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Hiv aids epidemiology & trends

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  • 1. HIV-AIDS Stemming the Tide of Epidemic Syed Amin Tabish
  • 2. What is HIV ? Human Immunodeficiency Virus is the virus that causes AIDS. HIV harms the body's immune system by attacking certain kinds of cells, known as helper T cells or CD4 cells, which are a part of the body's natural line of defense against illness. As time goes by, HIV destroys so many of these cells that the body is no longer able to defend itself against certain cancers, viruses, bacteria, or parasites. If left untreated, HIV can lead to AIDS and death.
  • 3. What is AIDS ? • AIDS occurs when an individual's immune system is weakened by HIV to the point where they develop any number of diseases or cancers. • People who haven't had one of these diseases or cancers, but whose immune system is shown by a laboratory test to be severely damaged are also considered to have progressed to an AIDS diagnosis.
  • 4. How HIV is transmitted HIV is spread by: • Sexual contact with an infected person • Sharing needles and/or syringes (primarily for drug injection) with someone who is infected • Through transfusions of infected blood or blood clotting factors. • Babies born to HIV-infected women may become infected before or during birth or through breastfeeding after birth. • In the health care setting, workers have been infected with HIV after being stuck with needles containing HIV-infected blood
  • 5. The HIV-AIDS Connection AIDS was first recognized in 1981 and has since become a major worldwide pandemic AIDS is caused by the human immunodeficiency virus (HIV) , which was discovered in 1983. By leading to the destruction and/or functional impairment of cells of the immune system, notably CD4+ T cells, HIV progressively destroys the body's ability to fight infections and certain cancers.
  • 6. Epidemiology & Trends • At the end of 2002, although the adult prevalence rate in Southeast Asia was a relatively low 0.6%, approx. 6 million adults and children were living with HIV/AIDS in the region. • An estimated 700,000 adults and children were newly infected with HIV during 2002 and there were 440,000 AIDS related deaths. Approximately 36% of infected adults were women.
  • 7. HIV Trends • In South and Southeast Asia, the major HIV transmission mode is heterosexual, followed by injecting drug use. • Unsafe blood is also a factor in some areas. • Throughout the region, injecting drug use offers the epidemic huge scope for growth.
  • 8. Households • HIV is found in varying concentrations or amounts in blood, semen, vaginal fluid, breast milk, saliva, and tears. • HIV does not survive well in the environment, making the possibility of environmental transmission remote. • Although HIV has been transmitted between family members in a household setting, this type of transmission is very rare. • These transmissions are believed to have resulted from contact between skin or mucous membranes and infected blood.
  • 9. Risk of transmission of HIV to HCW HIV Percutaneous Exposure: .05%-0,4% Mucocutaneous Exposue: 0.006-0.05% Hepatitis B Virus Percutaneous Exposure: 9-30% Hepatitis C Virus Percutaneous Exposure: 3-10%
  • 10. Casual Contact • Casual contact through closedmouth or "social" kissing is not a risk for transmission of HIV. Because of the potential for contact with blood during "French" or open-mouth kissing, CDC recommends against engaging in this activity with a person known to be infected
  • 11. Casual Contact - II • HIV has been found in saliva and tears in very low quantities from some AIDS patients. • It is important to understand that finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid. • HIV has not been recovered from the sweat of HIV-infected persons.
  • 12. Course of HIV Disease • Untreated HIV disease typically progresses relentlessly in almost all infected persons from clinically silent infection detectable only by laboratory tests to severely damaged immunologic function, resulting in AIDS. • Without treatment, the disease progresses over a median interval of about 10 years, although with great individual variation, and eventually causes death in most, if not all, cases. • During the course of HIV disease, a variety of clinical syndromes may occur.
  • 13. AIDS Diagnosis • CDC lists numerous opportunistic infections and cancers that, in the presence of HIV infection, constitute an AIDS diagnosis. • In 1993, CDC expanded the criteria for an AIDS diagnosis in adults and adolescents to include CD4 + T cell count at or below 200 cells per microliter in the presence of HIV infection
  • 14. Diagnosing HIV - II •Persons living with AIDS often have infections of the lungs, brain, eyes, and other organs, and frequently suffer debilitating weight loss, diarrhea, and a type of cancer called Kaposi’s Sarcoma.
  • 15. Speedometer •RNA viral load: up •CD4 Cell Count: <200 •Symptomatic: CD Count 200–350 cu m
  • 16. Clinical Course Events critical in determining the ultimate course of HIV disease include: HIV spread to tissues and cells that ultimately may represent hard to eradicate viral reservoirs; Extensive damage to lymph node cellular architecture; Stimulation of an immune response against HIV; and Loss of HIV-specific CD4+ and possibly CD8+ cell clones that may be effective in controlling HIV infection
  • 17. Altering the Natural Course of HIV • Interventions include: - prophylaxis against opportunistic infections, - antiretroviral therapy, and - strategies to restore immune competence. Antimicrobial medications is now widely used for prevention or clinical suppression of Pneumocystis carinii pneumonia and Mycobacterium avium complex infections.
  • 18. Prophylaxis • Appropriate regimens can significantly decrease the incidence of each infection. • Appropriate prophylaxis is now the standard of care for HIV disease. • These interventions improve quality of life, prolong survival, and decrease hospitalizations.
  • 19. Treatment Although the advent of highly effective antiretroviral therapy has resulted in significant increases in survival for HIVinfected individuals, the impact of combination antiretroviral therapy will be largely confined to the industrialized world, which at present constitutes less than 10% of the worldwide HIV-infected population. Given the scope of the AIDS epidemic, even an imperfect AIDS vaccine could potentially save millions of lives.
  • 20. Vaccine Development Vaccine-induced protection against HIV disease could be achieved by: • Complete protection from infection (sterile immunity) • Clearance of virus and infected cells (abortive infection) • Persistent infection without disease • Because HIV may induce AIDS even after a long asymptomatic period, the desired goal of most AIDS vaccine trials to date has been to induce sterile immunity.
  • 21. AIDS-HIV Posters MESSAGES Simple Complex
  • 22. More complex messages (1987-1992)
  • 23. How to stop yourself becoming infected
  • 24. Safer sex and condoms (1987-1997)
  • 25. Present day campaigns (2000-2001)
  • 26. World AIDS Day (1988-1998)
  • 27. The early posters (1984)
  • 28. Who can get AIDS (1985 - 1987)
  • 29. The Picture of Viruses
  • 30. A paper model based on molecular modelling of HIV
  • 31. AIDS virus attaches to a healthy CD-4 Receptor Site
  • 32. Transmission electron micrograph of human HIV on infected human lymphocyte
  • 33. A scanning electron micrograph of 2 AIDS virus (HIV-O) particles on a CD-8 cell surface.
  • 34. HIV budding from a T-cell
  • 35. HIV cartoon with core exposed
  • 36. Immature HIV particle
  • 37. Mature HIV particle cartoon
  • 38. EM photo of HIV.
  • 39. HIV structural components
  • 40. HIV1, genomic diagram
  • 41. Immature HIV
  • 42. HIV
  • 43. HIV Cartoon
  • 44. HIV computer graphic
  • 45. HIV Cartoon
  • 46. Replication Cycle of HIV
  • 47. Ways to reduce the Risk of HIV Transmission • Choosing not to have sex, or making an agreement with a partner who is not HIV-positive to be sexually faithful to each other. • Using a condom or barrier methods • Not sharing needles for injection drug use. • Getting tested! And asking partners to do the same.
  • 48. Focus on AIDS • India is a pluralistic society with 1.04 billion population. • With the diverse sociocultural dimensions (including 4000 languages and dialects) and in the absence of AIDS vaccine, prevention is the absolute necessity. • AIDS is a behavioural problem and needs to be tackled in that context.
  • 49. HIV prevention saves lives Fighting HIV where it ’s hitting hardest • More critical than ever • More diverse than ever • More hope than ever - We are entering a new era in HIV prevention, one in which scientific research provides cutting-edge behavioral and biomedical approaches to prevention. - Effective risk reduction strategies, combined with new treatments for HIV and other sexually transmitted diseases, offer more hope than ever of further reducing the spread of HIV. - HIV prevention means using every effective weapon to stop new HIV infections from occurring.
  • 50. Prevention • Recent advances in basic and clinical research in HIV disease have dramatically changed the perspective of patients, clinicians, and researchers. • In the absence of a credible vaccine there is a need to effect a change in the behaviour of high risk groups. • Prevention is an absolute necessity. HIV prevention means using every effective weapon to stop new HIV infections from occurring.
  • 51. Stemming the Tide of Epidemic • The 'natural' course of the epidemic can be changed by consistent political commitment at all levels. • A well-funded, politically supported and comprehensive prevention programmes can save millions of lives by reducing the number of new HIV infections.
  • 52. Looking Ahead You can see HIV/AIDS as part of life Not life as part of HIV/AIDS