1 00:00:01,690 --> 00:00:02,784 - [Instructor] Now with immune system, 2 00:00:02,784 --> 00:00:04,894 sometimes there's special case. 3 00:00:04,894 --> 00:00:07,625 AIDS is one of those cases. 4 00:00:07,625 --> 00:00:10,851 AIDS, or Acquired Immune Deficiency Syndrome, 5 00:00:10,851 --> 00:00:15,753 is caused when a person is infected with the HIV. 6 00:00:15,753 --> 00:00:19,372 HIV is Human Immunodeficiency Virus. 7 00:00:19,372 --> 00:00:22,299 The name right there, immunodeficiency. 8 00:00:22,299 --> 00:00:24,482 The immune system will not function properly. 9 00:00:24,482 --> 00:00:27,732 The HIV is so potent because it targets 10 00:00:28,816 --> 00:00:30,399 the helper T cells. 11 00:00:32,516 --> 00:00:34,107 Now if you remember, the helper T cells 12 00:00:34,107 --> 00:00:37,135 are one of the main cells that will 13 00:00:37,135 --> 00:00:40,325 activate your immune response, so if you don't 14 00:00:40,325 --> 00:00:43,068 have these helper T cells you really can't 15 00:00:43,068 --> 00:00:46,568 activate your immune response efficiently. 16 00:00:48,997 --> 00:00:51,982 Now HIV can be transmitted through any body fluid. 17 00:00:51,982 --> 00:00:56,212 We're talking blood, semen, breast milk, vaginal secretions. 18 00:00:56,212 --> 00:00:59,214 The idea is though, blood probably is 19 00:00:59,214 --> 00:01:02,215 one of the more potent ways, but usually 20 00:01:02,215 --> 00:01:04,101 semen, vaginal secretions, breast milk, 21 00:01:04,101 --> 00:01:07,535 all have high enough concentrations. 22 00:01:07,535 --> 00:01:09,737 Here's how HIV works. 23 00:01:09,737 --> 00:01:13,202 HIV is a retrovirus, so when it's in your body 24 00:01:13,202 --> 00:01:16,334 it will find a cell to bind to. 25 00:01:16,334 --> 00:01:19,776 It will then insert the viral DNA. 26 00:01:19,776 --> 00:01:23,776 The viral DNA will use your own cell's machinery 27 00:01:24,779 --> 00:01:27,279 to make a single-stranded DNA. 28 00:01:28,424 --> 00:01:31,259 Well, DNA is our genetic code. 29 00:01:31,259 --> 00:01:36,124 That single-stranded DNA becomes a double-stranded DNA 30 00:01:36,124 --> 00:01:37,624 just like our DNA. 31 00:01:38,884 --> 00:01:41,004 It will head into the nucleus 32 00:01:41,004 --> 00:01:44,000 and in the nucleus it will be reproduced, 33 00:01:44,000 --> 00:01:48,797 copied, and read just like any other bit of DNA. 34 00:01:48,797 --> 00:01:52,964 When the double-stranded DNA from the retrovirus is read 35 00:01:54,462 --> 00:01:56,545 it will make viral codes. 36 00:01:57,602 --> 00:01:59,820 It will make proteins which can make up 37 00:01:59,820 --> 00:02:01,237 the virus itself. 38 00:02:02,514 --> 00:02:07,157 That means that this viral RNA that was inserted 39 00:02:07,157 --> 00:02:10,433 into a cell uses your cell's machinery 40 00:02:10,433 --> 00:02:12,683 to make more of that virus. 41 00:02:14,119 --> 00:02:17,869 That just keeps on going and going and going. 47 00:02:30,698 --> 00:02:34,584 So now, in AIDS, there's several different phases. 48 00:02:34,584 --> 00:02:36,629 Phase one, if you know it's going to take 49 00:02:36,629 --> 00:02:39,591 a few weeks to a few years. 50 00:02:39,591 --> 00:02:41,823 There is no one set time frame. 51 00:02:41,823 --> 00:02:45,131 Everyone progresses at different rates. 52 00:02:45,131 --> 00:02:47,659 You'll have these flu-like symptoms, 53 00:02:47,659 --> 00:02:52,231 swollen lymph nodes, chill, fever, fatigue, body aches 54 00:02:52,231 --> 00:02:54,353 but if the doctor does a test for the flu 55 00:02:54,353 --> 00:02:57,033 it will come back negative. 56 00:02:57,033 --> 00:03:01,195 At this point, the retrovirus is just getting going. 57 00:03:01,195 --> 00:03:03,620 It's invading the cells, creating more retroviruses, 58 00:03:03,620 --> 00:03:06,707 and spreading throughout your body. 59 00:03:06,707 --> 00:03:08,533 You body's aware there's a problem 60 00:03:08,533 --> 00:03:10,834 so it's trying to attack it. 61 00:03:10,834 --> 00:03:13,417 It's acting like you have a flu 62 00:03:14,913 --> 00:03:17,191 but the problem is a lot of people don't 63 00:03:17,191 --> 00:03:19,356 exhibit symptoms. 64 00:03:19,356 --> 00:03:21,800 It just occurs in their body without any clue 65 00:03:21,800 --> 00:03:25,515 because it's happening so gradually 66 00:03:25,515 --> 00:03:28,015 but that virus is multiplying. 67 00:03:28,875 --> 00:03:30,940 Antibodies are made. 68 00:03:30,940 --> 00:03:32,203 The problem is, the antibodies you're making 69 00:03:32,203 --> 00:03:35,509 really aren't working very well. 70 00:03:35,509 --> 00:03:37,633 They can get rid of parts of the virus. 71 00:03:37,633 --> 00:03:40,807 It might get rid of some of the aspects here or there 72 00:03:40,807 --> 00:03:43,855 but it does not clear the entire virus out. 73 00:03:43,855 --> 00:03:46,772 Now those antibodies you're making, 74 00:03:47,626 --> 00:03:50,232 they might not be good in six months 75 00:03:50,232 --> 00:03:53,231 or a year from that point because the HIV virus 76 00:03:53,231 --> 00:03:55,148 is constantly changing. 77 00:03:57,426 --> 00:03:59,748 It's one of the biggest problems of why 78 00:03:59,748 --> 00:04:03,165 medicine cannot find a cure or a vaccine. 79 00:04:04,515 --> 00:04:06,748 The virus just changes too frequently 80 00:04:06,748 --> 00:04:09,165 for anything to keep current. 81 00:04:11,490 --> 00:04:15,213 Once that phase is gone then you get to phase two. 82 00:04:15,213 --> 00:04:19,380 It can occur about six months to anywhere to 10 years. 83 00:04:20,767 --> 00:04:22,604 This has a problem because now 84 00:04:22,604 --> 00:04:25,104 it's opportunistic infections. 85 00:04:26,569 --> 00:04:28,761 Opportunistic infections are any infection 86 00:04:28,761 --> 00:04:32,880 that in a healthy person you probably could fight off 87 00:04:32,880 --> 00:04:35,897 but with your immune system being compromised now 88 00:04:35,897 --> 00:04:37,977 these infections can take set 89 00:04:37,977 --> 00:04:42,144 and cause some major problems, and the reason here, 90 00:04:43,352 --> 00:04:44,935 the helper T cells. 91 00:04:45,856 --> 00:04:49,287 All the helper T cells are becoming infected, 92 00:04:49,287 --> 00:04:51,005 they're becoming destroyed. 93 00:04:51,005 --> 00:04:54,800 The numbers are slowly dwindling down. 94 00:04:54,800 --> 00:04:57,671 The fewer and fewer helper T cells, 95 00:04:57,671 --> 00:05:01,838 the slower and slower and weaker the immune response is. 96 00:05:03,313 --> 00:05:07,480 If untreated, this phase two will go into the next phase, 97 00:05:10,327 --> 00:05:11,827 the phase of AIDS. 98 00:05:15,504 --> 00:05:17,893 So phase three, full-blown AIDS. 99 00:05:17,893 --> 00:05:21,315 Now AIDS is diagnosed when the helper T cells 100 00:05:21,315 --> 00:05:24,815 fall below 200 cells per cubic millimeter. 101 00:05:26,759 --> 00:05:31,582 That means your body just cannot adequately fight infections 102 00:05:31,582 --> 00:05:34,348 because the cells that activate the immune response 103 00:05:34,348 --> 00:05:36,015 just aren't there. 104 00:05:36,015 --> 00:05:40,976 So phase three, this is what typically is called AIDS, 105 00:05:40,976 --> 00:05:42,753 is when the helper T cells are below 106 00:05:42,753 --> 00:05:46,170 that 200 cell per cubic millimeter count. 107 00:05:47,326 --> 00:05:51,360 Tuberculosis, pneumonia, mengitis, encephalitis, 108 00:05:51,360 --> 00:05:55,403 Kaposi's sarcoma, non-Hodgkins lymphoma, cancers, 109 00:05:55,403 --> 00:05:59,456 all these opportunistic infections will now 110 00:05:59,456 --> 00:06:03,028 come into the system and try to take over. 111 00:06:03,028 --> 00:06:06,757 Now any one of these is quite problematic. 112 00:06:06,757 --> 00:06:08,880 More often than not a healthy individual 113 00:06:08,880 --> 00:06:11,784 with a fully functional immune system 114 00:06:11,784 --> 00:06:16,182 will not have any of these be able to take hold. 115 00:06:16,182 --> 00:06:18,363 Well if you're thinking, hold on, I had pneumonia 116 00:06:18,363 --> 00:06:20,898 or hey, I had meningitis, 117 00:06:20,898 --> 00:06:22,720 these can take hold but usually they take hold 118 00:06:22,720 --> 00:06:26,553 while you're already sick with something else. 119 00:06:27,409 --> 00:06:29,133 For instance, I've had pneumonia. 120 00:06:29,133 --> 00:06:31,031 Not the end of the world. 121 00:06:31,031 --> 00:06:33,047 I was down and out for about a week or two, 122 00:06:33,047 --> 00:06:35,481 but the pneumonia was only able to take hold 123 00:06:35,481 --> 00:06:38,154 because I was already sick with a head cold 124 00:06:38,154 --> 00:06:40,689 and upper respiratory infection. 125 00:06:40,689 --> 00:06:44,972 That infection allowed the pneumonia infection to come in 126 00:06:44,972 --> 00:06:47,028 because it's opportunistic. 127 00:06:47,028 --> 00:06:49,847 If I didn't have that head cold and chest infection 128 00:06:49,847 --> 00:06:51,590 pneumonia would not have a had a chance, 129 00:06:51,590 --> 00:06:54,813 so that's that idea of opportunistic. 130 00:06:54,813 --> 00:06:57,021 Something must be affecting your immune system 131 00:06:57,021 --> 00:07:00,612 for these to come in and take hold. 132 00:07:00,612 --> 00:07:03,531 Now, if there's no treatment at this point, 133 00:07:03,531 --> 00:07:05,803 it's pretty much always fatal 134 00:07:05,803 --> 00:07:08,483 because any one of these opportunistic infections 135 00:07:08,483 --> 00:07:12,420 could be deadly, so treatment is pretty much 136 00:07:12,420 --> 00:07:14,798 essential to try to help combat 137 00:07:14,798 --> 00:07:17,381 these opportunistic infections. 138 00:07:19,122 --> 00:07:20,921 So here's a graph showing your T cell count, 139 00:07:20,921 --> 00:07:22,694 your antibodies, HIV in the blood, 140 00:07:22,694 --> 00:07:25,471 all things mixed together. 141 00:07:25,471 --> 00:07:27,690 Now the bottom of the graph is years. 142 00:07:27,690 --> 00:07:30,745 You can see within the first year, HIV in the blood spikes 143 00:07:30,745 --> 00:07:33,353 and gets knocked down. 144 00:07:33,353 --> 00:07:36,729 That's because your antibodies are fighting it. 145 00:07:36,729 --> 00:07:41,115 So phase one basically means the HIV has spiked, 146 00:07:41,115 --> 00:07:44,288 antibodies are trying to catch up. 147 00:07:44,288 --> 00:07:47,381 Phase two you can see, well, HIV in 148 00:07:47,381 --> 00:07:49,183 the blood's pretty low. 149 00:07:49,183 --> 00:07:50,416 The antibodies do a good a job 150 00:07:50,416 --> 00:07:54,178 but they're not getting rid of everything 151 00:07:54,178 --> 00:07:55,391 and the biggest problem is, 152 00:07:55,391 --> 00:07:57,831 look what's happening in phase two. 153 00:07:57,831 --> 00:08:00,081 The T cells are plummeting. 154 00:08:01,200 --> 00:08:03,856 So even though the antibodies are pretty efficient here, 155 00:08:03,856 --> 00:08:07,902 they're not 100% and the ones that are being missed, 156 00:08:07,902 --> 00:08:10,141 those HIV virus particles that are still going, 157 00:08:10,141 --> 00:08:11,966 they're killing and destroying 158 00:08:11,966 --> 00:08:14,549 more and more and more T cells. 159 00:08:16,075 --> 00:08:18,765 Eventually, you'll end up at a point 160 00:08:18,765 --> 00:08:21,140 where there's more HIV in the blood 161 00:08:21,140 --> 00:08:23,361 than there are T cells. 162 00:08:23,361 --> 00:08:26,880 It's that point that typically is where 163 00:08:26,880 --> 00:08:29,630 you say now it's full-blown AIDS. 169 00:08:43,378 --> 00:08:46,628 Now any of these behaviors can increase 170 00:08:47,764 --> 00:08:50,076 your chance of getting AIDS. 171 00:08:50,076 --> 00:08:51,933 Now these are worldwide numbers. 172 00:08:51,933 --> 00:08:55,719 Males, usually about 3/4 of new cases. 173 00:08:55,719 --> 00:08:58,530 So it's going to be sex, man with man. 174 00:08:58,530 --> 00:08:59,869 It can be sharing needles during 175 00:08:59,869 --> 00:09:01,764 intravenous drug use. 176 00:09:01,764 --> 00:09:04,023 Heterosexual with an HIV-infected female. 177 00:09:04,023 --> 00:09:06,257 What all three of these share in common 178 00:09:06,257 --> 00:09:08,757 is in exchanging bodily fluid. 179 00:09:09,996 --> 00:09:14,193 In the first two, it could be exchanging blood. 180 00:09:14,193 --> 00:09:16,070 In the first and third it could be exchanging 181 00:09:16,070 --> 00:09:19,237 semen or vaginal fluids in the female. 182 00:09:21,104 --> 00:09:25,271 Females, only about 1/4 of new cases, again worldwide. 183 00:09:26,598 --> 00:09:29,858 If a female has sex with an HIV-infected male 184 00:09:29,858 --> 00:09:31,858 or sharing drug needles. 185 00:09:34,456 --> 00:09:36,539 Now the idea of safe sex. 186 00:09:37,865 --> 00:09:40,450 Well, you hear all over the place, 187 00:09:40,450 --> 00:09:43,080 abstinence is the only way perfectly to be safe. 188 00:09:43,080 --> 00:09:45,953 That because it's the only 100% way. 189 00:09:45,953 --> 00:09:47,822 Anything beyond that, you never get more than 190 00:09:47,822 --> 00:09:50,910 a 99 point some percent chance. 191 00:09:50,910 --> 00:09:54,189 Even tube-tying, vasectomy, you name 192 00:09:54,189 --> 00:09:57,261 the different types of contraception, 193 00:09:57,261 --> 00:09:59,103 every one of them, even the best ones, 194 00:09:59,103 --> 00:10:02,770 are only at 99 point seven or eight percent. 195 00:10:03,638 --> 00:10:07,212 There's no 100% method out there, 196 00:10:07,212 --> 00:10:09,904 so that's why they say abstinence is the safest. 197 00:10:09,904 --> 00:10:12,424 Well, if that's not the choice, reduce 198 00:10:12,424 --> 00:10:14,071 the number of sexual partners. 199 00:10:14,071 --> 00:10:16,359 The fewer people you're close with, 200 00:10:16,359 --> 00:10:20,297 the less chance of having an infection. 201 00:10:20,297 --> 00:10:21,689 Low-risk behavior. 202 00:10:21,689 --> 00:10:23,552 Individuals that are engaging in drug use 203 00:10:23,552 --> 00:10:25,648 a lot of times have a higher risk because of 204 00:10:25,648 --> 00:10:28,315 the intravenous needle potential 205 00:10:29,529 --> 00:10:32,087 or someone that is constantly being with 206 00:10:32,087 --> 00:10:36,152 other individuals, having different partners. 207 00:10:36,152 --> 00:10:40,202 The idea of avoiding high-risk sexual practices. 208 00:10:40,202 --> 00:10:42,821 Anal-genital is a very high risk, 209 00:10:42,821 --> 00:10:45,764 one of the reasons being that a lot of times 210 00:10:45,764 --> 00:10:47,980 this will cause tearing of the anal 211 00:10:47,980 --> 00:10:50,410 or the rectal tissue. 212 00:10:50,410 --> 00:10:52,434 That tearing will be bleeding. 213 00:10:52,434 --> 00:10:54,934 Blood carries virus particles. 214 00:10:58,480 --> 00:11:00,515 Latex, polyurethane condoms, barriers 215 00:11:00,515 --> 00:11:03,636 are ways of helping prevent the passage of fluids 216 00:11:03,636 --> 00:11:05,337 but it's one of those things where 217 00:11:05,337 --> 00:11:07,145 even then they're not 100%. 218 00:11:07,145 --> 00:11:09,921 There could be a rip, there could be a tear. 219 00:11:09,921 --> 00:11:11,698 If anyone thinks they're exposed, 220 00:11:11,698 --> 00:11:13,265 thinks there might have been a risk factor, 221 00:11:13,265 --> 00:11:16,186 might have been an issue, get tested. 222 00:11:16,186 --> 00:11:18,287 It's better to catch it early because 223 00:11:18,287 --> 00:11:20,855 today's modern medicines, it might be 224 00:11:20,855 --> 00:11:22,766 a lot of medicine to take but a lot of times 225 00:11:22,766 --> 00:11:25,933 HIV can be put into a remissive state. 226 00:11:26,803 --> 00:11:28,410 There are people that have had the HIV virus 227 00:11:28,410 --> 00:11:30,910 for 15, 25 years at this point 228 00:11:31,838 --> 00:11:34,055 living a relatively normal life, 229 00:11:34,055 --> 00:11:36,697 just having to take an increased amount of medication 230 00:11:36,697 --> 00:11:40,114 to try to keep the HIV infection in check 231 00:11:42,161 --> 00:11:44,756 so getting tested will help answer the questions. 232 00:11:44,756 --> 00:11:48,356 It will help answer are you or are you not infected. 233 00:11:48,356 --> 00:11:52,048 It also could help catch it at an earlier stage. 234 00:11:52,048 --> 00:11:54,206 The key thing though is just be safe. 235 00:11:54,206 --> 00:11:56,123 Be smart about choices. 236 00:11:57,767 --> 00:11:59,854 Today's treatments, those drugs I was talking about. 237 00:11:59,854 --> 00:12:02,187 One of the HIV drugs is AZT, 238 00:12:03,057 --> 00:12:05,724 reverse transcriptase inhibitor. 239 00:12:06,953 --> 00:12:08,419 If you're saying, what the heck is 240 00:12:08,419 --> 00:12:10,532 a reverse transcriptase inhibitor, 241 00:12:10,532 --> 00:12:13,148 it's the way it works when your RNA 242 00:12:13,148 --> 00:12:16,231 from the virus is made back into DNA. 243 00:12:18,193 --> 00:12:21,140 The term transcription is when DNA is made 244 00:12:21,140 --> 00:12:25,307 into RNA, so reverse, go the other way, RNA to DNA. 245 00:12:26,380 --> 00:12:29,963 If you can stop the HIV virus from creating 246 00:12:31,755 --> 00:12:35,922 new virus particles, you can help keep the virus in check. 247 00:12:37,110 --> 00:12:38,027 That's AZT. 248 00:12:39,169 --> 00:12:42,118 Protease inhibitors, well these things are 249 00:12:42,118 --> 00:12:45,411 meant again to prohibit a certain pathway 250 00:12:45,411 --> 00:12:47,744 within the viral production. 251 00:12:48,845 --> 00:12:50,094 Then we have Maraviroc. 252 00:12:50,094 --> 00:12:51,924 It's a newer drug on the market 253 00:12:51,924 --> 00:12:56,515 but it helps to protect the T cells specifically. 254 00:12:56,515 --> 00:12:58,456 It does not allow HIV to actually enter 255 00:12:58,456 --> 00:13:01,706 into the T cell and destroy the T cell. 256 00:13:03,289 --> 00:13:05,935 The whole thing though is early treatment. 257 00:13:05,935 --> 00:13:07,646 The only way for early treatment is 258 00:13:07,646 --> 00:13:09,923 early detection to get tested. 259 00:13:09,923 --> 00:13:12,880 With all these drugs, people are living 260 00:13:12,880 --> 00:13:16,924 longer and more normal lives once they've been infected. 261 00:13:16,924 --> 00:13:18,360 The best thing to do obviously is 262 00:13:18,360 --> 00:13:21,423 don't get infected, practice safe practices 263 00:13:21,423 --> 00:13:25,590 but if it unfortunately occurs, click it, seek help. 264 00:13:28,064 --> 00:13:31,356 Go over basically to come clinic and get tested. 265 00:13:31,356 --> 00:13:35,523 Figure out what's going on earlier rather than later. 266 00:13:36,505 --> 00:13:38,726 Now they're working on a vaccine. 267 00:13:38,726 --> 00:13:41,015 The problem is, they can't quite pin it down. 268 00:13:41,015 --> 00:13:42,166 They've been working on a vaccine for 269 00:13:42,166 --> 00:13:44,653 the past decade or two almost. 270 00:13:44,653 --> 00:13:46,997 The vaccine is constantly under development 271 00:13:46,997 --> 00:13:50,450 but every time they identify a unique feature to target, 272 00:13:50,450 --> 00:13:52,208 the virus mutates. 273 00:13:52,208 --> 00:13:53,125 It changes. 274 00:13:54,291 --> 00:13:56,941 That's one of the biggest problems with HIV 275 00:13:56,941 --> 00:14:00,241 is how often this virus is changing. 276 00:14:00,241 --> 00:14:02,546 The only way a vaccine can be efficient 277 00:14:02,546 --> 00:14:05,546 is if what the vaccine is presenting 278 00:14:07,483 --> 00:14:10,733 is matched exactly with a future virus. 279 00:14:12,275 --> 00:14:15,725 If a virus changes, the vaccine is useless 280 00:14:15,725 --> 00:14:18,039 and sometimes the HIV virus is changing 281 00:14:18,039 --> 00:14:20,872 as frequently as every six months. 282 00:14:23,427 --> 00:14:25,350 So vaccines, they're trying to figure it out 283 00:14:25,350 --> 00:14:27,741 but so far they haven't found one thing 284 00:14:27,741 --> 00:14:29,574 that stays consistent.