Basic facts about HIV&AIDS

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  • 1. 1 BASIC FACTS ABOUT HIV/AIDS a presentation by Global Health International
  • 2. Definitions  HIV – Human Immunodeficiency Virus The virus which causes AIDS  SIV – Simian Immunodeficiency Virus Retrovirus found in numerous strains in primates; the specific strains infecting humans are HIV-1 & HIV-2  AIDS – Acquired Immune Deficiency Syndrome A collection of symptoms & signs of illnesses due to immune depletion 2
  • 3. Relationship of HIV & AIDS 3
  • 4. 4 The HIV virus
  • 5. 5 Types of HIV HIV Type 1 HIV Type 2 - Most predominant world wide - More virulent - Has subtypes M, N, O and P (M is most predominant) - Subtype M has strains A, B, C, D, F, G, H, J and K - Mainly in West Africa - Less easily transmitted - Longer period from initial infection and onset of illness
  • 6. HIV origin: the theories  Hunter theory: Most accepted theory. That SIV was transferred to humans after chimps being killed & eaten or their blood getting into hunters’ cuts/wounds  Oral Polio vaccine theory: Congo, Ruanda & Burundi in the late 1950s. That the vaccine was cultivated using kidney cells of local chimps infected with SIV 6
  • 7. HIV origin: the theories  Conspiracy theory: -HIV manufactured as a biological warfare programme, to wipe out black & homosexual people. -HIV was developed by the US as a weapon of germ warfare -Right wing American groups blamed the Soviets for the AIDS epidemic. 7
  • 8. HIV origin: the theories  Colonialism theory: Locals were forced into labour camps where SIV could have infected them. They were inoculated with unsterile needles against diseases e.g. smallpox. Many camps employed prostitutes to keep workers happy  Heavenly theory: HIV came from an angry God who was unhappy with gays, IVDUs & promiscuity. Others believed that HIV came as a cosmic debris as part of the tail of a comet 8
  • 9. 9 Origin of HIV/AIDS  HIV is a zoonotic infection-resembles SIV  Genetic analysis indicates HIV introduced into humans ~ 1931  1959 serum sample from Congo HIV+  Here chimpanzees are kept as pets and butchered forfood  HIV 1st discovered in 1980s by Luc Montagnier (Paris); Later in 1980s by Robert Gallo (US)
  • 10. 10 Origin of HIV/AIDS  No. of people who developed AIDS before the 1980s are unknown  First cases of AIDS recognized in early 1980s  In 1984, 1st AIDS (‘slim disease’) case in Uganda was reported
  • 11. Modes of HIV transmission  Sexual intercourse (heterosexual & same sex; commonest mode of transmission)  Mother to Child transmission (pregnancy, labour, birth, breast feeding)  Occupational exposure  Blood products infusion  Donor organ and tissue transplantation  (Intravenous) Injection drug use 11
  • 12. 12 Phase 1  Rapid spread through urban sexual networks along major highways from its origin in the Lake Victoria region  The fight against HIV began only after the civil war in 1986. ACP set up in 1987  By this time Urban areas had prevalence rates of up to 29% . HIV/AIDS trend in Uganda
  • 13. 13 Phase 1 cont’d  CBOs came up targeting education, HIV prevention(ABC) & stigma reduction TASO was one of the first  Philly Bongoley Lutaaya (19 October 1951 – 15 December 1989), a Ugandan musician spent his life writing songs about his battle with AIDS; toured many places spreading messages of prevention & hope. HIV/AIDS trend in Uganda
  • 14. 14 HIV/AIDS trend in Uganda Phase 2: 1992 to 2000  HIV prevalence fell dramatically, from about 15% in 1991 in adults to about 5% in 2001  Reason: Gov’t. ABC prevention campaign & the high numbers of AIDS-related deaths  Prevention initiatives continued through the nineties with high levels of funding from both the gov’t & international donors e.g. World Bank
  • 15. 15 HIV/AIDS trend in Uganda Phase 3: 2000 to 2005  The third phase saw the stabilization of HIV prevalence at 6.4%  Free ARV drugs were introduced in 2004  Funders included World Bank, Global Health, PEPFAR, CDC
  • 16. HIV/AIDS trend in Uganda WHO 2010 HIV epidemiology report & 2011 Uganda demographics report:  HIV prevalence rate 6.5% among adults  HIV prevalence rate 0.7% among children  1.2 million people living with HIV/AIDS in Uganda  1.2 million children are orphans due to AIDS  130,000 new HIV infections occur annually  60,000 deaths occur annually  540,000 adults & children in need of ARVs  240,000 adults & children on ARVs 16
  • 17. Global distribution of HIV by sex & age (Source WHO & UNAIDS 2010) 17
  • 18. 18 18 Urban-Rural HIV Infection Prevalence: (Source WHO & UNAIDS 2010) 10.2 12.8 6.7 1.4 5.7 6.5 4.8 0.6 0 2 4 6 8 10 12 14 All Females Males Children <5yrs Urban Rural  Urban residents have a significantly higher risk of HIV infection  The urban- rural disparity stronger for women and children than for men.
  • 19. So, What happens when HIV enters the Human body? 1. Window Period  Time from initial infection with HIV to time antibodies are detectable (usually 3-8 weeks)  Period varies between individuals & depends on the test used  95% of people develop antibodies within 3-4 months  HIV antibody tests may give negative results in an infected person during this period  Very high Viral Load  Victim highly infectious 19
  • 20. 2. Seroconversion  The change from non-detectable antibody test (Negative test) to detectable antibody levels (Positive test) is referred to as seroconversion  Seroconversion marks end of the window period  Presents with unspecific symptoms e.g. fever, flu, headache, general weakness, poor appetite, etc  Symptoms short lived; patient improves in 2-4 weeks 20 So, What happens when HIV enters the Human body?
  • 21. 21 3. Development of Symptoms & Signs i.e. Stage I  Asymptomatic stage of HIV infection  There may only be enlarged lymph nodes So, What happens when HIV enters the Human body?
  • 22. 22 ….when HIV enters the Human body Stage II Multiple symptoms and conditions e.g.  Skin rash  Herpes zoster  Oral ulcers  Fungal nail infections  Recurrent Respiratory Tract Infections
  • 23. 2323 ….when HIV enters the Human body Stage III Multiple symptoms & conditions e.g.  TB of the lungs  Diarrhoea > a month  Oral thrush  >10% unintended weight loss  Persistent fevers (unexplained) for > a month
  • 24. 2424 ….when HIV enters the Human body Stage IV Multiple symptoms and conditions e.g.  Cancers like Kaposi’s sarcoma  Oesophageal candidiasis  Pneumocystis jiroveci pneumonia  Cryptococcal meningitis  TB outside the lungs
  • 25. AND HOW WILL A PERSON WITH HIV/AIDS PRESENT CLINICALLY? 25
  • 26. 26 MANIFESTATIONS OF HIV/AIDS 1. Manifestations due to Opportunistic Infections 2. Manifestations due to HIV/AIDS Associated Cancers 3. Manifestations due to Drugs used in treatment of HIV/AIDS 4. Other HIV/AIDS related conditions
  • 27. 27 1. Manifestations due to Opportunistic Infections Fungal skin infections 27
  • 28. 28 1. Manifestations due to Opportunistic Infections Oral thrush
  • 29. 29 1. Manifestations due to Opportunistic Infections Oral Hairy Leukoplakia
  • 30. 30 1. Manifestations due to Opportunistic Infections Angular Cheilitis (Candidiasis)
  • 31. 31 1. Manifestations due to Opportunistic Infections Mixed Infections
  • 32. 32 1. Manifestations due to Opportunistic Infections Herpes simplex virus
  • 33. 33 1. Manifestations due to Opportunistic Infections Extensive H.S. infection of lips & nose
  • 34. 34 1. Manifestations due to Opportunistic Infections Molluscum contagiosum
  • 35. 1. Manifestations due to Opportunistic Infections Molluscum contagiosum 35
  • 36. 1. Manifestations due to Opportunistic Infections Herpes zooster 36
  • 37. 1. Manifestations due to Opportunistic Infections Generalised itchy Skin rash 37
  • 38. 1. Manifestations due to Opportunistic Infections TB of the skin 38
  • 39. 1. Manifestations due to Opportunistic Infections Herpes simplex genitalia 39
  • 40. 1. Manifestations due to Opportunistic Infections HPV 40
  • 41. 41 1. Manifestations due to Opportunistic Infections HPV 41
  • 42. 42 1. Manifestations due to Opportunistic Infections Vaginal Candidiasis 42
  • 43. MANIFESTATIONS OF HIV/AIDS 2. HIV/AIDS Associated Cancers 43
  • 44. 44 2. HIV/AIDS Associated Cancers Kaposi’s sarcoma: gum & legs affected
  • 45. 45 2. HIV/AIDS Associated Cancers Kaposi’s sarcoma: palate involvement 45
  • 46. 46 2. HIV/AIDS Associated Cancers Lymphoma
  • 47. 2. HIV/AIDS Associated Cancers Squamous cell carcinoma of the eye 47
  • 48. 2. HIV/AIDS Associated Cancers Kaposi’s sarcoma 48
  • 49. 49 MANIFESTATIONS OF HIV/AIDS 3. Manifestations due to Drugs used in HIV/AIDS Treatment 49
  • 50. 3. Manifestations due to drugs Nevirapine rash 50
  • 51. 51 3. Manifestations due to drugs Steven Johnson’s Syndrome 51
  • 52. 52 3. Manifestations due to drugs Nevirapine side effects 52
  • 53. 53 3. Manifestations due to drugs Severe Anaemia of AZT 53
  • 54. 54 3. Manifestations due to drugs Fat maldistribution (Stavudine induced) 54
  • 55. 55 3. Manifestations due to drugs Loss of body fat (as with Protease Inhibitors) 55
  • 56. 56 MANIFESTATIONS OF HIV/AIDS 4. Other HIV/AIDS Associated Conditions
  • 57. 4. Other HIV/AIDS Associated conditions Psoriasis 57
  • 58. 58 4. Other HIV/AIDS Associated conditions Eczema 58
  • 59. 59 4. Other HIV/AIDS Associated conditions HIV wasting syndrome 59
  • 60. 60 May God have mercy upon mankind