Mória Reception and Identification Centre ( Greek : Κέντρο Υποδοχής και Ταυτοποίησης Μόριας ), better known as Mória Refugee Camp , or just "Mória", was founded in January 2013 and served as the largest refugee camp in Europe until it was burned down in September 2020. It was located outside the village of Moria ( Greek : Μόρια , Mória ) near Mytilene on the island of Lesbos . Enclosed with barbed wire and a chain-link fence, the military camp served as a European Union “ hotspot ”. It was described by Human Rights Watch as an open air prison.
143-495: In August 2018, it was dubbed by the field coordinator of Doctors Without Borders as "the worst refugee camp on earth", as reported by the BBC. "I've never seen the level of suffering we are witnessing here every day", says Luca Fontana, MSF Lesbos coordinator (7'42). The camp was built to accommodate around 3,000 people, however there were around 20,000 people living in the camp in summer 2020, among whom 6,000 to 7,000 were children under
286-493: A long terminal repeat (LTR). Regions in the LTR act as switches to control production of new viruses and can be triggered by proteins from either HIV or the host cell. The Psi element is involved in viral genome packaging and recognized by gag and rev proteins. The SLIP element ( TTTTTT ) is involved in the frameshift in the gag - pol reading frame required to make functional pol . The term viral tropism refers to
429-600: A career in French politics, rising to the position of Minister for Europe and Foreign Affairs , which he held 2007–2010. After entering the country, the volunteers, in addition to Biafran health workers and hospitals, were subjected to attacks by the Nigerian Armed Forces , and witnessed civilians being murdered and starved by the blockading forces. The doctors publicly criticised the Nigerian government and
572-535: A cell by a virion can be called "cell-free spread" to distinguish it from a more recently recognized process called "cell-to-cell spread". In cell-free spread (see figure), virus particles bud from an infected T cell, enter the blood or extracellular fluid and then infect another T cell following a chance encounter. HIV can also disseminate by direct transmission from one cell to another by a process of cell-to-cell spread, for which two pathways have been described. Firstly, an infected T cell can transmit virus directly to
715-481: A cell surface. The unusual processing and high density means that almost all broadly neutralising antibodies that have so far been identified (from a subset of patients that have been infected for many months to years) bind to, or are adapted to cope with, these envelope glycans. The molecular structure of the viral spike has now been determined by X-ray crystallography and cryogenic electron microscopy . These advances in structural biology were made possible due to
858-490: A cholera epidemic and MSF responded by providing medical support that were adapted for usage in the country. Cambodia is one of 22 countries listed by WHO as having a high burden of tuberculosis. WHO estimates that 64% of all Cambodians carry the tuberculosis mycobacterium. Hence, MSF has since shifted its focus away from HIV/AIDS to tuberculosis, handing over most HIV-related programs to local health authorities. The 2011 Libyan civil war has prompted efforts by MSF to set up
1001-414: A few tested specimens might provide inconclusive results because of a low quantity specimen. In these situations, a second specimen is collected and tested for HIV infection. Modern HIV testing is extremely accurate, when the window period is taken into consideration. A single screening test is correct more than 99% of the time. The chance of a false-positive result in a standard two-step testing protocol
1144-428: A fire badly damaged the camp of more than 12,000 asylum seekers. On 10 September, three Greek ships were sent to help shelter the migrants. By then, the camp was almost completely destroyed. Most of the refugees were left homeless on the street. During protests demanding their evacuation Greek police fired tear gas at them. The Greek government maintains that the fires were started deliberately by migrants protesting that
1287-468: A hospital and mental health services to help locals affected by the conflict. The fighting created a backlog of patients that needed surgery. With parts of the country slowly returning to livable, MSF has started working with local health personnel to address the needs. The need for psychological counseling has increased and MSF has set up mental health services to address the fears and stress of people living in tents without water and electricity. Currently MSF
1430-567: A hot, dry environment, and spread by the wind. This was corroborated by a report from the Lesbos fire department. After the closure of the Moria camp, a temporary facility was rapidly set up at Kara Tepe. A more organised closed reception centre for refugees and asylum seekers was approved to be built by the Greek government with EU approval after the fire destroyed the Moria camp. It will be located at
1573-451: A human host cell when the newly formed virus particle buds from the cell. The viral envelope contains proteins from the host cell and relatively few copies of the HIV envelope protein, which consists of a cap made of three molecules known as glycoprotein (gp) 120 , and a stem consisting of three gp41 molecules that anchor the structure into the viral envelope. The envelope protein, encoded by
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#17327910270871716-574: A key step in the progression to AIDS. A number of studies with subtype B-infected individuals have determined that between 40 and 50 percent of AIDS patients can harbour viruses of the SI and, it is presumed, the X4 phenotypes. HIV-2 is much less pathogenic than HIV-1 and is restricted in its worldwide distribution to West Africa . The adoption of "accessory genes" by HIV-2 and its more promiscuous pattern of co-receptor usage (including CD4-independence) may assist
1859-516: A large increase in civilian attacks and rape by armed groups. In addition to providing surgical and psychological support in existing hospitals – offering the only free surgery available in Port-au-Prince – field missions have been set up to rebuild water and waste management systems and treat survivors of major flooding caused by Hurricane Jeanne ; patients with HIV/AIDS and malaria, both of which are widespread in
2002-613: A more stable conformation following the NC binding, in which both the DIS and the U5:AUG regions of the gRNA participate in extensive base pairing. RNA can also be processed to produce mature messenger RNAs (mRNAs). In most cases, this processing involves RNA splicing to produce mRNAs that are shorter than the full-length genome. Which part of the RNA is removed during RNA splicing determines which of
2145-857: A multi-purpose clinic in contrast to a HIV/AIDS specialised treatment centre. MSF also provided humanitarian aid in times of natural disaster such as a major flood in 2002 which affected up to 1.47 million people. MSF introduced a community-based tuberculosis programme in 2004 in remote villages, where village volunteers are delegated to facilitate the medication of patients. In partnership with local health authorities and other NGOs, MSF encouraged decentralized clinics and rendered localized treatments to more rural areas from 2006. Since 2007, MSF has extended general health care, counselling, HIV/AIDS and TB treatment to prisons in Phnom Penh via mobile clinics. However, poor sanitation and lack of health care still prevails in most Cambodian prisons as they remain as some of
2288-447: A number of mechanisms, including pyroptosis of abortively infected T cells, apoptosis of uninfected bystander cells, direct viral killing of infected cells, and killing of infected CD4 T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4 T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections, leading to
2431-534: A project intended to provide medical aid to the refugees. Although the project did not receive support from the majority of MSF, some, including later Minister Bernard Kouchner , chartered a ship called L'Île de Lumière ("The Island of Light"), and, along with doctors, journalists and photographers, sailed to the South China Sea and provided some medical aid to the boat people. The splinter organisation that undertook this, Médecins du Monde , later developed
2574-504: A result of its Rwanda mission, the position of MSF with respect to neutrality moved closer to that of the ICRC, a remarkable development in the light of the origin of the organisation. The ICRC lost 56 and MSF lost almost one hundred of their respective local staff in Rwanda, and MSF-France, which had chosen to evacuate its team from the country (the local staff were forced to stay), denounced
2717-570: A series of debates in France around humanitarian ethics. The group also set up equipment to produce clean drinking water for the population of San Salvador , capital of El Salvador, after 10 October 1986 earthquake that struck the city. The early 1990s saw MSF open a number of new national sections, and at the same time, set up field missions in some of the most dangerous and distressing situations it had ever encountered. In 1990, MSF first entered Liberia to help civilians and refugees affected by
2860-464: A strain of SIV found in sooty mangabees. Since HIV-1 is derived from SIVcpz, and HIV-2 from SIVsm, the genetic sequence of HIV-2 is only partially homologous to HIV-1 and more closely resembles that of SIVsm. Many HIV-positive people are unaware that they are infected with the virus. For example, in 2001 less than 1% of the sexually active urban population in Africa had been tested, and this proportion
3003-558: A target T cell via a virological synapse . Secondly, an antigen-presenting cell (APC), such as a macrophage or dendritic cell, can transmit HIV to T cells by a process that either involves productive infection (in the case of macrophages) or capture and transfer of virions in trans (in the case of dendritic cells). Whichever pathway is used, infection by cell-to-cell transfer is reported to be much more efficient than cell-free virus spread. A number of factors contribute to this increased efficiency, including polarised virus budding towards
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#17327910270873146-646: A tool for foreign governments. MSF has since still found it necessary to condemn the actions of governments, such as in Chechnya in 1999, but has not demanded another military intervention since then. More than a thousand staffers accused the charity of white supremacy when they voiced their concerns in a 2020 petition. One staffer from Cameroon detailed her experiences with racism from the group's leaders. Many concerns involved different treatment of expatriate staff from Europe and North America, who are typically white, compared to national staff. In an interview with NPR,
3289-535: A true war zone, including exposure to hostile fire, in 1976. MSF spent nine years (1976–1984) assisting surgeries in the hospitals of various cities in Lebanon, during the Lebanese Civil War , and established a reputation for its neutrality and willingness to work under fire. Throughout the war, MSF helped both Christian and Muslim soldiers alike, helping whichever group required the most medical aid at
3432-405: Is a charity that provides humanitarian medical care. It is a non-governmental organisation (NGO) of French origin known for its projects in conflict zones and in countries affected by endemic diseases . The organisation provides care for diabetes , drug-resistant infections , HIV/AIDS , hepatitis C , tropical and neglected diseases, tuberculosis , vaccines and COVID-19 . In 2019,
3575-679: Is a fatality rate of 99% within 1–4 months of infection. Since the treatment centre was set up, MSF has cured more than 27,000 Kala-Azar patients with a success rate of approximately 90–95%. There are plans to open an additional Kala-Azar treatment centre in Malakal , Southern Sudan, to cope with the overwhelming number of patients that are seeking treatment. MSF has been providing necessary medical supplies to hospitals and training Sudanese health professionals to help them deal with Kala-Azar. MSF, Sudanese Ministry of Health and other national and international institutions are combining efforts to improve on
3718-667: Is addressed in Section 2 of the Rules portion of this final document. MSF has an associative structure where operational decisions are made, independently, by the six operational centres ( Amsterdam , Barcelona - Athens , Brussels , Geneva , Paris and West and Central Africa – with Headquarter office in Abidjan, Ivory Coast ). Common policies on core issues are coordinated by the International Council, in which each of
3861-956: Is also important to prevent or slow down epidemics. MSF has been active in Uganda since 1980, and provided relief to civilians during the country's guerrilla war during the Second Obote Period . However, the formation of the Lord's Resistance Army saw the beginning of a long campaign of violence in northern Uganda and southern Sudan. Civilians were subjected to mass killings and rapes, torture, and abductions of children, who would later serve as sex slaves or child soldiers . Faced with more than 1.5 million people displaced from their homes, MSF set up relief programmes in internally displaced person (IDP) camps to provide clean water, food and sanitation. Diseases such as tuberculosis , measles, polio, cholera, ebola , and HIV/AIDS occur in epidemics in
4004-460: Is an adaptation for repair of genome damage, and that recombinational variation is a byproduct that may provide a separate benefit. The final step of the viral cycle, assembly of new HIV-1 virions, begins at the plasma membrane of the host cell. The Env polyprotein (gp160) goes through the endoplasmic reticulum and is transported to the Golgi apparatus where it is cleaved by furin resulting in
4147-516: Is bound with the CD4 protein, the envelope complex undergoes a structural change, exposing the chemokine receptor binding domains of gp120 and allowing them to interact with the target chemokine receptor. This allows for a more stable two-pronged attachment, which allows the N-terminal fusion peptide gp41 to penetrate the cell membrane. Repeat sequences in gp41, HR1, and HR2 then interact, causing
4290-424: Is even lower in rural populations. Furthermore, in 2001 only 0.5% of pregnant women attending urban health facilities were counselled, tested or received their test results. Again, this proportion is even lower in rural health facilities. Since donors may therefore be unaware of their infection, donor blood and blood products used in medicine and medical research are routinely screened for HIV. HIV-1 testing
4433-464: Is high as the glycans shield the underlying viral protein from neutralisation by antibodies. This is one of the most densely glycosylated molecules known and the density is sufficiently high to prevent the normal maturation process of glycans during biogenesis in the endoplasmic and Golgi apparatus. The majority of the glycans are therefore stalled as immature 'high-mannose' glycans not normally present on human glycoproteins that are secreted or present on
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4576-399: Is initially done using an enzyme-linked immunosorbent assay (ELISA) to detect antibodies to HIV-1. Specimens with a non-reactive result from the initial ELISA are considered HIV-negative, unless new exposure to an infected partner or partner of unknown HIV status has occurred. Specimens with a reactive ELISA result are retested in duplicate. If the result of either duplicate test is reactive,
4719-447: Is largely confined to West Africa . HIV is similar in structure to other retroviruses. It is roughly spherical with a diameter of about 120 nm , around 100,000 times smaller in volume than a red blood cell . It is composed of two copies of positive- sense single-stranded RNA that codes for the virus' nine genes enclosed by a conical capsid composed of 2,000 copies of the viral protein p24 . The single-stranded RNA
4862-612: Is more likely, leading to immunodeficiency. Three groups of HIV-1 have been identified on the basis of differences in the envelope ( env ) region: M, N, and O. Group M is the most prevalent and is subdivided into eight subtypes (or clades ), based on the whole genome, which are geographically distinct. The most prevalent are subtypes B (found mainly in North America and Europe), A and D (found mainly in Africa), and C (found mainly in Africa and Asia); these subtypes form branches in
5005-526: Is one of the organisation's largest interventions. MSF provides a range of health care services including nutritional support, reproductive healthcare, Kala-Azar treatment, counselling services and surgery to the people living in Sudan . Common diseases prevalent in Sudan include tuberculosis , kala-azar also known as visceral leishmaniasis , meningitis , measles , cholera , and malaria . Kala-azar , also known as visceral leishmaniasis , has been one of
5148-561: Is present as both free virus particles and virus within infected immune cells . Research has shown (for both same-sex and opposite-sex couples) that HIV is not contagious during sexual intercourse without a condom if the HIV-positive partner has a consistently undetectable viral load . HIV infects vital cells in the human immune system, such as helper T cells (specifically CD4 T cells), macrophages , and dendritic cells . HIV infection leads to low levels of CD4 T cells through
5291-586: Is the only International Aid organisation with actual presence in the country. MSF is providing Maritime Search And Rescue (SAR) services on the Mediterranean Sea to save the lives of migrants attempting to cross with unseaworthy boats. The Mission started in 2015 after the EU ended its major SAR operation Mare Nostrum severely diminishing much needed SAR capacities in the Mediterranean. Throughout
5434-412: Is tightly bound to nucleocapsid proteins, p7, and enzymes needed for the development of the virion such as reverse transcriptase , proteases , ribonuclease and integrase . A matrix composed of the viral protein p17 surrounds the capsid ensuring the integrity of the virion particle. This is, in turn, surrounded by the viral envelope , that is composed of the lipid bilayer taken from the membrane of
5577-534: Is unknown how often such mixed packaging occurs under natural conditions. Bonhoeffer et al. suggested that template switching by reverse transcriptase acts as a repair process to deal with breaks in the single-stranded RNA genome. In addition, Hu and Temin suggested that recombination is an adaptation for repair of damage in the RNA genomes. Strand switching (copy-choice recombination) by reverse transcriptase could generate an undamaged copy of genomic DNA from two damaged single-stranded RNA genome copies. This view of
5720-431: The 2004 Indian Ocean earthquake . MSF went through a long process of self-examination and discussion in 2005–2006. Many issues were debated, including the treatment of "nationals" as well as "fair employment" and self-criticism. MSF issued a statement for safe abortion following Dobbs v. Jackson Women's Health Organization . MSF has been active in a large number of African countries for decades, sometimes serving as
5863-638: The African green monkey (SIVagm) and sooty mangabey (SIVsmm) are thought to have a long evolutionary history with their hosts. These hosts have adapted to the presence of the virus, which is present at high levels in the host's blood, but evokes only a mild immune response, does not cause the development of simian AIDS, and does not undergo the extensive mutation and recombination typical of HIV infection in humans. In contrast, when these strains infect species that have not adapted to SIV ("heterologous" or similar hosts such as rhesus or cynomologus macaques ),
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6006-508: The Aral Sea area, and look after civilians affected by drug-resistant disease, famine, and epidemics of cholera and AIDS. They vaccinated 3 million Nigerians against meningitis during an epidemic in 1996 and denounced the Taliban's neglect of health care for women in 1997. Arguably, the most significant country in which MSF set up field missions in the late 1990s was Sierra Leone, which
6149-568: The Bosnian War had begun. The city had become surrounded by the Bosnian Serb Army and, containing about 60,000 Bosniaks , had become an enclave guarded by a United Nations Protection Force . MSF was the only organisation providing medical care to the surrounded civilians, and as such, did not denounce the genocide for fear of being expelled from the country (it did, however, denounce the lack of access for other organisations). MSF
6292-544: The CCR5-Δ32 mutation are resistant to infection by the R5 virus, as the mutation leaves HIV unable to bind to this co-receptor, reducing its ability to infect target cells. Sexual intercourse is the major mode of HIV transmission. Both X4 and R5 HIV are present in the seminal fluid , which enables the virus to be transmitted from a male to his sexual partner . The virions can then infect numerous cellular targets and disseminate into
6435-642: The First and Second Congo War brought increased violence and instability to the area. MSF has had to evacuate its teams from areas such as around Bunia , in the Ituri district due to extreme violence, but continues to work in other areas to provide food to tens of thousands of displaced civilians, as well as treat survivors of mass rapes and widespread fighting. The treatment and possible vaccination against diseases such as cholera , measles , polio , Marburg fever , sleeping sickness , HIV/AIDS , and bubonic plague
6578-524: The Great Lakes refugee crisis , and subsequent cholera epidemics, starvation and more mass killings in the large groups of civilians. MSF-France returned to the area and provided medical aid to refugees in Goma . At the time of the genocide, competition between the medical efforts of MSF, the ICRC, and other aid groups had reached an all-time high, but the conditions in Rwanda prompted a drastic change in
6721-602: The Khmer Rouge . In response, MSF set up its first refugee camp missions in Thailand. When Vietnam withdrew from Cambodia in 1989, MSF started long-term relief missions to help survivors of the mass killings and reconstruct the country's health care system. Although its missions to Thailand to help victims of war in Southeast Asia could arguably be seen as its first wartime mission, MSF saw its first mission to
6864-638: The Liberian Civil War . Constant fighting throughout the 1990s and the Second Liberian Civil War have kept MSF volunteers actively providing nutrition, basic health care, and mass vaccinations, and speaking out against attacks on hospitals and feeding stations, especially in Monrovia . Field missions were set up to provide relief to Kurdish refugees who had survived the al-Anfal Campaign , for which evidence of atrocities
7007-814: The Treatment Action Group . In 1999, the organisation spoke out about the lack of humanitarian support in Kosovo and Chechnya, having set up field missions to help civilians affected by the respective political situations. Although MSF had worked in the Kosovo region since 1993, the onset of the Kosovo War prompted the movement of tens of thousands of refugees, and a decline in suitable living conditions. MSF provided shelter, water and health care to civilians affected by NATO's strategic bombing campaigns . A serious crisis within MSF erupted in connection with
7150-445: The adsorption of glycoproteins on its surface to receptors on the target cell followed by fusion of the viral envelope with the target cell membrane and the release of the HIV capsid into the cell. Entry to the cell begins through interaction of the trimeric envelope complex ( gp160 spike) on the HIV viral envelope and both CD4 and a chemokine co-receptor (generally either CCR5 or CXCR4 , but others are known to interact) on
7293-421: The gag polyproteins still need to be cleaved into the actual matrix, capsid and nucleocapsid proteins. This cleavage is mediated by the packaged viral protease and can be inhibited by antiretroviral drugs of the protease inhibitor class. The various structural components then assemble to produce a mature HIV virion. Only mature virions are then able to infect another cell. The classical process of infection of
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#17327910270877436-514: The microtubule -based transport to the nucleus, the viral single-strand RNA genome is transcribed into double-strand DNA, which is then integrated into a host chromosome. HIV can infect dendritic cells (DCs) by this CD4-CCR5 route, but another route using mannose-specific C-type lectin receptors such as DC-SIGN can also be used. DCs are one of the first cells encountered by the virus during sexual transmission. They are currently thought to play an important role by transmitting HIV to T cells when
7579-599: The mujahideen , and in February 1980, MSF publicly denounced the Khmer Rouge . During the 1983–1985 famine in Ethiopia , MSF set up nutrition programmes in the country in 1984, but was expelled in 1985 after denouncing the abuse of international aid and the forced resettlements. MSF's explicit attacks on the Ethiopian government led to other NGOs criticizing their abandonment of their supposed neutrality and contributed to
7722-403: The phylogenetic tree representing the lineage of the M group of HIV-1. Co-infection with distinct subtypes gives rise to circulating recombinant forms (CRFs). In 2000, the last year in which an analysis of global subtype prevalence was made, 47.2% of infections worldwide were of subtype C, 26.7% were of subtype A/CRF02_AG, 12.3% were of subtype B, 5.3% were of subtype D, 3.2% were of CRF_AE, and
7865-438: The α -chemokine receptor, CXCR4 , for entry. Dual-tropic HIV-1 strains are thought to be transitional strains of HIV-1 and thus are able to use both CCR5 and CXCR4 as co-receptors for viral entry. The α -chemokine SDF-1 , a ligand for CXCR4, suppresses replication of T-tropic HIV-1 isolates. It does this by down-regulating the expression of CXCR4 on the surface of HIV target cells. M-tropic HIV-1 isolates that use only
8008-427: The β -chemokine receptor, CCR5 , for entry and are thus able to replicate in both macrophages and CD4 T cells. This CCR5 co-receptor is used by almost all primary HIV-1 isolates regardless of viral genetic subtype. Indeed, macrophages play a key role in several critical aspects of HIV infection. They appear to be the first cells infected by HIV and perhaps the source of HIV production when CD4 cells become depleted in
8151-467: The 14.6 million people in need of anti-retroviral treatment the WHO estimated that only 5.25 million people were receiving it in developing countries, and MSF continues to urge governments and companies to increase research and development into HIV/AIDS treatments to decrease cost and increase availability. In the late 1990s, MSF missions were set up to treat tuberculosis and anaemia in residents of
8294-754: The 24 sections (national offices) is represented. The International Council meets in Geneva, Switzerland, where the International Office, which coordinates international activities common to the operational centres, is based. MSF has general consultative status with the United Nations Economic and Social Council . It received the 1999 Nobel Peace Prize in recognition of its members' continued efforts to provide medical care in acute crises, as well as raising international awareness of potential humanitarian disasters. James Orbinski , who
8437-587: The CCR5 receptor are termed R5; those that use only CXCR4 are termed X4, and those that use both, X4R5. However, the use of co-receptors alone does not explain viral tropism, as not all R5 viruses are able to use CCR5 on macrophages for a productive infection and HIV can also infect a subtype of myeloid dendritic cells , which probably constitute a reservoir that maintains infection when CD4 T cell numbers have declined to extremely low levels. Some people are resistant to certain strains of HIV. For example, people with
8580-405: The DIS (dimerization initiation signal) hairpin is exposed. The formation of the gRNA dimer is mediated by a 'kissing' interaction between the DIS hairpin loops of the gRNA monomers. At the same time, certain guanosine residues in the gRNA are made available for binding of the nucleocapsid (NC) protein leading to the subsequent virion assembly. The labile gRNA dimer has been also reported to achieve
8723-970: The Ebola outbreak in West Africa in 2014, MSF met serious medical demands largely on its own, after the organisation's early warnings were largely ignored. MSF-Burundi has aided in attending to casualties suffered in the 2019 Burundi landslides . MSF is involved in Sri Lanka, where a 26-year civil war ended in 2009 and MSF has adapted its activities there to continue its mission. For example, it helps with physical therapy for patients with spinal cord injuries. It conducts counseling sessions, and has set up an "operating theatre for reconstructive orthopaedic surgery and supplied specialist surgeons, anaesthetists and nurses to operate on patients with complicated war-related injuries". MSF first provided medical help to civilians and refugees who have escaped to camps along
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#17327910270878866-419: The HIV env gene, allows the virus to attach to target cells and fuse the viral envelope with the target cell's membrane releasing the viral contents into the cell and initiating the infectious cycle. As the sole viral protein on the surface of the virus, the envelope protein is a major target for HIV vaccine efforts. Over half of the mass of the trimeric envelope spike is N-linked glycans . The density
9009-441: The HIV protein-coding sequences is translated. Mature HIV mRNAs are exported from the nucleus into the cytoplasm , where they are translated to produce HIV proteins, including Rev . As the newly produced Rev protein is produced it moves to the nucleus, where it binds to full-length, unspliced copies of virus RNAs and allows them to leave the nucleus. Some of these full-length RNAs function as mRNAs that are translated to produce
9152-570: The HIV virological synapse in vivo . The many dissemination mechanisms available to HIV contribute to the virus' ongoing replication in spite of anti-retroviral therapies. HIV differs from many viruses in that it has very high genetic variability . This diversity is a result of its fast replication cycle , with the generation of about 10 virions every day, coupled with a high mutation rate of approximately 3 x 10 per nucleotide base per cycle of replication and recombinogenic properties of reverse transcriptase. This complex scenario leads to
9295-526: The LTR promoter acting by binding the TAR RNA element. The TAR may also be processed into microRNAs that regulate the apoptosis genes ERCC1 and IER3 . The rev protein (p19) is involved in shuttling RNAs from the nucleus and the cytoplasm by binding to the RRE RNA element. The vif protein (p23) prevents the action of APOBEC3G (a cellular protein that deaminates cytidine to uridine in
9438-543: The Red Cross for their seemingly complicit behaviour. These doctors concluded that a new aid organisation was needed that would ignore political/religious boundaries and prioritise the welfare of survivors. Apart from Nigeria, MSF exists in several African countries including Benin, Zambia, Uganda, Kenya, South Africa, Rwanda, Sudan, Sierra Leone, and others. The Groupe d'intervention médicale et chirurgicale en urgence ("Emergency Medical and Surgical Intervention Group")
9581-529: The Thai-Cambodian border in 1979. Due to long decades of war, a proper health care system in the country was severely lacking and MSF moved inland in 1989 to help restructure basic medical facilities. In 1999, Cambodia was hit with a malaria epidemic. The situation of the epidemic was aggravated by a lack of qualified practitioners and poor quality control which led to a market of fake antimalarial drugs. Counterfeit antimalarial drugs were responsible for
9724-433: The U.S.: Although IFA can be used to confirm infection in these ambiguous cases, this assay is not widely used. In general, a second specimen should be collected more than a month later and retested for persons with indeterminate western blot results. Although much less commonly available, nucleic acid testing (e.g., viral RNA or proviral DNA amplification method) can also help diagnosis in certain situations. In addition,
9867-518: The Vastria area (near the village of Nees Kydonies ) in north-east Lesbos and was scheduled be completed by summer 2022. However, the greek Council of State revoked the construction permit, due to a lack of an environmental study, and construction work has since been put on hold. Doctors Without Borders Médecins Sans Frontières ( MSF ; pronounced [medsɛ̃ sɑ̃ fʁɔ̃tjɛʁ] ), also known as Doctors Without Borders ,
10010-594: The activities of the VOS Prudence protesting restrictions and threats by the Libyan "Coast Guard". HIV The human immunodeficiency viruses ( HIV ) are two species of Lentivirus (a subgroup of retrovirus ) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. Without treatment,
10153-409: The adaptive benefit of recombination in HIV could explain why each HIV particle contains two complete genomes, rather than one. Furthermore, the view that recombination is a repair process implies that the benefit of repair can occur at each replication cycle, and that this benefit can be realized whether or not the two genomes differ genetically. On the view that recombination in HIV is a repair process,
10296-423: The advent of AIDS. HIV-positive patients acquire an enormously broad spectrum of opportunistic infections, which was particularly problematic prior to the onset of HAART therapies; however, the same infections are reported among HIV-infected patients examined post-mortem following the onset of antiretroviral therapies. Thus, during the course of infection, viral adaptation to the use of CXCR4 instead of CCR5 may be
10439-614: The aftermath of the Biafran famine of the Nigerian Civil War , by a small group of French doctors and journalists who sought to expand accessibility to medical care across national boundaries and irrespective of race , religion , creed or political affiliation. MSF's principles and operational guidelines are highlighted in its Charter, the Chantilly Principles, and the later La Mancha Agreement. Governance
10582-459: The age of 18. Because of overcrowding, the camp expanded into a nearby olive grove, known as "Moria jungle", where the living quarters were makeshift, typically made out of pallets and tarps. The migrants cut down an estimated 5,000 olive trees, some of them centuries old, to use as firewood. The residents of the nearby village of Moria have complained of increased criminality, including break-ins, vandalism, and looting of houses. Visited in 2019,
10725-403: The animals develop AIDS and the virus generates genetic diversity similar to what is seen in human HIV infection. Chimpanzee SIV (SIVcpz), the closest genetic relative of HIV-1, is associated with increased mortality and AIDS-like symptoms in its natural host. SIVcpz appears to have been transmitted relatively recently to chimpanzee and human populations, so their hosts have not yet adapted to
10868-620: The area. Long-term projects following the end of the civil war included psychological support and phantom limb pain management. Since 1979, MSF has been providing medical humanitarian assistance in Sudan , a nation plagued by starvation and the civil war , prevalent malnutrition and one of the highest maternal mortality rates in the world. In March 2009, it is reported that MSF has employed 4,590 field staff in Sudan tackling issues such as armed conflicts, epidemic diseases, health care and social exclusion. MSF's continued presence and work in Sudan
11011-545: The average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype . In most cases, HIV is a sexually transmitted infection and occurs by contact with or transfer of blood , pre-ejaculate , semen , and vaginal fluids . Non-sexual transmission can occur from an infected mother to her infant during pregnancy , during childbirth by exposure to her blood or vaginal fluid, and through breast milk . Within these bodily fluids, HIV
11154-490: The camp had been put in lockdown due to a COVID-19 outbreak amongst the migrants in the camp. On September 16, 2020, four Afghan men were formally charged with arson for allegedly starting the fire. Two other migrants, both aged 17, which is below the age of full adult criminal responsibility in Greece, were also allegedly involved in starting the fire, and were held in police detention on the mainland. Defence lawyers stated that
11297-487: The camp was described as a " concentration camp on European soil" by Jean Ziegler , vice-chairman of the committee of experts advising the UN Human Rights Council. Pope Francis also referred to the camp as a concentration camp. On 30 September 2019, a fire in the camp killed one Afghan woman who was the wife of the man who would commit the 2023 Lisbon Ismaili Centre stabbings . On 8 September 2020,
11440-592: The cell as new virus particles that will begin the replication cycle anew. Two types of HIV have been characterized: HIV-1 and HIV-2. HIV-1 is the virus that was initially discovered and termed both lymphadenopathy associated virus (LAV) and human T-lymphotropic virus 3 (HTLV-III). HIV-1 is more virulent and more infective than HIV-2, and is the cause of the majority of HIV infections globally. The lower infectivity of HIV-2, compared to HIV-1, implies that fewer of those exposed to HIV-2 will be infected per exposure. Due to its relatively poor capacity for transmission, HIV-2
11583-470: The cell types a virus infects. HIV can infect a variety of immune cells such as CD4 T cells , macrophages , and microglial cells . HIV-1 entry to macrophages and CD4 T cells is mediated through interaction of the virion envelope glycoproteins (gp120) with the CD4 molecule on the target cells' membrane and also with chemokine co-receptors . Macrophage-tropic (M-tropic) strains of HIV-1, or non- syncytia -inducing strains (NSI; now called R5 viruses ) use
11726-407: The charity was active in 70 countries with over 35,000 personnel; mostly local doctors, nurses and other medical professionals, logistical experts, water and sanitation engineers, and administrators. Private donors provide about 90% of the organisation's funding, while corporate donations provide the rest, giving MSF an annual budget of approximately US$ 1.63 billion. MSF was founded in 1971, in
11869-621: The civil war, providing emergency medical humanitarian assistance in multiple locations. The situation of poor infrastructure in the South was aggravated by the civil war and resulted in the worsening of the region's appalling health indicators. An estimated 75 percent of people in the nascent nation has no access to basic medical care and 1 in seven women dies during childbirth. Malnutrition and disease outbreaks are perennial concerns as well. In 2011, MSF clinic in Jonglei State , South Sudan,
12012-459: The collapse of the extracellular portion of gp41 into a hairpin shape. This loop structure brings the virus and cell membranes close together, allowing fusion of the membranes and subsequent entry of the viral capsid. After HIV has bound to the target cell, the HIV RNA and various enzymes, including reverse transcriptase, integrase, ribonuclease, and protease, are injected into the cell. During
12155-418: The country by rebel groups and the government led to several massacres, and MSF teams have even begun to suspect that an ethnic cleansing is occurring. Mass measles vaccinations, tuberculosis treatment and the re-opening of hospitals closed by fighting are projects run by MSF, which is the only group providing aid in much of the country. MSF has strongly promoted the use of contraception in Africa. During
12298-417: The country, also receive better treatment and monitoring. As a result of 12 January 2010 Haiti earthquake , reports from Haiti indicated that all three of the organisation's hospitals had been severely damaged; one collapsing completely and the other two having to be abandoned. Following the quake, MSF sent about nine planes loaded with medical equipment and a field hospital to help treat the victims. However,
12441-507: The country, and volunteers provide vaccinations (in the cases of measles and polio) and/or treatment to the residents. Mental health is also an important aspect of medical treatment for MSF teams in Uganda since most people refuse to leave the IDP camps for constant fear of being attacked. MSF first camp set up a field mission in Côte d'Ivoire in 1990, but ongoing violence and the 2002 division of
12584-400: The deaths of at least 30 people during the epidemic. This has prompted efforts by MSF to set up and fund a malaria outreach project and utilise Village Malaria Workers. MSF also introduced a switching of first-line treatment to a combination therapy (Artesunate and Mefloquine) to combat resistance and fatality of old drugs that were used to treat the disease traditionally. Cambodia is one of
12727-447: The development of AIDS. HIV is a member of the genus Lentivirus , part of the family Retroviridae . Lentiviruses have many morphologies and biological properties in common. Many species are infected by lentiviruses, which are characteristically responsible for long-duration illnesses with a long incubation period . Lentiviruses are transmitted as single-stranded , positive- sense , enveloped RNA viruses . Upon entry into
12870-577: The development of stable recombinant forms of the viral spike by the introduction of an intersubunit disulphide bond and an isoleucine to proline mutation ( radical replacement of an amino acid) in gp41. The so-called SOSIP trimers not only reproduce the antigenic properties of the native viral spike, but also display the same degree of immature glycans as presented on the native virus. Recombinant trimeric viral spikes are promising vaccine candidates as they display less non-neutralising epitopes than recombinant monomeric gp120, which act to suppress
13013-532: The establishment of the majority of the support sections: MSF-Greece (1990), MSF-USA (1990), MSF-Canada (1991), MSF-Japan (1992), MSF-UK (1993), MSF-Italy (1993), MSF-Australia (1994), as well as Germany, Austria, Denmark, Sweden, Norway, and Hong Kong (MSF-UAE was formed later). Malhuret and Brauman were instrumental in professionalising MSF. In December 1979, after the Soviet army had invaded Afghanistan , field missions were immediately set up to provide medical aid to
13156-414: The following trial had "major procedural violations" including incomplete translations, and that the conviction was based largely on testimony from one witness who did not attend. An investigation by Forensic Architecture based on photos and videos of the spread of the fire found that the it was more likely to have been started by improvised electricity supplies in the midst of flammable tent-like housing in
13299-431: The generation of many variants of HIV in a single infected patient in the course of one day. This variability is compounded when a single cell is simultaneously infected by two or more different strains of HIV. When simultaneous infection occurs, the genome of progeny virions may be composed of RNA strands from two different strains. This hybrid virion then infects a new cell where it undergoes replication. As this happens,
13442-576: The generation of recombinational variation would be a consequence, but not the cause of, the evolution of template switching. HIV-1 infection causes chronic inflammation and production of reactive oxygen species . Thus, the HIV genome may be vulnerable to oxidative damage , including breaks in the single-stranded RNA. For HIV, as well as for viruses in general, successful infection depends on overcoming host defense strategies that often include production of genome-damaging reactive oxygen species. Thus, Michod et al. suggested that recombination by viruses
13585-552: The genetic information that is transmitted from parental to progeny genomes. Viral recombination produces genetic variation that likely contributes to the evolution of resistance to anti-retroviral therapy . Recombination may also contribute, in principle, to overcoming the immune defenses of the host. Yet, for the adaptive advantages of genetic variation to be realized, the two viral genomes packaged in individual infecting virus particles need to have arisen from separate progenitor parental viruses of differing genetic constitution. It
13728-593: The hardest hit HIV/AIDS countries in Southeast Asia. In 2001, MSF started introducing antiretroviral (ARV) therapy to AIDS patients for free. This therapy prolongs the patients' lives and is a long-term treatment. In 2002, MSF established chronic diseases clinics with the Cambodian Ministry of Health in various provinces to integrate HIV/AIDS treatment, alongside hypertension, diabetes, and arthritis which have high prevalence rate. This aims to reduce facility-related stigma as patients are able to seek treatment in
13871-512: The idea of humanitarian intervention as a duty, in particular on the part of Western nations such as France. In 2007 MSF clarified that for nearly 30 years MSF and Kouchner have had public disagreements on such issues as the right to intervene and the use of armed force for humanitarian reasons. Kouchner is in favour of the latter, whereas MSF stands up for an impartial humanitarian action, independent from all political, economic and religious powers. In 1982, Malhuret and Rony Brauman (who became
14014-415: The immune response to target epitopes. The RNA genome consists of at least seven structural landmarks ( LTR , TAR , RRE , PE, SLIP, CRS, and INS), and nine genes ( gag , pol , and env , tat , rev , nef , vif , vpr , vpu , and sometimes a tenth tev , which is a fusion of tat , env and rev ), encoding 19 proteins. Three of these genes, gag , pol , and env , contain information needed to make
14157-521: The integrated DNA provirus is transcribed into RNA. The full-length genomic RNAs (gRNA) can be packaged into new viral particles in a pseudodiploid form. The selectivity in the packaging is explained by the structural properties of the dimeric conformer of the gRNA. The gRNA dimer is characterized by a tandem three-way junction within the gRNA monomer, in which the SD and AUG hairpins , responsible for splicing and translation respectively, are sequestered and
14300-743: The landings of some of the planes had to be delayed due to the massive number of humanitarian and military flights coming in. The Kashmir conflict in North India resulted in a more recent MSF intervention (the first field mission was set up in 1999) to help civilians displaced by fighting in Jammu and Kashmir , as well as in Manipur . Psychological support is a major target of missions, but teams have also set up programmes to treat tuberculosis, HIV/AIDS and malaria. Mental health support has been of significant importance for MSF in much of southern Asia since
14443-424: The main period of the genocide. MSF, together with several other aid organisations, had to leave the country in 1995, although many MSF and ICRC volunteers worked together under the ICRC's rules of engagement, which held that neutrality was of the utmost importance. These events led to a debate within the organisation about the concept of balancing neutrality of humanitarian aid workers against their witnessing role. As
14586-701: The major health problems in Sudan . After the Comprehensive Peace Agreement between North and Southern Sudan on 9 January 2005, the increase in stability within the region helped further efforts in healthcare delivery. Médicins Sans Frontières tested a combination of sodium stibogluconate and paromomycin, which would reduce treatment duration (from 30 to 17 days) and cost in 2008. In March 2010, MSF set up its first Kala-Azar treatment centre in Eastern Sudan, providing free treatment for this otherwise deadly disease. If left untreated, there
14729-590: The mission MSF has operated its own vessels like the Bourbon Argos (2015–2016), Dignity 1 (2015–2016) and VOS Prudence (2016–2017). MSF has also provided medical teams to support other NGOs and their ships like the MOAS Phoenix (2015) or the Aquarius (2017–2018) and Ocean Viking (2019–2020) with SOS Méditerranée and Mediterranea Saving Humans . In August 2017 MSF decided to suspend
14872-407: The murders and demanded that a French military intervention stop the genocide. MSF-France introduced the slogan "One cannot stop a genocide with doctors" to the media, and the controversial Opération Turquoise followed less than one month later. This intervention directly or indirectly resulted in movements of hundreds of thousands of Rwandan refugees to Zaire and Tanzania in what became known as
15015-413: The organisation's president in 1982) brought increased financial independence to MSF by introducing fundraising-by-mail to better collect donations. The 1980s also saw the establishment of the other operational sections from MSF-France (1971): MSF-Belgium (1980), MSF-Switzerland (1981), MSF-Holland (1984), and MSF-Spain (1986). MSF-Luxembourg was the first support section, created in 1986. The early 1990s saw
15158-566: The organisation's work in Kosovo when the Greek section of MSF was expelled from the organisation. The Greek MSF section had gained access to Serbia at the cost of accepting Serb government imposed limits on where it could go and what it could see – terms that the rest of the MSF movement had refused. A non-MSF source alleged that the exclusion of the Greek section happened because its members extended aid to both Albanian and Serbian civilians in Pristina during NATO's bombing. The rift
15301-410: The patient. Macrophages and microglial cells are the cells infected by HIV in the central nervous system . In the tonsils and adenoids of HIV-infected patients, macrophages fuse into multinucleated giant cells that produce huge amounts of virus. T-tropic strains of HIV-1, or syncytia -inducing strains (SI; now called X4 viruses ) replicate in primary CD4 T cells as well as in macrophages and use
15444-435: The president of the organisation acknowledged Doctors Without Borders was founded in racism and pledged to do better. MSF played an important role for including snakebite as a WHO Category A Neglected Tropical Disease (NTD) status in, a WHO resolution and development of global strategy to decrease burden of snakebite. MSF highlighted the scarcity of anti-venom in Africa due to stoppage of manufacturing and brought urgency to
15587-406: The remaining 5.3% were composed of other subtypes and CRFs. Most HIV-1 research is focused on subtype B; few laboratories focus on the other subtypes. The existence of a fourth group, "P", has been hypothesised based on a virus isolated in 2009. The strain is apparently derived from gorilla SIV (SIVgor), first isolated from western lowland gorillas in 2006. HIV-2's closest relative is SIVsm,
15730-425: The reverse transcriptase, by jumping back and forth between the two different RNA templates, will generate a newly synthesized retroviral DNA sequence that is a recombinant between the two parental genomes. This recombination is most obvious when it occurs between subtypes. The closely related simian immunodeficiency virus (SIV) has evolved into many strains, classified by the natural host species. SIV strains of
15873-404: The scenario and led media advocacy efforts. On June 20, 2024, MSF announced closing down its access-to-medicines campaign focused on enabling access to medicines in resource limited settings. MSF plans to replace the campaign with a new effort that will focus on products, like medicines and vaccines, that MSF needs for its own relief efforts. Several advocates have criticized this move including
16016-519: The single-stranded viral DNA and/or interferes with reverse transcription ). The vpr protein (p14) arrests cell division at G2/M . The nef protein (p27) down-regulates CD4 (the major viral receptor), as well as the MHC class I and class II molecules. Nef also interacts with SH3 domains . The vpu protein (p16) influences the release of new virus particles from infected cells. The ends of each strand of HIV RNA contain an RNA sequence called
16159-412: The site of cell-to-cell contact, close apposition of cells, which minimizes fluid-phase diffusion of virions, and clustering of HIV entry receptors on the target cell towards the contact zone. Cell-to-cell spread is thought to be particularly important in lymphoid tissues , where CD4 T cells are densely packed and likely to interact frequently. Intravital imaging studies have supported the concept of
16302-403: The sole provider of health care, food, and water. Although MSF has consistently attempted to increase media coverage of the situation in Africa to increase international support, long-term field missions are still necessary. Treating and educating the public about HIV/AIDS in sub-Saharan Africa , which sees the most deaths and cases of the disease in the world, is a major task for volunteers. Of
16445-673: The specimen is reported as repeatedly reactive and undergoes confirmatory testing with a more specific supplemental test (e.g., a polymerase chain reaction (PCR), western blot or, less commonly, an immunofluorescence assay (IFA)). Only specimens that are repeatedly reactive by ELISA and positive by IFA or PCR or reactive by western blot are considered HIV-positive and indicative of HIV infection. Specimens that are repeatedly ELISA-reactive occasionally provide an indeterminate western blot result, which may be either an incomplete antibody response to HIV in an infected person or nonspecific reactions in an uninfected person. HIV deaths in 2014 excluding
16588-556: The structural proteins Gag and Env. Gag proteins bind to copies of the virus RNA genome to package them into new virus particles. HIV-1 and HIV-2 appear to package their RNA differently. HIV-1 will bind to any appropriate RNA. HIV-2 will preferentially bind to the mRNA that was used to create the Gag protein itself. Two RNA genomes are encapsidated in each HIV-1 particle (see Structure and genome of HIV ). Upon infection and replication catalyzed by reverse transcriptase, recombination between
16731-496: The structural proteins for new virus particles. For example, env codes for a protein called gp160 that is cut in two by a cellular protease to form gp120 and gp41. The six remaining genes, tat , rev , nef , vif , vpr , and vpu (or vpx in the case of HIV-2), are regulatory genes for proteins that control the ability of HIV to infect cells, produce new copies of virus (replicate), or cause disease. The two tat proteins (p16 and p14) are transcriptional transactivators for
16874-427: The target cell surface. Gp120 binds to integrin α 4 β 7 activating LFA-1 , the central integrin involved in the establishment of virological synapses , which facilitate efficient cell-to-cell spreading of HIV-1. The gp160 spike contains binding domains for both CD4 and chemokine receptors. The first step in fusion involves the high-affinity attachment of the CD4 binding domains of gp120 to CD4. Once gp120
17017-413: The target cell, the viral RNA genome is converted (reverse transcribed) into double-stranded DNA by a virally encoded enzyme, reverse transcriptase , that is transported along with the viral genome in the virus particle. The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded enzyme, integrase , and host co-factors . Once integrated,
17160-450: The time. In 1984, as the situation in Lebanon deteriorated further and security for aid groups was minimised, MSF withdrew its volunteers. Claude Malhuret was elected as the new president of Médecins Sans Frontières in 1977, and soon after debates began over the future of the organisation. In particular, the concept of témoignage ("witnessing"), which refers to speaking out about the suffering that one sees as opposed to remaining silent,
17303-485: The treatment and diagnosis of Kala-Azar. Research on its cures and vaccines are currently being conducted. In December 2010, South Sudan was hit with the worst outbreak of Kala-Azar in eight years. The number of patients seeking treatment increased eight-fold as compared to the year before. Sudan's latest civil war began in 1983 and ended in 2005 when a peace agreement was signed between North Sudan and South Sudan . MSF medical teams were active throughout and prior to
17446-414: The two HIV envelope glycoproteins, gp41 and gp120 . These are transported to the plasma membrane of the host cell where gp41 anchors gp120 to the membrane of the infected cell. The Gag (p55) and Gag-Pol (p160) polyproteins also associate with the inner surface of the plasma membrane along with the HIV genomic RNA as the forming virion begins to bud from the host cell. The budded virion is still immature as
17589-484: The two genomes can occur. Recombination occurs as the single-strand, positive-sense RNA genomes are reverse transcribed to form DNA. During reverse transcription, the nascent DNA can switch multiple times between the two copies of the viral RNA. This form of recombination is known as copy-choice. Recombination events may occur throughout the genome. Anywhere from two to 20 recombination events per genome may occur at each replication cycle, and these events can rapidly shuffle
17732-840: The two groups of colleagues merged to form Médecins Sans Frontières (Doctors Without Borders). MSF's first mission was to the Nicaraguan capital, Managua , where a 1972 earthquake had destroyed most of the city and killed between 10,000 and 30,000 people. The organisation, today known for its quick response in an emergency, arrived three days after the Red Cross had set up a relief mission. On 18 and 19 September 1974, Hurricane Fifi caused major flooding in Honduras and killed thousands of people (estimates vary), and MSF set up its first long-term medical relief mission. Between 1975 and 1979, after South Vietnam had fallen to North Vietnam , millions of Cambodians immigrated to Thailand to avoid
17875-570: The viral DNA into the host cell's genome is carried out by another viral enzyme called integrase . The integrated viral DNA may then lie dormant, in the latent stage of HIV infection. To actively produce the virus, certain cellular transcription factors need to be present, the most important of which is NF- κ B (nuclear factor kappa B), which is upregulated when T cells become activated. This means that those cells most likely to be targeted, entered and subsequently killed by HIV are those actively fighting infection. During viral replication,
18018-536: The virus in its adaptation to avoid innate restriction factors present in host cells. Adaptation to use normal cellular machinery to enable transmission and productive infection has also aided the establishment of HIV-2 replication in humans. A survival strategy for any infectious agent is not to kill its host, but ultimately become a commensal organism. Having achieved a low pathogenicity, over time, variants that are more successful at transmission will be selected. The HIV virion enters macrophages and CD4 T cells by
18161-425: The virus is captured in the mucosa by DCs. The presence of FEZ-1 , which occurs naturally in neurons , is believed to prevent the infection of cells by HIV. HIV-1 entry, as well as entry of many other retroviruses, has long been believed to occur exclusively at the plasma membrane. More recently, however, productive infection by pH -independent, clathrin-mediated endocytosis of HIV-1 has also been reported and
18304-463: The virus may become latent , allowing the virus and its host cell to avoid detection by the immune system, for an indeterminate amount of time. The virus can remain dormant in the human body for up to ten years after primary infection; during this period the virus does not cause symptoms. Alternatively, the integrated viral DNA may be transcribed , producing new RNA genomes and viral proteins, using host cell resources, that are packaged and released from
18447-403: The virus to evade the body's immune system. The reverse transcriptase also has ribonuclease activity that degrades the viral RNA during the synthesis of cDNA, as well as DNA-dependent DNA polymerase activity that creates a sense DNA from the antisense cDNA. Together, the cDNA and its complement form a double-stranded viral DNA that is then transported into the cell nucleus . The integration of
18590-540: The virus. This virus has also lost a function of the nef gene that is present in most SIVs. For non-pathogenic SIV variants, nef suppresses T cell activation through the CD3 marker. Nef 's function in non-pathogenic forms of SIV is to downregulate expression of inflammatory cytokines , MHC-1 , and signals that affect T cell trafficking. In HIV-1 and SIVcpz, nef does not inhibit T-cell activation and it has lost this function. Without this function, T cell depletion
18733-597: The way humanitarian organisations approached aid missions. The Code of Conduct for the International Red Cross and Red Crescent Movement and NGOs in Disaster Relief Programmes was created by the ICRC in 1994 to provide a framework for humanitarian missions and MSF is a signatory of this code. The code advocates the provision of humanitarian aid only, and groups are urged not to serve any political or religious interest, or be used as
18876-475: The whole organism. However, a selection process leads to a predominant transmission of the R5 virus through this pathway. In patients infected with subtype B HIV-1, there is often a co-receptor switch in late-stage disease and T-tropic variants that can infect a variety of T cells through CXCR4. These variants then replicate more aggressively with heightened virulence that causes rapid T cell depletion, immune system collapse, and opportunistic infections that mark
19019-461: The world's most crowded prisons. In 2007, MSF worked with the Cambodian Ministry of Health to provide psychosocial and technical support in offering pediatric HIV/AIDS treatment to affected children. MSF also provided medical supplies and staff to help in one of the worst dengue outbreaks in 2007, which had more than 40,000 people hospitalized, killing 407 people, primarily children. In 2010, Southern and Eastern provinces of Cambodia were hit with
19162-656: Was being collected in 1991. 1991 also saw the beginning of the civil war in Somalia , during which MSF set up field missions in 1992 alongside a UN peacekeeping mission. Although the UN-aborted operations by 1993, MSF representatives continued with their relief work, running clinics and hospitals for civilians. MSF first began work in Srebrenica (in Bosnia and Herzegovina) as part of a UN convoy in 1993, one year after
19305-552: Was being opposed or played down by Malhuret and his supporters. Malhuret thought MSF should avoid criticism of the governments of countries in which they were working, while Kouchner believed that documenting and broadcasting the suffering in a country was the most effective way to solve a problem. In 1979, after four years of refugee movement from South Vietnam and the surrounding countries by foot and by boat , French intellectuals made an appeal in Le Monde for "A Boat for Vietnam",
19448-695: Was forced to leave the area in 1995 when the Bosnian Serb Army captured the town. 40,000 Bosniak civilian inhabitants were deported, and approximately 7,000 were killed in mass executions. When the genocide in Rwanda began in April 1994, some delegates of MSF working in the country were incorporated into the International Committee of the Red Cross (ICRC) medical team for protection. Both groups succeeded in keeping all main hospitals in Rwanda's capital Kigali operational throughout
19591-633: Was formed in 1971 by French doctors who had worked in Biafra, to provide aid and to emphasize the importance of survivors' rights. At the same time, Raymond Borel , the editor of the French medical journal TONUS , had started a group called Secours Médical Français ("French Medical Relief") in response to the 1970 Bhola cyclone , which killed at least 625,000 in East Pakistan (now Bangladesh). Borel had intended to recruit doctors to provide aid to survivors of natural disasters. On 22 December 1971,
19734-576: Was healed only in 2005 with the re-admission of the Greek section to MSF. A similar situation was found in Chechnya, whose civilian population was largely forced from their homes into unhealthy conditions and subjected to the violence of the Second Chechen War . MSF has been working in Haiti since 1991, but since President Jean-Bertrand Aristide was forced from power, the country has seen
19877-547: Was involved in a civil war at the time. In 1998, volunteers began assisting in surgeries in Freetown to help with an increasing number of amputees , and collecting statistics on civilians (men, women and children) being attacked by large groups of men claiming to represent ECOMOG . The groups of men were travelling between villages and systematically chopping off one or both of each resident's arms, raping women, gunning down families, razing houses, and forcing survivors to leave
20020-457: Was looted and attacked by raiders. Hundreds, including women and children were killed. Valuable items including medical equipment and drugs were lost during the raid and parts of the MSF facilities were destroyed in a fire. The incident had serious repercussions as MSF is the only primary health care provider in this part of Jonglei State. Although active in the Congo region of Africa since 1985,
20163-746: Was one of the few major countries supportive of the Biafrans (the United Kingdom, the Soviet Union and the United States sided with the Nigerian government), and the conditions within the blockade were unknown to the world. A number of French doctors volunteered with the French Red Cross to work in hospitals and feeding centers in besieged Biafra. One of the co-founders of the organisation was Bernard Kouchner , who later had
20306-448: Was recently suggested to constitute the only route of productive entry. Shortly after the viral capsid enters the cell, an enzyme called reverse transcriptase liberates the positive-sense single-stranded RNA genome from the attached viral proteins and copies it into a complementary DNA (cDNA) molecule. The process of reverse transcription is extremely error-prone, and the resulting mutations may cause drug resistance or allow
20449-473: Was the president of the organisation at the time, accepted the prize on behalf of MSF. Prior to this, MSF also received the 1996 Seoul Peace Prize . Christos Christou succeeded Joanne Liu as international president in June 2019. During the Nigerian Civil War of 1967 to 1970, the Nigerian military formed a blockade around the nation's newly independent south-eastern region, Biafra . At this time, France
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