HIV infection ACT I

Scene: There is a room filled with 50 students, 1 teacher, and 1 puppet. 6

students and the puppet go to the front of the room in front of these prying
eyes to speak on HIV. The puppet will be the star of the show. There is a
table in the front of the room. Melissa sits in the chair behind the table and
props the puppet on top the table while she puts a small box where no one
can see it. This starts the beginning of the Act.
Nadia: Hello, my name is Nadia.
Kevin: I am Kevin
Katelynn: I am Katie
Ciera: I am Ciera
Elizabeth: I am Elizabeth
Koshy: I am Koshy
Melissa: I am Melissa {changes voice}
Saucey: I am Saucey
Elizabeth: And we are here to talk a little bit on HIV and Hepatitis as well as
describe a new program that would be beneficial to young teens in educating
them on these diseases. To start off, I will introduce you to our guest of
honor.
Saucey: Hello, my name is Saucey and I have HIV which stands for Human
Immunodeficiency Virus. Im part human.
Elizabeth: [To classroom] Ok everyone say hello to Saucey!
Entire group: Hello Saucey!
Saucey: Hello, thanks for having me.
Nadia: HIV has been becoming a major concern in the United States and
abroad and we hear more about it every year. In fact, there are
approximately 50,000 new cases of HIV each year. This makes the
population vulnerable because it is still such a high number and 12.8 million
people have this disease . This provides opportunites for even more people
to contract this disease. As a result we need more programs to educate
children, teenagers, and even adults on the risks of contracting this virus.

Worldwide, 38 million people live with HIV infection and 2/3 of those people
live in Sub-Saharan Africa. Since the epidemic began, approximately 1.1
million people in the US have been diagnosed with AIDS and nearly 619,000
died from it.
Saucey: The largest number of new HIV infections in 2010 were 11,200
white males who had sex with other men followed by 10,600 black men
having sex with other men. Heterosexuals accounted for 25% of the
estimated new cases in 2010 and 27% of the people living with HIV infection
in 2009. Infections in women are primarily due to heterosexual contact or
injection drug use. IN 2010, women accounted for 20% of new HIV infections
and in 2009 for 24% of the people living with HIV infection.
Elizabeth: Enough with all these facts.. omgggg.
Melissa: Injection drug users represented 8% of new cases in 2010 and 16%
of the people in 2009. African Americans experience the most severe burden
of HIV in that they represent 12% of the US population and an estimated
44% of new cases in 2010. Hispanic/Latinos represented 16% of the
population in 2010 and 20% of new cases. Although persons over 50 years
of age continue to represent a relatively small proportion of new infections,
those who have unprotected sex, consume alcohol, or inject drugs are at
higher risk for contracting HIV/AIDS than younger people with the same
lifestyle characteristics.
Saucey: The geographic distribution of HIV infections is more concentrated
in urban areas like Sesame Street or even Houston. According to Aids.gov,
this prevalence has remained at a steady rate for the past few years at
50,000 new infections each year. The makes the population vulnerable
because it is still such a high number and approximately 12.8 of these
people, as young as 13, are not even aware they have HIV. This provides
oppurtunities for even more people to get infected each year.
Katie: So Saucey do you know how people can get HIV?
Saucey: Sure. HIV is contracted in four ways: Contaminated blood
transfusion (which doesnt happen very often in the U.S. because of
screening), Shared injection drug use, Mothers can even pass the virus onto
their newborns as well as through breastmilk, and unfortunately, I got it
through unprotected sex with Elmo. [Puts her hands in the air] Who knew he
had so many partners?

Katie: HIV usually includes three stages: The primary infection which usually
occurs within 1 month of contracting the virus, clinical latency which is a
period of time with no obvious symptoms, and the final stage of symptomatic
disease. In the begininning stages, a person can have such signs or
symptoms such as fever [Saucey puts her hand to her forehead], fatigue
[Saucey bends over on table], myalgias [Saucey crosses her arms and goes
OOOoooooo], sore throat [Saucey puts her hands to her throat], night
sweats [Saucey shivers], maculopapular rash [Saucey says, You cant see
mine because of my long hair], and headache [Saucey puts both hands on
sides of head and goes OOoooooo]. HIV is a retrovirus that selectively
attacks the CD4 T lymphocytes which are the immune cells responsible for
orchestrating and coordinating the immune response to infections. As a
consequence, persons with this infection hae a deteriorating immune system
and thus is more susceptible to severe infections from ordinary organisms.
Ciera: Now with the help of Saucey, we will teach you a little more.
[Elizabeth hands her the virus model from behind Sauceys back]. HIV is
spherical and contains an electron dense core surrounded by a lipid envelope
and the core contains a capsid or outer shell made up of a protein called p24
and it uses RNA, instead of DNA, to replicate itself into the host cell. It does
this in eight steps. Now Saucey is going to allow me to take two healthy
human cells from her body which of course have been enlarged for viewing
purposes. [Elizabeth hands her two clear balls from behind Saucey]. These
are healthy CD4 T cells which fight off infections in your body [holds up the
balls for everyone to see and puts one of them away and keeps the other
one]. The first step involves the binding of the virus to this cell which is
called attachment [attaches virus to ball]. When it does this, it binds with
other surface molecules called chemokine coreceptors. The second step
involves the internalization of the virus. After attachment, the viral envelope
peptides fuse to the CD4 cell membrane which uncoats the cell so the viruss
contents can enter the host cell. [Takes virus off ball and puts ball away].
Step three consists of DNA synthesis. To reproduce, the virus much change
its RNA into DNA using reverse transcrptase enzyme [takes thread out of
virus while talking about RNA]. This enzyme makes a copy of the viral RNA,
and then in reverse makes a complementary DNA strand that will carry
instructions for viral replication. The fourth step is called integration. The
cDNA enters the nucleus and is inserted into the cells original DNA.
Koshy: The fifth step involves transcription of the double-stranded viral DNA
to form a single stranded messenger RNA with the instructions for building
new viruses. The sixth step includes translation of the viral mRNA.

Ribosomal RNA using the instruction from the mRNA to form polyproteins
which are essential in the construction of new viruses. The seventh step is
called cleavage. During cleavage, the protease enzyme cuts the polyprotein
chain into the individual proteins that will make up new viruses. Finally,
during the eighth step, the core proteins migrate to the cell membrane,
where they acquire a lipid envelope that buds off from the cell membrane.
[Elizabeth hands Koshy the virus balls from behind Saucey]. Productive
infections, associated with extensive viral budding lead to cell death and
these HIV viruses [holds balls for all to see] are ready for to dominate. As
time goes on the HIV cells replicate exponentionally and kills off the CD4
cells.
Saucey: Once the CD4 count becomes less than 200 cell/uL or less than
14%, the infected person officially has AIDS which stands for Acquired
ImmunoDeficiency Syndrome. There is still hope however. There are
medications constantly being developed that help fight off the virus. New
technologies and research have invented new medicines to make life easier
with the virus; however, they are usually not a cure and may come with side
effects like everything else. There is still hope though and infected people
need to know that life can be easier if they seek out help and support
through family and organizations.
Nadia: Now since that is over with, we are now going to talk about our pro
Saucey: [raises hand and interrupts Nadia] Hey hey I have something else
to say.
Nadia: What is that?
Saucey: I also have Hepatitis [lowers head]
Nadia: Well I guess we are going to talk about Hepatitis now! So Saucey,
what kind of information you have for us?
Saucey: Well hepatitis can easily be caught by different people especially
healthcare workers. Viral hepatitis is a group of infections that primarily
affect the liver and there are several different forms of it along with its
unique causes and characteristics. It can make a population vulnerable
because most of the time, people are not even aware they have the virus
and can pass it on to other people.
Nadia: The first form is Hepatitis A which is a benign infection and thanks to
the vaccination for hepatitis A, it is rarely seen in the U.S. today. It is carried

mainly through the fecal-oral route. This infection can cause a mild flu-like
illness or acute hepatitis with jaundice, and it could also cause acute liver
failure. Poor hygiene, improper food handling, poor sanitary conditions, and
contaminated food are the contributing factors. It is a ribonucleic acid virus
that is usually found in feces 2 or more weeks before the onset of symptoms
and up to 1 week after the onset of jaundice and the IgM antibody usually
shows up in the serum if the virus exists. To prevent ongoing outbreaks, it is
recommended that people get the Hepatitus A vaccine as well making sure
everyone washes their hands thoroughly before and after handling food.
Saucey: And I have Hepatitis B which can either be an acute or chronic liver
disease and it is spread through infected blood or body fluids which includes
needle sticks, IV drug use, semen, vaginal secretions, and saliva with sexual
transmission being the most common mode. About 12 million Americans
have been infected with Hepatitis B and the majority of the people with
acute Hepatitis B were able to resove it. Of the more than 1 million
Americans with chronic infections, approximately 15 to 25% die from chronic
liver disease. It is a DNA virus with a complex structure of 3 distinct
antigens: the surface antigen, the core antigen, and the e antigen. Either
one of these antigens lets the doctor know you most likely have the virus.
Hepatitis B can also live on a dry surface for at least 7 days and it is much
more infectious than HIV.
Kevin: Hepatitis C can also cause both acute and chronic illnesses and acute
C is usually asymptomatic which makes it difficult to detect unless with
laboratory testing. The most common causes of acute Hepatitis C are
injection drug use and outbreaks among HIV positive men who have sex with
men. In fact, about 30 to 40% of HIV infected patients also have Hepatitis C
which is primarily related to IV drug use and places the person at greater risk
for progression to cirrhosis. The majority of people usually acquire the
chronic infection and most are unaware they have it as well. People can also
get hepatits C from getting tattoos as well. Thanks to Ms. Dominguez, we
found out that the virus actually lives in the ink itself. The chronic Hepatitis
C disease usually results in progressive liver disease and 20 to 30% of
patients develop cirrhosis and Hep C is the most common cause of chronic
liver disease and the most common indication for liver transplantation in the
United States. Hep C is a RNA virus that is primarily transmitted
percutaneously with the most common mode being the sharing of
contaminated needles and equipment among IV drug users. Chronic Hep B
and Hep C account for 80% of the cases of hepatocellular cancer.

Saucey: Hey it is just like the alphabet! A, B, C, and theres still more!!
Katie: Hepatitis D is a defective single-stranded RNA virus that cannot
survive on its own so it needs the help of Hepatitis B to replicate it. It can be
acquired at the same time as Hep B, and it is transmitted percutaneouldy
similar to Hep B. Hep D can cause a spectrum of illness ranging from
asymptomatic chronic carrier state to acute liver failure and there is no
vaccine for the virus. Getting the vaccine for Hep B; however, will reduce the
risk for Hep D.
Ciera: Hepatitis E is an RNA virus transmitted by the fecal-oral route with the
usual mode of transmission being drinking contaminated water. Hep E
occurs primarily in developing countries with epidemics in India, Mexico, and
Africa; however, there have been a few reported cases in the U.S. but from
people who have traveled from other countries.
Saucey: Wow, thats a lot of Hepatitises!