDS People living with AIDS At the end of 2007, the CDC estimates that 468,578 people were living with AIDS in America, around 20,000 more than 2006. 571,378 people living with HIV/AIDS in the 39 states and dependent areas. However, the total number of people living in the USA with HIV/AIDS is thought to be around 1.1 million3 Canadian Stat for HIV infection and AIDS AIDS cases in adults (15 or over) by exposure category Positive HIV test reports in adults (15 or over) by exposure category Male Male Exposure category 2007 Female Female Cumulative total until end December 2007 2007 Cumulative total until end December 2007 Exposure Category Cumulative total until end December 2007 2007 Cumulative total until end 2007 December 2007 31 13,295 - - Men who have sex with men (MSM) 514 17,967 - - Men who have sex with men (MSM) MSM and injection drug use 20 738 - - MSM and injection drug use 0 829 - - Injection drug use 156 3,700 1,824 Injection drug use 28 1,178 7 432 0 460 0 140 105 Blood/blood 5 products 610 3 207 Blood/bloo d products Heterosexu al contact 120 3,067 167 2,620 Heterosexu 23 al contact 1,780 9 1,147 Other 53 17 247 Other 0 16 1 4 46 529 No identified risk 24 932 2 106 4,697 Risk not reported 84 932 26 100 10,124 Total 190 18,816 45 1,929 No identified risk 84 718 2,459 Risk not reported 749 19,969 Total 1,782 49,228 254 592 Estimated number of people living with HIV/AIDS, 2007 Indian stat People living with HIV/AIDS 2.31 million Adult (15 years or above) HIV prevalence 0.34% Across India HIV prevalence appears to be low among the general population, but disproportionately high among high-risk groups, such as IDUs, female sex workers, men who have sex with men (MSM) and STD clinic attendees. The average HIV prevalence among women attending antenatal clinics in India is 0.48%. Much higher rates are found among people attending STD clinics (3.6%), female sex workers (5.1%), injecting drug users (7.2%) and men who have sex with men (7.4%). As the table below shows, the rates among different groups vary widely between states. Structure of a generic retrovirus. The basic structure of Human Immunodeficiency Virus-1, a retrovirus. Structure of HIV Stages of Retrovirus Reproduction Replication of HIV-1 HIV Binding via Cell Surface Receptors Enzyme Targets of New Anti-HIV Treatments Major HIV-1 enzymes against which new drug therapies have been targeted. Presentation of Antigen to T Cells through MHC Class II Molecules of HIV AIDS Deaths in the United States from January 1986 to June 1998 Drugs Approved for HIV Infection Nucleoside/Nucleotide Non-nucleoside RT Inhibitors RT Inhibitors •abacavir •delavirdine •ddC •nevirapine •ddI •efavirenz •d4T zidovudine (AZT), •3TC •ZDV •tenofovir nucleoside RT inhibitors: zalcitabine (ddC), didanosine (ddI), stavudine (D4T), and lamivudine (3TC) Protease Inhibitors •ritonavir •saquinavir •indinavir •amprenavir •nelfinavir •lopinavir The groups of antiretroviral drugs There are five groups of antiretroviral drugs. Each of these groups attacks HIV in a different way. Antiretroviral drug class Nucleoside/Nucleotide Reverse Transcriptase Inhibitors Abbreviations NRTIs, nucleoside analogues, nukes NNRTIs, Non-Nucleoside Reverse non-nucleosides, Transcriptase Inhibitors non-nukes Protease Inhibitors Fusion or Entry Inhibitors Integrase Inhibitors PIs First approved to treat HIV 1987 1997 1995 How they attack HIV NRTIs interfere with the action of an HIV protein called reverse transcriptase, which the virus needs to make new copies of itself. NNRTIs also stop HIV from replicating within cells by inhibiting the reverse transcriptase protein. PIs inhibit protease, which is another protein involved in the HIV replication process. 2003 Fusion or entry inhibitors prevent HIV from binding to or entering human immune cells. 2007 Integrase inhibitors interfere with the integrase enzyme, which HIV needs to insert its genetic material into human cells. Side effects of AIDS therapeutics Metabolic changes are occurring in people with chronic HIV infection. One of these changes causes HIV-associated lipodystrophy syndrome (HIV-LS). This condition results in abnormal fat distribution and cholesterol and glucose abnormalities. Gender and HIV infection itself can influence cell metabolism, making it difficult to distinguish adverse drug effects from the natural progression of the disease. Some anti-HIV drugs are toxic to mitochondria. Tissues that require high levels of energy, like muscles and nerves, are most susceptible to the affects of damaged mitochondria. A decrease in the mitochondrial energy supply can result in muscle wasting, heart failure, peripheral nerve damage causing numbness and pain. Other symptoms include low blood cell counts, swelling and fatty degeneration of the liver, and inflammation of the pancreas. Other more general signs include fatigue, depression, and high lactic acid levels in the blood. Cutting edge developments in AIDS therapeutics •New protease inhibitors and more potent, less toxic RT inhibitors. •Fusion inhibitors -- drugs that interfere with HIV's ability to enter a cell •Integrase inhibitors -- drugs that interfere with HIV's ability to insert its genes into a cell's normal DNA. •Therapeutic vaccines are also being evaluated for this purpose and could help reduce the number of anti-HIV drugs needed or the duration of treatment. •Therapeutic immune boosters •Lysozyme and RNase therapy http://www.iavi.org/Lists/IAVIPublications/attachments/9ba3a2c4-2232-48c5-a08e5532cb32b836/IAVI_Sankalp_December_2009_ENG.pdf November 16, 2009 | Renewed Hope for an AIDS Vaccine Despite questions, the Thailand trial spreads optimism