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Printable Handouts
Navigable Slide Index
- Introduction
- Learning from patients (1)
- Evaluation
- The beginning of an epidemic
- Clues from patients (1)
- Case definition of AIDS 1982
- White blood cells
- Lymphocyte subsets
- CD4 T cells and AIDS
- Discoverers of HIV
- Clues from patients (2)
- Lymphatic system
- Lymph node
- 1983: Isolation of a retrovirus from a lymph node
- Evidence that HIV causes AIDS (1)
- Evidence that HIV causes AIDS (2)
- Evidence that HIV causes AIDS (3)
- HIV: a retrovirus
- What is a retrovirus?
- Viruses infect host cells
- Virus (HIV) vs bacteria (E. coli)
- How does something so small wreak such havoc?
- HIV is an infection of the human immune system
- Progressive loss of CD4+ T cells
- Endoscopic and histological GI tract examination
- Learning from patients (2)
- Discovery of CCR5 as a co-receptor for HIV entry
- Ability to measure the amount of virus in blood
- Viral set point at 1 yr predicts disease progression
- Development of AIDS is like a train wreck
- HIV life cycle
- Why are outcomes different? (1)
- Why are outcomes different? (2)
- Viral factors: replication capacity
- Subtype distribution of collected HIV-1 sequences
- Why are outcomes different? (3)
- Differences in host genetics
- Why are outcomes different? (4)
Topics Covered
- Original description of AIDS
- Identification of HIV as a causative agent
- Evidence that HIV causes AIDS
- Molecular mechanisms of HIV infection
Links
Series:
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Therapeutic Areas:
Talk Citation
Walker, B. (2019, August 29). How HIV causes disease 1: identification and characterization of HIV [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 14, 2024, from https://doi.org/10.69645/WXKF9977.Export Citation (RIS)
Publication History
Financial Disclosures
- There are no commercial/financial matters to disclose
How HIV causes disease 1: identification and characterization of HIV
Published on August 29, 2019
35 min
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:00
My name is Bruce Walker; I'm a professor of medicine at Harvard Medical School and
at Massachusetts Institute of Technology and
the director of the Ragon Institute of MGH, MIT, and Harvard.
I'm a physician-scientist and have been
involved in caring for patients since the very beginning in the epidemic
and involved in doing research, also, to
learn from those patients ever since I finished medical school.
0:32
I want to start this talk by connecting it back to the patients that were really
the harbinger of what was to become the global HIV epidemic.
This is really my own personal experience.
My first experience with this disease was when
I was working in the emergency room at Mass General Hospital.
A 19-year-old man was transferred in from
a chronic care hospital where he was being cared for tuberculosis.
He had profound weight loss, had been diagnosed
by detection of tuberculosis in the sputum, and was on therapy
at this chronic care hospital when he had
an acute change in mental status leading them to
the presumptive diagnosis that this was
probably pulmonary tuberculosis with TB meningitis.
1:22
When the patient arrived in the emergency room I began to work him up and
as the data started coming back we were really quite shocked.
It turned out that he didn't have tuberculosis at the brain as we had expected.
But, rather, he had a mass lesion which results mainly shown to be lymphoma which was
very rare occurrence unless somebody was on profound immunosuppression.
Moreover, as we investigated his lungs,
he didn't have tuberculosis but he had multiple tumors as well as pneumonia.
The tumors ended up being caused by Kaposi's sarcoma.
Now, to me, this was really something unusual.
I had a few months earlier seen a patient who had
Kaposi's sarcoma and was told by the physician in charge of the ward where I
was working that Kaposi sarcoma was typically seen in men of
Mediterranean descent and was usually a skin lesion.
But, here, it was in a young man not of Mediterranean origin and it was in his lungs.
Moreover, pneumocystis was something that had really only been encountered in the context
of cancer chemotherapy to my knowledge and here it was in this young man.
As we further worked up his abdomen he didn't have tuberculosis there either, but had
multiple tumors that were also Kaposi's sarcolemma and
he had disseminated CMV infection of the colon.
So, essentially, cancers and
infectious diseases, all the same time, a life-threatening and they rapidly die.