GROUP 3 PRESENTATION ON

HIV /AIDS

DEFINITION OF HIV / AIDS

HIV (human immunodeficiency
virus) is a virus that attacks the
immune system, specifically
targeting CD4 cells (T-cells), which
are crucial for fighting infections.
HIV from the genus lentivirus , and
a family of reviridae and
characterized by oral thrust ,
unexplained fevers , kaposis
sarcoma, unexplained weight loss
and recurring respiratory tract
infections.If left untreated, HIV can
lead to AIDS (acquired
immunodeficiency syndrome), a
condition characterized by a
severely weakened immune system
and increased vulnerability to
opportunistic infections.

AIDS is the late stage of HIV

infection, occurring when the
immune system is significantly
damaged. A person is diagnosed
with AIDS when their CD4 cell count
falls below 200 cells per cubic
millimeter of blood or when they
develop certain opportunistic
infections.

CAUSATIVE AGENTS OF HIV /

AIDS
it is caused by the human
Immunodeficiency Virus from the
genus lentivirus , and a family of
reviridae.
There two types of HIV , which are
HIV -1 and HIV-2 .
HIV -1 is seen as a global epidemic
and it is more virulent and infective
while HIV-2 has lower infectivity as
compared.
When HIV enters your body through
sexual contact or transfusions with
infected blood, the virus attaches to
a specified type of immune system
cell called dendritic cells,in mucosal
membranes that line the mouth, the
vagina, rectum, penis, and the
upper gastrointestinal tract. The
dendritic cells transport the virus to
the lymph nodes where they can
infection other immune system
cells.

MODE OF TRANSMISSION

HIV (Human Immunodeficiency

Virus) is primarily transmitted
through specific behaviors and
contact with certain bodily fluids of
an infected person. The main
modes of transmission include:

1. **Unprotected Sexual Contact**:

The most common way HIV is
transmitted is through unprotected
sexual intercourse (vaginal or anal)
with an infected person. HIV can
enter the body through mucous
membranes in the genital or rectal
areas.

2. **Sharing Needles**: Sharing

needles or syringes with someone
who is HIV positive can lead to
transmission, as the virus can be
present in the blood that remains in
the needle or syringe.

3. **Mother-to-Child
Transmission**: An HIV-positive
mother can transmit the virus to her
child during childbirth or
breastfeeding. This is known as
vertical transmission.

4. **Blood Transfusions and Organ

Transplants**: Although rare in
many countries due to rigorous
screening, receiving contaminated
blood products or organ transplants
from an HIV-positive donor can
result in transmission.

5. **Occupational Exposure**:
Healthcare workers may be at risk if
they are accidentally exposed to
HIV through needlesticks or contact
with infected bodily fluids.

6. **Open Wounds**: Direct contact

with open wounds or sores of an
HIV-positive person can also pose a
risk, though this is less common.

INCIDENCE
The global HIV and AIDS incidence
has shown a decline in recent years.
According to the World Health
Organization (WHO), an estimated
39.9 million people were living with
HIV at the end of 2023, with 1.3
million people acquiring HIV in
2023.¹

*HIV Incidence Breakdown:*

- _Children:_ 120,000 children

acquired HIV in 2023.
- _Adults:_ 1.2 million adults
acquired HIV in 2023.
- _Global Rate:_ The number of
people acquiring HIV decreased to
0.17 per 1000 uninfected population
in 2023 from 0.32 in 2010.

*HIV-Related Mortality:*

- In 2023, 630,000 people died

from HIV-related causes globally.
- Since 2010, HIV-related deaths
have been reduced by 51%.

*Regional Incidence:*

- The WHO African Region accounts

for 65% of people living with HIV,
with an estimated 25.8 million
people.²

Overall, while progress has been

made in reducing HIV and AIDS
incidence, continued efforts are
necessary to achieve the goal of
ending the HIV epidemic by 2030.

INCUBATION PERIOD OF HIV /

AIDS

HIV Incubation Period

The incubation period for HIV is the
time between exposure to the virus
and the onset of symptoms.

*Acute HIV Infection*

- The incubation period for acute
HIV infection is typically around 2-4
weeks after exposure.
- During this period, people may
experience flu-like symptoms, such
as fever, fatigue, and swollen lymph
nodes.

*Asymptomatic HIV Infection*

- After the acute phase, HIV can
remain asymptomatic for several
years.
- The virus continues to replicate
and damage the immune system
during this period.

AIDS Incubation Period

AIDS (Acquired Immunodeficiency
Syndrome) is the most advanced
stage of HIV infection.

*Progression to AIDS*
- Without treatment, HIV can
progress to AIDS in around 8-10
years.
- With antiretroviral therapy (ART),
the progression to AIDS can be
significantly delayed or even
prevented.

Keep in mind that these incubation

periods can vary significantly
depending on individual factors,
such as:

- Age
- Overall health
- Presence of co-infections
- Access to treatment and care.

PATHOPHYSIOLOGY
HIV Structure and Replication
1. *HIV structure*: HIV is a
retrovirus composed of two copies
of single-stranded RNA, surrounded
by a lipid envelope.
2. *HIV replication*: HIV replicates
through the following steps:
1. *Attachment*: HIV attaches to
host cells through the CD4 receptor
and CCR5 or CXCR4 co-receptors.
2. *Fusion*: HIV's lipid envelope
fuses with the host cell membrane.
3. *Reverse transcription*: HIV's
RNA is converted into DNA through
reverse transcription.
 4. *Integration*: HIV's DNA is
integrated into the lymphocytes
cell's genome.
5. *Transcription and translation*:
HIV's genetic material is transcribed
and translated into new viral
particles.

HIV Infection and Immune Response

1. *Acute infection*: Initial HIV
infection breakdown and kill CD4+T
cell account for cell depletion.
2. CD4+ T cell depletion*: HIV
infects and kills CD4+ T cells lining
in intestinal mucosa , mucosal
tissue, mucosal barriers and Centra
nervous system leading to immune
system dysfunction.
3. Chronic infection*: HIV evades
the immune system through
mutation, latency, and immune
suppression.

Pathogenesis of HIV Infection

1. *Immunodeficiency*: HIV
infection leads to
immunodeficiency, increasing
susceptibility to infections and
cancers.
2. *Inflammation and immune
activation*: Chronic HIV infection
causes persistent inflammation and
immune activation, contributing to
tissue damage and disease
progression.
3. *Neurological complications*:
HIV can infect the central nervous
system, leading to neurological
complications, such as neuropathy.
4. *Cardiovascular and metabolic
complications*: HIV infection and
antiretroviral therapy (ART) can
increase the risk of cardiovascular
and metabolic complications, such
as atherosclerosis and insulin
resistance.

Opportunistic Infections and

Cancers
1. *Opportunistic infections*:
Weakened immune system allows
opportunistic infections, such as
Pneumocystis jirovecii pneumonia
(PCP) and Mycobacterium
tuberculosis.
2. *Cancers*: HIV infection
increases the risk of certain
cancers, such as Kaposi's sarcoma,
non-Hodgkin lymphoma, and
cervical cancer.

CLINICAL MANIFESTATION
HIV (Human Immunodeficiency
Virus) infection can lead to AIDS
(Acquired Immunodeficiency
Syndrome) if left untreated. The
clinical manifestations of HIV/AIDS
can be categorized into three main
stages: acute HIV infection, chronic
HIV infection, and AIDS.

1. **Acute HIV Infection**: This

stage occurs within 2 to 4 weeks
after exposure to the virus.
Symptoms may resemble flu-like
illnesses and can include:
- Fe ver
- Chills
- Rash
- Night sweats
- Muscle aches
- Fatigue
- Swollen lymph nodes
- Sore throat
- Mouth ulcers

2. **Chronic HIV Infection**: After

the acute phase, the virus becomes
less active in the body, although it
is still present. People in this stage
may not exhibit symptoms for
several years. However, the virus
continues to damage the immune
system. During this time, individuals
may experience:
- Persistent lymphadenopathy
(swollen lymph nodes)
- Fatigue
- Recurrent fevers
- Diarrhea
- Weight loss

3. **AIDS**: This is the most severe

phase of HIV infection,
characterized by a significantly
weakened immune system. It is
diagnosed when the CD4 cell count
drops below 200 cells/mm³ or when
certain opportunistic infections or
cancers occur. Clinical
manifestations at this stage may
include:
- Rapid weight loss
- Recurring fever or profuse night
sweats
- Extreme fatigue
- Prolonged swelling of the lymph
nodes
- Diarrhea lasting more than a
week
- Pneumonia
- Sores of the mouth, anus, or
genitals
- Neurological disorders such as
memory loss, depression, and other
neurologic conditions

Opportunistic infections and

cancers that can arise in AIDS
include:
- Tuberculosis (TB)
- Candidiasis (thrush)
- Pneumocystis pneumonia
- Toxoplasmosis
- Certain types of cancers such as
Kaposi's sarcoma and non-Hodgkin
lymphoma

It is crucial for individuals at risk to

undergo regular testing and seek
early treatment, as antiretroviral
therapy (ART) can significantly
improve health outcomes and
quality of life.
DIAGNOSTIC INVESTIGATION
MEDICAL MANAGEMENT
Medical Management.
Antiretroviral Therapy (ART) is a
treatment regimen for HIV/AIDS that
involves taking a combination of
medications to suppress the virus.
The goal of ART is to:

1. Reduce the amount of HIV in the

body (viral load)
2. Boost the immune system by
increasing CD4 cell count
3. Prevent disease progression and
complications
4. Improve quality of life

1. *Antiretroviral Therapy (ART)*

- Combination of medications to
suppress the virus.
- Medications:
- NRTIs (Nucleoside Reverse
Transcriptase Inhibitors): Tenofovir
and Emtricitabine
- NNRTIs (Non-Nucleoside Reverse
Transcriptase Inhibitors): Efavirenz
and Rilpivirine
- PIs (Protease Inhibitors):
Atazanavir and Darunavir
- INSTIs (Integrase Strand Transfer
Inhibitors): Raltegravir and
Dolutegravir
2. *Opportunistic Infection (OI)
Prevention and Treatment*
- Medications to prevent and treat
OIs.
- Medications:
- Trimethoprim/Sulfamethoxazole
- Pentamidine
- Pyrimethamine
3. *Post-Exposure Prophylaxis
(PEP)*
- Medications taken after potential
exposure to HIV.
- Medications:
- Tenofovir/Emtricitabine +
Raltegravir
- Tenofovir/Emtricitabine +
Lopinavir/Ritonavir
4. *Pre-Exposure Prophylaxis
(PrEP)*
- Medications taken before
potential exposure to HIV.
- Medications:
- Tenofovir/Emtricitabine (Truvada)
- Tenofovir/Alafenamide/
Emtricitabine (Descovy)

NURSING MANAGEMENT
1. **Education and Counseling**:
- Educating patients about HIV
transmission, the importance of
adherence to ART, and the benefits
of maintaining an undetectable viral
load.
- Counseling on safe sex
practices and harm reduction
strategies to prevent HIV
transmission.

2. **Assessment and Monitoring**:

- Conducting regular assessments
of physical health, mental health,
and adherence to medication.
- Monitoring for side effects of
ART and managing any adverse
effects that may occur.

3. **Supportive Care**:
- Providing emotional support and
addressing psychosocial issues,
including anxiety, depression, and
stigma associated with HIV/AIDS.
- Facilitating access to support
groups and mental health services.

4. **Nutritional Support**:
- Assessing nutritional status and
providing dietary recommendations
to manage weight loss and promote
overall health.

5. **Coordination of Care**:
 - Collaborating with a
multidisciplinary team, including
physicians, social workers, and
nutritionists, to provide
comprehensive care.
- Assisting with referrals for
additional services, such as housing
assistance, substance use
treatment, or vocational training.

6. **Encouraging Regular Follow-

up**:
- Emphasizing the importance of
regular medical appointments for
ongoing monitoring and
management.

7. **Advocacy**:
- Advocating for patient rights and
access to healthcare resources,
including medications and
preventive services.

Through this integrated approach of

medical and nursing management,
healthcare providers can effectively
support individuals living with HIV/
AIDS, helping them achieve better
health outcomes and improved
quality of life.
COMPLICATIONS

HIV/AIDS can lead to a variety of

complications due to the
progressive weakening of the
immune system. These
complications can be categorized
into opportunistic infections,
malignancies, and other conditions
associated with the disease.

1. **Opportunistic Infections**:
These infections take advantage of
the weakened immune system and
can include:
- **Pneumocystis pneumonia
(PCP)**: A common lung infection
in individuals with AIDS.
- **Tuberculosis (TB)**: A serious
bacterial infection that primarily
affects the lungs but can spread to
other parts of the body.
- **Candidiasis**: Fungal
infections that can affect the mouth
(thrush), throat, or vagina.
- **Toxoplasmosis**: A parasitic
infection that can lead to
neurological issues if the brain is
affected.
- **Cryptococcal meningitis**: A
fungal infection that can cause
severe inflammation of the
membranes surrounding the brain
and spinal cord.

2. **Malignancies**: Individuals with

HIV/AIDS are at increased risk for
certain types of cancers, including:
- **Kaposi's Sarcoma**: A cancer
that causes lesions in the skin and
mucous membranes.
- **Non-Hodgkin Lymphoma**: A
group of blood cancers that can
occur in lymphatic tissue.
- **Invasive Cervical Cancer**:
Women with HIV are at higher risk
for cervical cancer due to persistent
HPV infection.

3. **Neurological Complications**:
HIV can affect the central nervous
system, leading to conditions such
as:
- **HIV-associated dementia**:
Cognitive impairment and memory
loss due to viral effects on the
brain.
- **Peripheral neuropathy**: Pain
and tingling in the hands and feet
caused by nerve damage.

4. **Gastrointestinal
Complications**: These may
include:
- **Diarrhea**: Chronic diarrhea
can occur due to infections or
medication side effects.
- **Weight loss and
malnutrition**: Resulting from
difficulty in absorbing nutrients and
the metabolic demands of fighting
infections.

5. **Wasting Syndrome**: This is

characterized by significant weight
loss, weakness, and a decrease in
muscle mass, often due to a
combination of factors including
chronic infection and malnutrition.

6. **Cardiovascular Disease**:
People living with HIV/AIDS have an
increased risk of heart disease,
partly due to chronic inflammation
and the side effects of some
antiretroviral therapies.

7. **Renal Complications**: HIV can

lead to kidney disease, including
conditions such as HIV-associated
nephropathy.

8. **Mental Health Issues**: The

psychological impact of living with
HIV/AIDS can lead to anxiety,
depression, and other mental health
disorders.

Prompt recognition and

management of these
complications are crucial to
improving outcomes and quality of
life for individuals living with HIV/
AIDS. Regular medical care and
adherence to antiretroviral therapy
can help mitigate many of these
risks.

PREVENTION

Preventing HIV/AIDS involves a

combination of strategies aimed at
reducing the risk of transmission
and promoting overall sexual health.
Key prevention methods include:

1. **Safe Sex Practices**:

- **Condom Use**: Consistent
and correct use of condoms during
sexual intercourse significantly
reduces the risk of HIV
transmission.
- **Mutual Monogamy**:
Engaging in a sexual relationship
with a partner who is also HIV-
negative can lower the risk of
exposure.

2. **Pre-exposure Prophylaxis
(PrEP)**:
- PrEP is a daily medication taken
by HIV-negative individuals to lower
the risk of becoming infected with
HIV. It is highly effective when taken
consistently.

3. **Post-exposure Prophylaxis
(PEP)**:
- PEP involves taking antiretroviral
medications within 72 hours after
potential exposure to HIV. It is
crucial to start this treatment as
soon as possible to reduce the risk
of infection.

4. **Regular Testing and Early

Treatment**:
- Routine HIV testing for
individuals at risk helps in early
detection of the virus. Early
diagnosis allows for timely
treatment with antiretroviral therapy
(ART), which can reduce the viral
load to undetectable levels,
significantly decreasing the risk of
transmission.

5. **Education and Awareness**:

- Providing education about HIV
transmission, prevention methods,
and reducing stigma can empower
individuals to make informed
choices and engage in safer
behaviors.

6. **Avoiding Sharing Needles**:

- People who inject drugs should
never share needles or other drug
paraphernalia. Needle exchange
programs can provide access to
clean needles and resources for
those at risk.

7. **Mother-to-Child Transmission
Prevention**:
- Pregnant women living with HIV
should receive appropriate medical
care and treatment to reduce the
risk of transmitting the virus to their
infants during pregnancy, childbirth,
or breastfeeding.

8. **Vaccination**:
- Vaccines for other sexually
transmitted infections (STIs), such
as hepatitis B and human
papillomavirus (HPV), can help
reduce the risk of HIV acquisition.

9. **Limiting Number of Sexual

Partners**:
- Reducing the number of sexual
partners can decrease the risk of
exposure to HIV and other STIs.

10. **Health Care Engagement**:

- Regular check-ups and ongoing
communication with healthcare
providers can help individuals stay
informed about their health and
prevention options.

By implementing these strategies,

individuals and communities can
significantly reduce the risk of HIV
transmission and contribute to the
overall prevention of HIV/AIDS.

NURSING DIAGNOSES

Here are nursing diagnoses for each

of the specified problems
experienced by patients with HIV/
AIDS:
1. **Fever**:
- Nursing Diagnosis:
**Hyperthermia** related to
infection or inflammatory response
as evidenced by elevated body
temperature.

2. **Chills**:
- Nursing Diagnosis: **Ineffective
Thermoregulation** related to
infection or systemic illness as
evidenced by patient reports of
chills and fluctuating body
temperature.

3. **Rash**:
- Nursing Diagnosis: **Impaired
Skin Integrity** related to skin rash
secondary to HIV infection or
medication side effects as
evidenced by the presence of rash
and patient complaints of itching or
discomfort.

4. **Night Sweats**:
- Nursing Diagnosis: **Disturbed
Sleep Pattern** related to night
sweats and discomfort as
evidenced by patient report of
frequent waking and difficulty
sleeping through the night.
5. **Fatigue**:
- Nursing Diagnosis: **Fatigue**
related to chronic illness and
immune system compromise as
evidenced by patient report of
extreme tiredness and decreased
ability to perform activities of daily
living.

6. **Swollen Lymph Nodes**:

- Nursing Diagnosis: **Ineffective
Tissue Perfusion** related to
lymphadenopathy secondary to
immune response to infection as
evidenced by swollen lymph nodes
and patient reports of discomfort.

7. **Diarrhea**:
- Nursing Diagnosis: **Diarrhea**
related to opportunistic infections
or side effects of medication as
evidenced by frequent loose stools
and patient report of increased
bowel movements.

8. **Weight Loss**:
- Nursing Diagnosis:
**Imbalanced Nutrition: Less than
Body Requirements** related to
chronic illness and gastrointestinal
symptoms as evidenced by patient
report of weight loss and decreased
appetite.

These nursing diagnoses can guide

the development of individualized
care plans focused on addressing
the specific challenges faced by
patients living with HIV/AIDS.