Structural Dynamics of HIV


Book Description

This book examines the structural dynamics of HIV among populations at heightened vulnerability to infection as the result of stigma, discrimination and marginalization. It first examines how the socio-structural context shapes HIV risk and how affected populations and national governments and programs have responded to these structural constraints. Chapters focus on structural determinants of HIV risk among transgender women in Guatemala, migrant workers in Mexico, Nigeria and Vietnam, and people who inject drugs in Tanzania. Next, the book examines resilience and community empowerment and mobilization among key populations such as female sex workers in the Dominican Republic and India, and young women and girls in Botswana, Malawi and Mozambique. A third set of chapters explores how national responses to HIV have addressed the role of structural factors in diverse political, geographic and epidemic settings including: Brazil, South Africa, Ukraine and the USA. Ultimately, effective and sustainable responses to HIV among marginalized groups must be grounded in an in-depth understanding of the factors that create vulnerability and risk and impede access to services. Throughout, this book brings together a rigorous social science research perspective with a strong rights-based approach to inform improvements in HIV programs and policies. It offers new insights into how to better address HIV and the health and human rights of historically excluded communities and groups.




Structural Interventions for HIV Prevention


Book Description

A COMPREHENSIVE NEW REFERENCE WORK ON STRUCTURAL APPROACHES TO PREVENTING HIV Structural interventions -- changes to environment aimed at influencing health behaviors -- are the most universal and cost-effective tool in preventing new incidences of HIV. They are not easy to get right, however. Structural Interventions for HIV Prevention offers an authoritative reference for both understanding these programs and instituting them to greatest effect. Whether through changes to policy, environment, social/community norms, or a combination of each, this volume offers actionable and attainable blueprints to creating and evaluating programs in any setting or country. It is an essential resource for researchers and practitioners in the continuing fights against HIV.




The Structural Dynamics of Human Immunodeficiency Virus Type I Reverse Transcriptase


Book Description

Human Immunodeficiency Virus Type 1 Reverse Transcriptase (RT) is the protein in HIV responsible for transcribing viral RNA into double stranded DNA, making it an essential component in viral infectivity and the most popular target for anti-viral therapies for HIV. Over the years, a plethora of inhibitors for RT have been developed, and many of them are currently approved for clinical use. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) are small molecules that act as non-competitive, allosteric inhibitors of RT, binding in a binding pocket inside of the polymerase domain of RT and hampering enzymatic activity. Although this is a widely used class of viral inhibitor, the mechanism of inhibition is currently unknown. In addition to this, most current knowledge of RT is concentrated on the heterodimer, while little is known of the monomeric precursors to this structure. In this study we employ HXMS and SAXS to probe the solution structural dynamics and solution structure of RT heterodimer and monomers. We show that the p51 subunit does not form the stable core of the protein. Rather the core consists of the fingers and palm subdomains of both subunits. A ß-sheet that forms half of the NNRTI binding site undergoes slow cooperative unfolding, which is slowed by several orders of magnitude upon NNRTI binding. In addition to this, HXMS analysis reveals an allosteric network of regions that spans both subunits of the RT heterodimer. This network is thought to play a vital role in RT inhibition. The structural dynamics and solution structure of RT monomers were determined, revealing that the monomers were structured but more flexible in solution compared to the solution structure of the heterodimer. HXMS revealed that the monomers had nearly identical secondary structure, with the main difference being slow cooperative unfolding in the p66 thumb subdomain. SAXS revealed that both monomers exist in an ensemble of conformation. The polymerase domain of both monomers exists both in an open p66-like conformation, a closed p51-like conformation, and several unique conformations. This research lays the foundation for a novel method of drug screening and discovery.




Disease Control Priorities, Third Edition (Volume 6)


Book Description

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.




Evidence-Based Health Economics


Book Description

This text recognises the need for evidence-based principles in economic evaluation, and that they should be based themselves on health economics. It discusses systematic review in economic analysis and suggests how to perform analyses in an evidence-based way.




HIV in US Communities of Color


Book Description

This book builds upon its previous edition by comprehensively updating important epidemiologic and clinical content of the HIV continuum amongst Black and Latino individuals of the United States, including the epidemiology, prevention, diagnosis, and treatment of HIV within these diverse communities. Illuminating current diagnostic and prevention considerations, as well as its evidence base, the text highlights important concepts and integrates critical aspects of the structural and social environment, such as mass incarceration and neighborhood-level disadvantage, that compromise our ability to decrease HIV risk and improve outcomes. Discussion regarding significant predictors of health inequity, including discrimination, medical mistrust, and stigma, specifically homophobia and transphobia, are included. The book also reviews the impact of significant advances in HIV prevention, such as pre-exposure prophylaxis (PrEP), within Black and Latino communities. Written by experts in their field, this second edition of HIV in US Communities of Color is a comprehensive and dynamic resource for all health care providers who support the care and treatment of Black and Latino individuals at risk for or living with HIV.




Virus Dynamics : Mathematical Principles of Immunology and Virology


Book Description

This groundbreaking book describes the emerging field of theoretical immunology, in particular the use of mathematical models to describe the spread of infectious diseases within patients. It reveals fascinating insights into the dynamics of viral and other infections, and the interactions between infectious agents and immune responses. Structured around the examples of HIV/AIDS and hepatitis B, Nowak and May show how mathematical models can help researchers to understand the detailed dynamics of infection and the effects of antiviral therapy. Models are developed to describe the dynamics of drug resistance, immune responses, viral evolution and mutation, and to optimise the design of therapy and vaccines. - ;We know, down to the tiniest details, the molecular structure of the human immunodeficiency virus (HIV). Yet despite this tremendous accomplishment, and despite other remarkable advances in our understanding of individual viruses and cells of the immune system, we still have no agreed understanding of the ultimate course and variability of the pathogenesis of AIDS. Gaps in our understanding like these impede our efforts towards developing effective therapies and preventive vaccines. Martin Nowak and Robert M May describe the emerging field of theoretical immunology in this accessible and well- written text. Using mathematical modelling techniques, the authors set out their ideas about how populations of viruses and populations of immune system cells may interact in various circumstances, and how infectious diseases spread within patients. They explain how this approach to understanding infectious diseases can reveal insights into the dynamics of viral and other infections, and the interactions between infectious agents and immune responses. The book is structured around the examples of HIV/AIDS and Hepatitis B virus, although the approaches described will be more widely applicable. The authors use mathematical tools to uncover the detailed dynamics of the infection and the effects of antiviral therapy. Models are developed to describe the emergence of drug resistance, and the dynamics of immune responses, viral evolution, and mutation. The practical implications of this work for optimisation of the design of therapy and vaccines are discussed. The book concludes with a glance towards the future of this fascinating, and potentially highly useful, field of study. - ;... an excellent introduction to a field that has the potential to advance substantially our understanding of the complex interplay between virus and host - Nature




The Roles of RNA Structural Dynamics and Molecular Interaction in Viral Gene Expression


Book Description

Current HIV antiretroviral therapies target multiple steps of the viral lifecycle. Expanding potential targets can bene t HIV therapy by increasing the types of drugs used in combination. Alternative splicing is a potential step to target because it allows 9 kb HIV viral genome to produce more than 40 different mRNA transcripts critical to viral replication. Alternative splicing is regulated through various interactions between cellular host proteins and specific structural elements present on the viral ribonucleic acid (RNA) that can act together either to enhance or repress splicing at specific sites. In order to better understand the splicing mechanisms, it is important to characterize the structures of the molecules responsible and understand how these molecules interact to perform their functions. For this reason, this research aims to shed light on RNA elements and proteins that play a role in HIV splicing, namely splice site acceptor 3 (ssA3). The A3 3'-splice site of HIV-1 is required for Tat mRNA production. The inefficient utilization of this splice site has been attributed to the presence of a second exonic splicing silencer (ESS2p), which acts to repress splice site A3. The cellular protein HnRNP H binds to ESS2P element to inhibit the splicing process. However, there is no structural and mechanistic information about how hnRNP H recognizes ESS2P to inhibit the splicing. In our studies, we aim to characterize the three-dimensional structures of hnRNP H and ESS2P. The domain organization of hnRNP H/F proteins is modular consisting of N-terminal tandem quasi-RNA Recognition Motifs 1 and 2 (HqRRM1,2) and a third C-terminal qRRM3 embedded within glycine-rich repeats. The tandem qRRMs are connected through a 10-residue linker with most of the amino acids strictly conserved between hnRNP H and F. We probed the structural dynamics of its HqRRM1,2 domain with X-ray crystallography, NMR spectroscopy, and small angle X-ray scattering (SAXS). We observed that HqRRM1,2 contains multiple conformations in solution by SAXS. These exchangeable conformations are located on the linker region and RNA recognition sites. Moreover, we also identified that the alternative structure exist in ssA3 by NMR. The three-dimensional structure of the major conformation of ESS2P has been determined using NMR spectroscopy and SAXS. The hairpin structure reveals that apical loop of ESS2P is the binding site for hnRNP A1 to inhibit splicing. The minor conformation of ESS2p potentially provides the binding site for hnRNP H with an exposed G-tract. Collectively, this work provides evidence that RNA itself can form different unique scaffolds to trap different RNA binding proteins to regulate splicing.




Gender, HIV and Risk


Book Description

This book examines the gender context of HIV and critiques the global policy response. Anderson contributes to the feminist task of de-invisibilising gender as structural violence and identifies how gendered power structures are responded to at the local level in Malawi.