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Final ppt

  1. 1. “Human Immunodeficiency Virus” H = Infects only Human beings I = Immunodeficiency virus weakens the immune system and increases the risk of infection V = Virus that attacks the body
  2. 2. “Acquired Immune Deficiency Syndrome” A = Acquired, not inherited I = Weakens the Immune system D = Creates a Deficiency of CD4+ cells in the immune system S = Syndrome, or a group of illnesses taking place at the same time
  3. 3.  H.I.V (Human Immunodeficiency Virus) is a unique type of virus (i.e. a retrovirus) that invades the T- helper cells (CD4 cells) in the body of the host (defense mechanism of a person).
  4. 4. AIDS (Acquired Immunodeficiency Syndrome) can be defined as opportunistic infections and malignancies that rarely occur in the absence of severe immunodeficiency.  Persons with positive HIV serology who have ever had a CD4 lymphocyte count below 200 cells/mcL or a CD4 lymphocyte percentage below 14% are considered to have AIDS.
  5. 5. AGENT FACTORS:  “Human Immunodeficiency virus” There are two types of HIV. 1. HIV-1 2. HIV-2
  6. 6. HIV-1 HIV-2 HIV-1 is more common worldwide. HIV-1 is easily transmitted. HIV-1 is pathogenic in nature Duration of HIV-1 infection is quite long. HIV-1 is commonly seen in India. HIV-2 is found in West Africa, Mozambique, and Angola. HIV-2 is less easily transmitted. HIV-2 is less pathogenic. Duration of HIV-2 infection is shorter . HIV-2 is relatively rare and has not been reported from India.
  7. 7. Greater concentration: • Blood • Semen • CSP Lesser concentration: • Tears • Saliva • Urine • Breast-milk • Cervical and vaginal secretions
  9. 9. AGE • Most cases in between 20-49 years. • Rarely seen in childrens under 15 yrs. SEX • Seen in both males & females. • Mostly in homosexual and bisexual mens. HIGH RISK • Male homosexuals & heterosexual partners. • IV drug abusers, transfusion if infected blood IMMUNOLOGY • HIV virus infects and destroys T-helper cells. • It results in reduced cellular immunity.
  10. 10. Viral DNA is transcribed into mRNA Integrase inserts viral DNA into Host DNA RNA transcribes DNA by enzyme Reverse Transcriptase RNA enters the human cell HIV virus binds to CD4 receptors on surface of T cells. Due to etiological factors
  11. 11. (continue..) Destruction of T- helper cells and immune response declines causing S/S. Host cell is killed as viruses are released and budding process starts. Polyprotein converts into genome n becomes permanent part of cell’s genetic structure. mRNA is translated into protein – polyprotein
  12. 12.  It is first and foremost a sexually transmitted disease.  It can be transmitted by all types of unprotected sex i.e. vaginal, oral or anal.  It is acquired mainly through heterosexual contact.
  13. 13.  Sharing Needles (Without sterilization) Increases the chances of contracting HIV  Unsterilized blades
  14. 14.  Transmitted by contaminated blood transfusion of whole blood cells.  Also transmits through contact with infected bodily fluids such as semen, vaginal fluids.
  15. 15.  During pregnancy (through placenta)  During birth
  16. 16. INCUBATION PERIOD upto 6 years or more
  17. 17. The clinical features of HIV infection is classified into four stages: 1. Initial infection 2. Asymptomatic stage 3. Symptomatic stage 4. AIDS
  18. 18.  Short, flu-like illness - occurs one to six weeks after infection  Mild symptoms  Infected person can infect other people
  19. 19.  Lasts for an average of ten years  This stage is free from symptoms  There may be swollen glands  The level of HIV in the blood drops to low levels  HIV antibodies are detectable in the blood
  20. 20.  The immune system deteriorates  Opportunistic infections and cancers start to appear.
  21. 21.  The immune system weakens  The illnesses become more severe leading to an AIDS diagnosis  The immune system weakens too much as CD4 cells decrease in
  23. 23.  Bacterial infections  Tuberculosis (TB)  Herpes Simplex  Herpes Zoster  Vaginal candidiasis  Hairy leukoplakia  Kaposi’s sarcoma IF CD4<500
  25. 25. IF CD4< 200  Pneumocystic carinii  Toxoplasmosis  Cryptococcosis  Coccidiodomycosis  Cryptosporiosis  Non hodgkin’s lymphoma
  26. 26. IF CD4 <50  Disseminated mycobacterium avium complex (MAC) infection  Histoplasmosis  CMV retinitis  CNS lymphoma  Progressive multifocal leukoencephalopathy  HIV dementia
  27. 27.  TB is the most common opportunistic infection in HIV and the first cause of mortality in HIV infected patients (10- 30%)  10 million patients co-infected in the world.  Immunosuppression induced by HIV modifies the clinical presentation of TB
  28. 28. CLINICAL: The WHO clinical case defines adult AIDS if the existence of at least two major signs associated with at least one minor sign in the absence of other known cases of immunosupression such as cancer or severe malnutrition or other recognized etiologies.
  29. 29. • Weight loss (10% of body wt) • Chronic diarrhoea • Prolonged fever MAJOR SIGNS • Persistent cough • Generalized dermatitis • Recurrent herpes zoster • Oropharyngeal candidiasis • Generalised lymphadenopathy MINOR SIGNS
  31. 31. Enzyme Linked Immunosorbent Assay (ELISA) • Screening test for HIV • Sensitivity > 99.9% Western blot • Confirmatory test • Specificity > 99.9% (when combined with ELIZA)
  32. 32. Absolute CD4 lymphocyte count • Predictor of HIV progression • Risk of opportunistic infections and AIDS when <200 HIV viral load tests • Best test for diagnosis of acute HIV infection • Correlates with disease progression and response to HAART
  33. 33.  Urine Western Blot ◦ As sensitive as testing blood ◦ Safe way to screen for HIV ◦ Can cause false positives in certain people at high risk for HIV
  34. 34.  Orasure ◦ The only FDA approved HIV antibody. ◦ As accurate as blood testing ◦ Draws blood-derived fluids from the gum tissue. ◦ NOT A SALIVA TEST!
  35. 35.  Nucleoside Reverse Transcriptase inhibitors ◦ AZT (Zidovudine)  Non-Nucleoside Transcriptase inhibitors ◦ Viramune (Nevirapine)  Protease inhibitors ◦ Norvir (Ritonavir)
  36. 36. PREVENTION
  37. 37.  Abstinence  Monogamous Relationship  Protected Sex  Sterile needles
  38. 38.  It is the only 100 % effective method of not acquiring HIV/AIDS.  Refraining from sexual contact: oral, anal, or vaginal.  Refraining from intravenous drug use
  39. 39.  A mutually monogamous (only one sex partner) relationship with a person who is not infected with HIV  HIV testing before intercourse is necessary to prove your partner is not infected
  40. 40.  Use condoms (female or male) every time you have sex.  Always use latex or polyurethane condom.
  41. 41.  If a needle/syringe or cooker is shared, it must be disinfected: ◦ Fill the syringe with undiluted bleach and wait at least 30 seconds. ◦ thoroughly rinse with water ◦ Do this between each person’s use