oppurtunistic infection occurs when the immunity of HIV patient wane ..It kills people with HIV.

1. HIV/AIDS AND COMMON
OPPURTUNISTIC INFECTION /IRIS

2. HIV

4. What is HIV?
 WHAT IS AIDS?
 A-Acquired
 I- Immuno
 D- Defeciency
 S-Syndrome

5. CD4 CELLS

6. What is oppurtunistic
infection?
Oppurtunistic
infection
CD4 cell

7. Natural history of HIV

8. COMMON OPPURTUNISTIC INFECTON
PROTOZOA FUNGUS
Pneumocystis jiroveci toxoplasmosis
Candiasis Cryptosporiodiasis
Cryptococcus neoformans Isosporiasis

9. Common agents for OIs
BACTERIA VIRUS
Streptococcal pneumonia Cytomegalo virus
Mycobacterial tuberculosis Varicella zooster
Mycobacterial avium complex Human pappiloma virus
Salmonellois Molluscum contagiosum
Oral hairy leukoplakia

10. CD4 VS OPPURTUNISTIC INFECTION
CD4 LEVEL OPPURTUNISTIC INFECTIONS
<400 Herpes zooster, Tuberculoisis
<300 Oral candidiasis
<200 Pneumocystis carini, pneomonia, oesophageal
candiasis
<100 MAC,Toxoplasmosis,Cryptococcus
<50 Cryptosporiadiasis

11. Tuberculosis
 Risk ofTB increases with progressive
immuno-suppression
 Risk of extra-pulmonaryTB and disseminated
TB increases
 Non specific finding in CXR.

12. Pneumocystis jiroveci
 Most common OIS in western world
 Characterised by cough, shortness of breath

13. ORAL CANDIASIS

14. HERPES ZOOSTER

15. TUBERCULOSIS

16. KAPOSI SARCOMA

17. Primary and secondary prophylaxis
for OIs
organism Condition Drugs
P.Jiroveci CD4 less than 500/mm3
WHO stage 2/3/4
Trimethoprim/sulfamethaxa
zole 1 tab od
M.Tuberculosis Mantoux >5mm Isoniazide 300 mg od for 6
months
Toxoplasma gondii CD4 count<100 TMP/Sulmethaxozole 1 tab
od
Crytocococcus neoformans CD4<100 Flucanazole 200 mg od
Mycobacterium avium
complex
CD4<100/mm3 Azithromycin 1200 mg /wkly

18. IRIS
 I-Immune
 R-Reconstitution
 I-Inflammatory
 S-Syndrome

19. Immune reconstitution inflammatory
syndrome
 Collection of inflammatory disorders
 with paradoxical worsening of preexisting
infectious process
 following initiation of HAART.

20. WHAT IS HAPPENING?

21. CHANCES OF IRIS ….
Level of CD4
Immune recovery following
HAART

22. Leading pathogens in IRIS
 Mycobacterium tuberculosis
 MAC
 Cytomegalovirus
 Cryptococcus
 Pneumocystis
 Herpes simplex
 Hepaatitis B

23. Management of IRIS
 ART after 2 weeks of therapy of OIs.
 Continuation of ART???
 Anti-inflammatory agent.