Mount St.

Joseph University

Glankler

School of Health Sciences

Nursing
Program
Physiology & Pathophysiology of HIV
1. Body fights HIV with lymphocytes
2. Lymphocytes consist of 3 major populations
a. T cells (consist of CD4+ {2/3 peripheral blood T cells} & CD8 {1/3 peripheral blood
T cells})
i. Activated T cells mount cellular immune response to viruses trapped in lymph
nodes
b. B cells
i. Make HIV specific antibodies & help decrease viral loads
c. Natural killer cells
d. These cells play vital role in normal immune system function
3. HIV is a retrovirus (carries genetic information on RNA) & cannot replicate unless it is
inside a living cell. The HIV life cycle is complex.
a. RNA retrovirus proteins bind to specific CD4 & chemokine receptor sites where it
enters the cell
b. The enzyme reverse transcriptase assists to make single viral DNA from RNA; the
DNA then copies itself to make double stranded viral DNA
i. Virus splices itself with the aid of the enzyme integrase into genome to
become part of the cells genetic structure
1. All daughter cells are also infected
2. Genetic codes can direct the cell to make HIV
3. The enzyme protease helps to produce the correct length RNA strands
during the budding process to aid in replication
ii. HIV is sloppy when makes copies of itself, therefore, new copies are
mutants of original; some mutants can multiply easily even though taking
drugs that stop normal HIV
1. Virus may remain inactive in infected cells for years; however,
antibodies are produced against the virus proteins
c. CD4 cells that are infected include
i. Lymphocytes, monocytes/macrophages, astrocytes, and oligodendrocytes
because HIV has the capability to infect human cells w/ CD4+ receptors on
their surfaces.
d. HIV causes immune dysfunction by destroying CD4+ T cells (T helper cells/CD4+ T
lymphocytes)
e. HIV invades CD4 cells & destroys them through three processes:
i. Viral replication leaves holes in cell membranes (HIV uses CD4 immune cells
genetic material to reproduce itself then kills the CD4 T cells)
ii. Infected cells fuse with other cells (Combine to form a syncytium that
destroys all affected cells)
iii. Antibodies against HIV bind to the infected cells and activate the complement
system, which destroy the infected cells
4. The normal lifespan of a CD4+ cell is approximately 100 days
a. The lifespan of a CD4+ cell infected with HIV is approximately 2 days
b. HIV destroys about 1 billion CD4+ T cells every day but body can replace enough for
many years; eventually the ability of HIV to destroy the CD4+ cells exceeds the
bodys ability to replace them

i. Immune problems start when CD4+T cell counts drop below 500 cells/l
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