HIV Activity Packet
What you will find in this packet:
1. Explanation of packet (page 1)
2. Instructions (page 1)
3. Activity (begins page 2)
Part I: Explanation of packet
Before completing this assignment, students should first learn about HIV and AIDS – specifically
the life cycle and treatment options, along with important concepts in genetics and immunology. The
purpose of this packet is to reinforce biological concepts while practicing statistical principles that will be
tested on the AP Exam. In this packet students will an in-class exercise and a homework assignment.
Additionally, students will get to take on the role of doctors, which is sure to capture their attention.
Part III: Instructions
To set up: Print off copies of all worksheets. Place “Pathology Lab Results” at the front of the
classroom. Students should work in groups of 4. Give one copy of both the “Patient Information
Worksheet” and the “Medicine Data Table” to each group of 4. In this activity, students will be
analyzing HIV+ patient histories, performing t-tests and chi square tests, and prescribing treatment
options. After completing the assignment, students should complete thehomework assignment to each
student.
Part IV: Activity
Worksheet list:
1.
2.
3.
4.
5.
Pathology Lab Results (place a few copies at the front of the classroom)
Patient Information Worksheet (one copy per group of 4)
Medicine Data Table (one copy per group of four)
HIV and Data Analysis Activity (one copy per student)
Homework Assignment (one copy per student)
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Pathology Lab Results: simulating lab at doctor’s office
Patient Information: #48392 CJ Blue
Tested for:
Platelets
White Blood Cells (WBCs)
T-cell count
Red Blood Cells (RBCs)
Glucose
Hemoglobin
Amount:
100,000/mL
5700 cells/µL
431 cells/mm3
5.1 mil cells/µL
98 mg/dL
13 gm/dL
Patient Information: #277948 Naomi Green
Tested for:
T-cell count
Platelets
Red Blood Cells (WBCs)
White Blood Cells (RBCs)
Hemoglobin
Glucose
Amount:
130 cells/mm3
234,000/mL
5.7 mil cells/µL
8,957 cells/µL
17 gm/dL
130 mg/dL
Patient Information: #920938 Cynthia Orange
Tested for:
Red Blood Cells (RBCs)
Glucose
T-cell count
White Blood Cells (RBCs)
Platelets
Hemoglobin
Amount:
6.1 mil cells/µL
77 mg/dL
395 cells/mm3
7,723 cells/µL
309,000/mL
9 gm/dL
Patient Information: #156309 John Red
Tested for:
Platelets
T-cell count
Hemoglobin
White Blood Cells (RBCs)
Red Blood Cells
Glucose
Amount:
276,835/mL
175 cells/mm3
10 gm/dL
4,714 cells/µL
6.1 mil cells/µL
99 mg/dL
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Patient Information Worksheet (one copy per group)
Patient #1 Information
The patient’s name is John Red. He was born on July 8, 1960 in North Carolina. He is 6’2” and weighs 180
pounds. He had a tonsillectomy (tonsils removed) when he was 8 years old. His grandfather had lung
cancer. His dad has heart disease and had a heart attack when he was 60, but survived. His twin brother
had a stroke when he was 33. His blood pressure today was 120/80 mm Hg. His heart rate is 75 bpm. He
is an accountant who liked to play sports and hike in his free time. He is currently suffering from Kaposi’s
Sarcoma, which is an opportunistic infection that comes when someone’s immune system is lowered
due to HIV/AIDS. Kaposi’s is a type of cancer that causes legions on the body. Today he has legions in his
mouth.
Patient #2 Information
The patient is CJ Blue. He is 5’7” and weighs 198 pounds. He was born on December 29, 1989 in New
York. His dad suffers from anxiety. His mom has arthritis. His grandfather has heart disease. He
previously had an appendectomy (appendix removed). He takes Flonase for asthma. His blood pressure
today was 120/80 mm Hg. His heart rate is 100 bpm. He is a graduate student at a university, who
enjoys video games and web design. Today he has a flu-like illness. He had been taking Nyquil for a few
days because he thought he had the flu. However, his HIV test just came back positive, so he knows it is
not the flu.
Patient #3 Information
The patient’s name is Naomi Green. She was born on January 1, 1981 in California. She is 5’3” and
weighs 90 pounds. Her grandmother had colon cancer. Her dad and sister have diabetes. Her mom has
heart disease. Her blood pressure today was 140/90 mm Hg. Her heart rate is 100 bpm. She is a stay at
home mom, who enjoys planning philanthropic events and school fundraising. She is suffering from
wasting syndrome, which means she is losing weight and muscle mass. Wasting syndrome is common
with HIV and AIDS.
Patient # 4 Information
The patient is Cynthia Orange. She is 5’10” and weighs 180 pounds. She was born on September 13,
1981 in Texas. Her grandmother had breast cancer. Her dad has type II diabetes. Her younger sister had
leukemia but survived. She previously had surgery for a torn ACL while playing basketball. Her blood
pressure today was 140/100 mm Hg. Her heart rate is 68 bpm. She is a scientist, who enjoys bird
watching in her free time. Today she is suffering from joint pain and swollen lymph nodes. She had been
taking ibuprofen because she did not know she had HIV until her test came back positive today.
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Medicine Data Tables: (one copy per group)
Medicine A: NRTI (nucleoside reverse transcriptase inhibitor)
Gender
Patient 1
Patient 2
Patient 3
M
F
F
D.O.B.
1989
1957
1978
T-cell count before
treatment (cells/mm3)
302
417
212
Follow-up T-cell count after 3
months (cells/mm3)
306
417
213
T-Cell count before
treatment (cells/mm3)
436
315
281
Follow-up T-cell count after 3
months (cells/mm3)
440
315
282
T-cell count before
treatment (cells/mm3)
404
213
340
Follow-up T-cell count after 3
months (cells/mm3)
409
219
347
Medicine B: PI (protease inhibitor)
Gender
Patient 1
Patient 2
Patient 3
F
M
M
D.O.B.
1963
1993
1984
Medicine C: HAART therapy (2 NRTIs and 1 PI)
Patient 1
Patient 2
Patient 3
Gender
D.O.B.
M
M
F
1999
1977
1950
Medicine D: Antibiotic
Patient 1
Patient 2
Patient 3
Gender
D.O.B.
M
F
F
1998
1968
1940
Before treatment
(cells/mm3)
206
300
447
4
Follow-up T-cell count after 3
months (cells/mm3)
209
300
447
Name: __________________________
Date: ___________________________
HIV and Data Analysis Activity
Part I: Patient Medical Record
1. Congratulations, you are now doctors! Working in groups of 4, you must analyze your
patient’s histories and diagnose them with the appropriate conditions. Additionally, you
must also determine their current symptoms. Use the following charts to gather all the
necessary information.
2. Everyone in the group is responsible for filling in the medical record for 1 patient. Do not
duplicate patients so that they all get the help they need.
3. Review: HIV infects _________
a. Heart cells
b. T-cells
c. Red Blood Cells
4. What are potential consequences of having a weakened immune system?
Patient Medical Record
PATIENT INFORMATION
First
M.I.
Last
Name:
Month
Day
Year
Date of Birth
GENERAL INFORMATION
Temperature
Weight
Heart Rate
Blood Pressure
Normal: 98.6 °F
Normal: Varies
Normal: 60-100 bpm
Normal : 120/80 mm Hg
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FAMILY HISTORY
PREVIOUS SURGERIES
CURRENT MEDICATIONS
CURRENT SYMPTOMS/OPPORTUNISTIC INFECTIONS
BLOOD TEST RESULTS (go to Pathology Lab to obtain results)
Date:
/
/
Normal Range
70 - 110 mg/dL
12 - 18 gm/dL
4,300 - 10,800 cells/µL
4.2 - 6.9 million cells/µL
150,000 - 350,000/mL
500-1000 cells/mm3
Glucose
Hemoglobin
White Blood Cells (WBCs)
Red Blood Cells (RBCs)
Platelets
T-cell count
Normal? Y/N
CURRENT CLASSIFICATION (T-cells/mm3)
Healthy >500
HIV+
500-200
Review: What are a few differences between HIV and AIDS?
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AIDS <200
Part II: Prescribing Medication
As you can see, patients diagnosed with HIV and AIDS have a broad range of symptoms. Now it is time to
prescribe a treatment option.
Dr. ___________________
Prescription Form
Medicine A:
NRTI (nucleoside reverse transcriptase inhibitor) – this medicine inhibits reverse
transcription, so that viral RNA cannot create cDNA within the host cell.
Medicine B:
PI (protease inhibitor) – This medicine prevents an enzyme (called protease) from
cleaving long HIV protein strands into smaller proteins, which are sent off in vesicles
to infect other cells.
Medicine C:
HAART therapy “cocktail” (2 NRTIS and 1 PI) – a combination therapy.
Medicine D:
Antibiotic – kills bacterial infections in the body.
1. Based on the descriptions of the medicines, which do you think will be most effective? Why?
2. Clinical trials were run for each of the 4 medicines listed above. The results are listed in the
“Medicine Data Tables” which have been provided to your group.
3. Divide up the 4 medicines among each of the 4 group members.
4. In order to determine which medicine is most effective in treating HIV/AIDS, a data analysis test
must be performed. In this case, we will use a t-test. Why is a t-test the appropriate test?
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5. Perform the t-test for your assigned medicine. *** use p = 0.05***
H0 (null hypothesis):
(In this example, the Specified mean difference (µ) is 0. )
Ha (alternative hypothesis):
Total difference (add up differences for all patients between ‘ before’ and ‘after’ treatment): ________
Mean difference: ________ (total difference/number of patients)
Standard Deviation:
Standard Error:
T – value
=
T –value
=
(mean difference) – (specified mean difference)
Standard Error
D F= n-1 = ______
Now find the α-value. α = ______________
How does α compare to the p-value of 0.05? _________________________ (hint: greater or less than)
6. Share the results with your group.
Medicine A- t= ______ α = _______
Medicine B - t= ______ α = _______
Medicine C - t=_______ α = _______
Medicine D- t=_______ α = _______
is the α – value
is the α – value
is the α – value
is the α – value
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greater or less than p?
greater or less than p?
greater or less than p?
greater or less than p?
7. Which medicine has statistically significant results (meaning it was an effective treatment)?
8. Did you predict correctly? If not, why do you think your medicine was not as effective?
Part III: HIV treatments throughout the world
Studies done in the United States show that HAART therapy is effective in the treatment of HIV.
However, a group of researchers is trying to determine if HAART therapy will be effective in HIV+
patients in other countries. To test this, researchers collected the average t-cell counts after 3 months of
HAART therapy for men and women in Scienceville, USA. These are the results they found:
Location
Scienceville, USA
Scienceville, USA
Gender
Avg T-cell count after 3 months of HAART Therapy
(cells/mm3)
440
451
Male
Female
Next, the researchers went to Medicineville, World. They tested the HAART therapy in 14 patients.
Results:
Location
Medicineville, World
Medicineville, World
Medicineville, World
Medicineville, World
Medicineville, World
Medicineville, World
Medicineville, World
Medicineville, World
Medicineville, World
Medicineville, World
Medicineville, World
Medicineville, World
Medicineville, World
Medicineville, World
Gender
Avg T-cell count after 3 months of HAART Therapy
(cells/mm3)
490
501
477
460
470
455
478
471
457
463
460
480
468
471
Female
Female
Female
Male
Female
Male
Male
Female
Male
Male
Male
Female
Male
Female
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1. A Chi Square Goodness of Fit test should be used to determine if the results observed in
Medicineville, World are statistically similar to the results obtained in Scienceville, USA
(expected results). Why would you use a Chi Square test and not a t-test?
2. Perform the Chi Square test.
(𝒐𝒃𝒔𝒆𝒓𝒗𝒆𝒅 − 𝒆𝒙𝒑𝒆𝒄𝒕𝒆𝒅)𝟐
𝑿 =∑
=
𝒆𝒙𝒑𝒆𝒄𝒕𝒆𝒅
𝟐
Fill in the chart:
Gender
Observed
Expected
(O-E)
(O-E)2
((O-E)2)/E)
X2
DF = n-1 = ________
=
α = __________
How does the α-value compare to the p-value?
3. Was there a statistically significant difference between the two populations? If so, what reasons
can you think of for why HAART therapy affected the patients in Medicineville, World differently
than the patients in Scienceville, USA?
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Name: ______________________
Homework Assignment: HIV Statistics
The goal of this homework assignment is to learn more about HIV prevalence in the US and the World.
Part I: HIV by Age in the US
Source: http://www.cdc.gov/hiv/risk/age/youth/index.html
Using this graph, answer the following questions.
1. What is the mean age of diagnosis?
2. What is the median age of diagnosis?
3. What is the mode age of diagnosis?
4. Describe the distribution of the graph (ex: skewed, bimodal, etc).
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Part II: HIV throughout the US
State/Dependent Area Number of Diagnoses of HIV Infection, 2011
California
5,973
Florida
5,403
Texas
5,065
New York
4,960
Georgia
2,522
Illinois
2,142
Maryland
1,783
North Carolina
1,672
New Jersey
1,567
Pennsylvania
1,545
Source: http://www.cdc.gov/hiv/statistics/basics/
5. Use the following information to construct an appropriate graph that accurately displays the
data.
6. Explain why you chose this type of graph.
7. Do you notice any trends? (For ex: geographic regions with high rates of HIV infection?)
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Part III: HIV throughout the world
Geographical
region
Number of children (014 years) receiving
antiretroviral therapy
Sub-Saharan
Africa
495 700
Eastern and
southern Africa
426 800
West and central
68 900
Africa
Latin America
and the
Caribbean
17 000
Latin America
13 500
The Caribbean
3 500
East, South and
South-East Asia
44 400
Europe and
Central Asia
8 200
North Africa and
900
the Middle East
Total
566 000
Estimated number of
children needing
antiretroviral therapy
Percentage of
children receiving
coverage?
1 830 000
1 310 000
520 000
39 000
29 000
10 200
111 000
7 800
6 500
1 990 000
Source: http://www.who.int/hiv/topics/paediatric/data/en/index1.html
8. Determine the percentage of children receiving treatment in each area of the world and
complete the chart.
9. What are reasons you can think of for why children in some world regions do not receive the
treatment they need?
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