Since the start of the epidemic HIV has infected over 75 million people and provoked more than 35 million deaths. Today, although HIV replication can be controlled by antiretroviral treatment, HIV infection remains an outstanding global health issue, with 36.7 million infected people and 1 million HIV-related deaths in 2016, according to WHO. Half of the infected population does not have access to antiretroviral treatment and 2 million new infections are registered every year. In addition there is currently no cure for HIV and antiretroviral treatment needs to be maintained for life. In this MOOC we will review different aspects of HIV infection: from its biological origin and its identification as the causative agent of AIDS to the perspectives of eradication.
We will summarize the status of the HIV epidemic in the world from the perspective of the virus (molecular diversity) and the host (populations). We will focus a large part of the course on the latest discoveries on the complex interactions between the virus and the host cell, the immune mechanisms that are set in motion to tackle the virus and how HIV is able to evade them. We will describe exceptional individuals who have developed efficient mechanisms to control the infection and animal models of spontaneous protection. Finally, we will address research issues with regard to clinical management of HIV infection and future perspectives on treatment and prevention. Altogether, this MOOC will provide a transversal insight into HIV research with the perspective of both scientists and clinicians.
Format
This MOOC is organized in 6 chapters :
- Origin, Epidemiology and Natural history of HIV infection.
- Mechanisms of HIV replication and dissemination. The establishment of viral reservoirs.
- HIV and the immune system.
- Physiopathology of HIV infection.
- Clinical management.
- Perspectives and future challenges.
Each module is composed of 5 sessions. In each session, you will find a 8-10-minute video and a multiple choice test to help you check your understanding. The videos are in English subtitled in French and in English.
Course syllabus
Chapter 1 : Origin, Epidemiology and natural history of HIV infection
- Discovery of the etiological agent of AIDS
- Origin of HIV and animal reservoirs
- Modes of transmission and natural history of infection
- Epidemiology of HIV and AIDS in the world
- Types, groups, subtypes and recombinants of HIV in the world
Chapter 2: Mechanisms of HIV replication and dissemination. The establishment of viral reservoirs.
- First steps of viral entry in the body. Mucosae: the entry gate.
- Cellular targets and mechanisms of viral dissemination from cell to cell.
- Replication cycle: facilitating and restriction factors.
- HIV transcription and latency.
- Cellular and anatomical reservoirs. Viral persistence on cART.
Chapter 3 : HIV and the immune system.
- Innate immune responses: viral sensing and dendritic cells.
- Innate immune responses : NK cells.
- Adaptive immune responses : T-cell responses.
- Adaptive immune responses : B-cell responses and antibodies.
- Immune evasion: from escape to viral neglect.
Chapter 4: Physiopathology of HIV infection
- Mechanisms of HIV-induced pathogenesis: inflammation, disruption of lymphoid tissue architectures, premature aging.
- HIV and co-infections.
- Natural control of pathogenesis in natural hosts.
- Exposed non-infected individuals.
- Natural control of infection and HIV remission.
Chapter 5 : Clinical management.
- Diagnostic methods.
- Anti-retroviral therapies.
- Biomarkers of disease progression and loss of viral control.
- Anti-retroviral resistance.
- Impact of long-term HIV infection on cART: Co-morbidity and non-AIDS mortality
Chapter 6 : Perspectives and future challenges.
- The antiretroviral treatment tomorrow.
- Treatment as prevention (PreP, PEP and TASP).
- Vaccines, what is there in the pipeline?
- Perspectives to achieve HIV remission or cure.
- What do PLWH expect next from research?
