AIDS
(Acquired
Immunodeficiency
Syndrome)
AIDS is a serious condition caused by the HIV
virus, where the body’s immune system becomes
very weak and can no longer fight off infections .
It is the last stage of HIV infection.
According to the World Health Organization
(WHO), AIDS is defined as:
"A condition caused by the Human
Immunodeficiency Virus (HIV), characterized by a
progressive failure of the immune system, leading
to life-threatening opportunistic infections and
cancers.
HIV stands for
Human
Immunodeficiency
Virus. It is a
retrovirus that
attacks the body's
immune system. If
HIV is not treated, it
can lead to a disease
called AIDS
Global statistics
In 2023, there were approximately 39.9 million people living with HIV,
1.3 million new infections, and 630,000 deaths from AIDS-related
illnesses. Since the start of the epidemic, 88.4 million people have
been infected and 42.3 million have died.
Regional trends
Some countries have seen a decrease in new cases, but others,
including the United States, Brazil, Spain, Portugal, Ukraine, and
Russia, have seen an increase since 2010.
Age and gender
HIV is primarily an epidemic among young people, but the number of
people over 50 living with HIV/AIDS has increased significantly.
The agent of AIDS is the Human Immunodeficiency Virus (HIV), which
belongs to the family Retroviridae and the genus Lentivirus.
Key Features of HIV
Types of HIV:
HIV-1: The most common and globally widespread type, responsible
for the majority of HIV infections.
HIV-2: Found primarily in West Africa, associated with slower disease
progression.
Structure:
Enveloped virus with a spherical shape.
Contains two single strands of RNA and the
enzyme reverse transcriptase for replication.
Mode of Action:
Targets CD4+ T lymphocytes (helper T cells),
macrophages, and dendritic cells.
Weakens the immune system, leading to opportunistic infections and
cancers, which characterize AIDS.
Transmission: Direct contact with infected body fluids (e.g.,
blood, semen, vaginal fluids, and breast milk).
Modes of Transmission for HIV/AIDS
1. Sexual Transmission: Unprotected vaginal, anal, or oral sex with an
infected partner.
2. Blood borne Transmission: Sharing needles, contaminated blood
transfusions, or non-sterile medical equipment.
3. Mother-to-Child Transmission: During pregnancy, childbirth, or
breastfeeding.
4. Occupational Exposure: Rare, through needle-stick injuries in
healthcare setting
5. Organ or Tissue Transplants: Receiving infected organs or tissues
(rare due to modern screening).
Note- HIV Does Not Spread through casual contact, air, water, food, or
insect bites.
Risk Factors for HIV/AIDS
1.Unprotected Sex: Without contraceptives, especially with multiple
partners.
2. Injection Drug Use: Sharing contaminated needles.
3. Other STIs: Increases susceptibility.
4. Mother-to-Child Transmission: During pregnancy, childbirth, or
breastfeeding.
5. Blood Transfusions/Organ Transplants: Using unscreened or
infected products (rare).
6. Occupational Exposure: Needle-stick injuries in healthcare.
7. Lack of Awareness: Misunderstanding prevention and transmission.
8. Unsafe Medical Practices: Using unsterilized instruments.
9. Stigma and Poverty: Barriers to healthcare and prevention tools.
Symptoms of HIV/AIDS
1. Early Symptoms
Often related to acute HIV infection before AIDS develops:
• Fever
• Fatigue
• Swollen lymph nodes
• Sore throat and Rash
• Muscle and joint pain
2. Chronic HIV Phase (Asymptomatic Stage)
• May last years with minimal or no symptoms as the virus replicates.
• Gradual decline in CD4+ T-cell count.
3. Symptoms of AIDS (Severe Immunosuppression)
General Symptoms:
• Persistent fever
• Chronic diarrhea
• Profound weight loss (wasting syndrome)
• Night sweats
Opportunistic Infections: Pneumocystis pneumonia (PCP),
Tuberculosis (TB), Cryptosporidiosis, candidiasis, Toxoplasmosis,
Cryptococcal meningitis
Cancers: Kaposi’s sarcoma, Non-Hodgkin lymphoma
Treatment and prevention of AIDS
Antiretroviral Therapy (ART)
• Combination of at least three drugs from different classes to
suppress HIV replication.
• Classes of ART drugs:
1. Nucleoside Reverse Transcriptase Inhibitors (NRTIs): Zidovudine,
Lamivudine.
2. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs): Efavirenz,
Nevirapine.
3. Protease Inhibitors (PIs): Lopinavir, Ritonavir.
4. Integrase Inhibitors: Dolutegravir, Raltegravir.
5. Entry/Fusion Inhibitors: Enfuvirtide, Maraviroc.
Management of Opportunistic Infections
• Prophylaxis and treatment of infections like tuberculosis, candidiasis,
and Pneumocystis pneumonia using various antifungal, antiviral or
other prophylaxis
Adjunct Therapies
• Immune boosters (e.g., vitamin supplementation).
• Management of side effects (e.g., antiemetics for nausea).
Lifestyle and Supportive Care
• Nutrition and exercise to strengthen immunity.
• Psychological support and counseling
Test for HIV
Blood test – CD4+ cell count
Nucleic acid tests
Western Blot: Gold standard test for confirmation by detecting
specific HIV proteins.
Antigen-Antibody tests
ELISA (Enzyme Linked Immuno-sorbent Assay)
PCR (Polymerase chain reaction )
Prevention
Sex education and AIDS education programme in schools.
Screening of blood before transfusion.
Rehabilitation of drug addicts.
Use of condoms and its promotion.
Contaminated needles or syringes should not be shared with
others.
Early diagnosis and treatment of other sexually transmitted
diseases.
Counseling and HIV testing.
