AIDS
By/ Mohamed [Link]
What is difference between
HIV and AIDS ?
HIV is a Human Immunodeficiency Virus
AIDS is Acquired Immune Deficiency Syndrome
( Syndrome which appears in advanced stages of HIV infection )
Virology
HIV infection → AIDS
HIV → Immune System → CD4+ T cells → Destruction
Single-stranded RNA → Target Cell → Double-Stranded DNA →
new virus particles → Replication Cycle
Types of HIV
HIV-1 HIV-2
( LAV or HTLV- III ) Poor Capacity for
Transmission
More COMMON
West Africa
More Infective
More Virulent
Signs and Symptoms
AIDS
Clinical Latency
Acute Infection
Acute Infection
(Acute HIV, Primary HIV, Acute Retroviral Syndrome)
Symptomatic
Asymptomatic
(40-90%)
Non Specific
( 3-20 Years )
Clinical Latency
(Asymptomatic HIV, Chronic HIV)
First • Few or No Symptoms
Last
• Fever, Weight Loss, GIT
Problems, Myalgia, Generalized
Lymphadenopathy
Absence of Specific
AIDS
Treatment
(Acquired Immune Deficiency Syndrome)
CD4+ T cell Count Below 200 cells/micro liter
OR
Occurrence of Specific Diseases in Association with HIV Infection
Additionally……..
Kaposi’s Sarcoma
Burkitt’s Lymphoma
Primary CNS Lymphoma
Cervical Cancer
Conjunctival Cancer
Opportunistic Infections
Transmission
Sexual
Body Fluids
Mother to Child
Sexual
Commercial
Homosexual Heterosexual Sex Workers
(Pornography)
Rough Sex Sexual Assault
Body Fluids
Blood
and
Blood Products
Mother to Child
Feeding
Delivery
Pregnancy
Diagnosis
[Link] Staging
PCR
HIV RNA or DNA
P24 Antigen
Antibody tests in children younger than 18 months are typically
inaccurate due to the continued presence of maternal antibodies.
Classifications
WHO CDC
WHO: World Health Organization
CDC: The United States Center for Disease Control and Prevention
WHO
does not require
laboratory tests
Primary HIV • May be either asymptomatic or associated with acute retroviral
infection syndrome.
• HIV infection is asymptomatic with a CD4+ T cell count (also known
Stage I as CD4 count) >500 per microlitre (µl or cubic mm) of blood. May
include generalized lymph node enlargement.
• Mild symptoms which may include minor mucocutaneous
Stage II manifestations and recurrent upper respiratory tract infections. A
CD4 count of < 500/µl.
• Advanced symptoms which may include unexplained chronic
Stage III diarrhea for longer than a month, severe bacterial infections
including tuberculosis of the lung, and a CD4 count of < 350/µl.
• severe symptoms which include toxoplasmosis of the brain,
Stage IV or AIDS candidiasis of the esophagus, trachea, bronchi or lungs and
Kaposi's sarcoma. A CD4 count of < 200/µl.
CDC
more frequently
adopted
Stage 0 • the time between a negative or indeterminate HIV
test followed less than 180 days by a positive test
Stage 1 • CD4 count ≥ 500 cells/µl and no AIDS defining
conditions
Stage 2 • CD4 count 200 to 500 cells/µl and no AIDS defining
conditions
Stage 3 • CD4 count ≤ 200 cells/µl or AIDS defining
conditions
Unknown • if insufficient information is available to make any
of the above classifications
For surveillance purposes, the AIDS diagnosis still stands even if,
after treatment, the CD4+ T cell count rises to above 200 per µL of
blood or other AIDS-defining illnesses are cured.
Prevention
Sexual contact
Pre-exposure
Post-exposure
Mother-to-child
Vaccination
Sexual contact
Condom Circumcision
Comprehensive
Vaginal Gel
Sexual
(Tenofovir) Education
Spermicide
nonoxynol-9
Pre-exposure
• among people with HIV whose CD4 count ≤ 550 cells/µL is a
Antiretroviral very effective way to prevent HIV infection of their partner (a
strategy known as treatment as prevention, or TASP).
Pre-exposure
prophylaxis • tenofovir, with or without emtricitabine
(PrEP)
Universal • effective in decreasing the risk of HIV
precautions
Intravenous drug • needle-exchange programs and
use opioid substitution therapy
Post-exposure
Post-exposure Prevention
Antiretrovirals Prophylaxis zidovudine Regimen
(PEP) (USA)
Tenofovir,
emtricitabine
and raltegravir
Mother-to-Child
Antiviral Avoid
Medications Breastfeeding
Vaccination
No licensed vaccine
RV 144
*RV 144 trial to date
Currently
NO Cure Treatment
Preventive
Highly Active Antiretroviral
and
Therapy (HAART)
Active Treatment
treatment of
Slows progression of
the disease opportunistic
infections
Antiviral Therapy
Antiviral Therapy
Protease Inhibitors
HAART (PI)
if the other regimen
loses effectiveness
NNRTI NRTIs
zidovudine
tenofovir NNRTI: non-nucleoside reverse transcriptase inhibitor.
lamivudine NRTIs: nucleoside analog reverse transcriptase
inhibitors.
emtricitabine
Notes Antiviral Therapy
Recommended in people of all ages including pregnant women
Once treatment is begun it is recommended that it is continued without
breaks or "holidays"
Benefits of treatment include a decreased risk of progression to AIDS and a
decreased risk of death also improves physical and mental health.
Common side effects: lipodystrophy syndrome, dyslipidemia, and diabetes
mellitus, especially with protease inhibitors. Other common symptoms
diarrhea, an increased risk of cardiovascular disease.
Society and culture
Religion
Economic
Stigma impact
and
AIDS
Media Criminal
Misconceptions
portrayal transmission
Stigma
Ryan White became a poster child for
HIV after being expelled from school
because he was infected
Economic impact
Changes in life expectancy in some
African countries, 1960–2012
Religion and AIDS
ً س ِّب
يل َ احشَةً َو
َ سا َء ِّ ََان ف ِّ َو ََل ت َ ْق َربُوا
َ الزنَا ۖ ِّإنَّهُ ك
(Nor come nigh to adultery: for it is a shameful (deed)
and an evil, opening the road (to other evils))
Al-Israa(32)
Media portrayal
Rock Hudson, a gay actor who had been married and
divorced earlier in life, who died on October 2, 1985
having announced that he was suffering from the virus
on July 25 that year. He had been diagnosed during
1984.
Criminal Transmission
intentional or reckless infection
of a person with the human
immunodeficiency virus (HIV).
Some countries or jurisdictions,
including some areas of the
United States, have laws that
criminalize HIV transmission or
exposure. Others may charge the
accused under laws enacted
before the HIV pandemic
Misconceptions
1) AIDS can spread through casual contact
2) sexual intercourse with a virgin will cure AIDS
3) HIV can infect only gay men and drug users
4) one could get HIV from kissing (16%), sharing a glass (5%),
spitting (16%), a public toilet seat (4%), and coughing or
sneezing (5%)
Thank You
