Opportunistic infections encountered in patients diagnosed with AIDS.

1. ● AIDS INTRODUCTION
● CLINICAL FEATURES OF
AIDS
● OPPORTUNISTIC
INFECTIONS
By Shubhangi Dhyani
Topics

2. What is the difference
between
AIDS and HIV INFECTION ?

3. ACQUIRED IMMUNODEFICIENCY SYNDROME
● This is the final phase of HIV infection ,or phase
3
● the CD4+ T cell count falls below a critical level
(<200/μL) and the patient becomes highly
susceptible to opportunistic infections
● It is not uncommon for CD4+ T cell counts in the
untreated patient to drop to as low as 10/μL or

7. Progression to AIDS after getting infected by HIV
After 7- 10 years
After more than 10 years
After 2- 3 years
HIV
INFECTION
Rapid
progressor
Normal
progressor
Long term
non
progressor

8. ELITE CONTROLERS
Originally, individuals were considered to be
long-term nonprogressors if they had been
infected with HIV for a long period , their CD4+
T cell counts were in the normal range, without
treatment .

9. Elite controllers
From this broader
group, a smaller
subgroup of “elite”
controllers or
nonprogressors was
identified.

10. ● These elite controllers, have extremely low levels
of plasma viremia that is often undetectable by
standard assays and normal CD4+ T cell counts
● It is noteworthy that certain of their HIV-specific
immune responses are robust and clearly superior
to those of HIV-infected progressors. In this group
of elite controllers certain HLA class I
haplotypes are overrepresented, particularly
HLA-B57-01 and HLA-B27-05

11. ● Weight loss
● Pyrexia of unknown origin
● Diarrhoea alternating with constipation
● Generalised lymphadenopathy
● Multiple opportunistic infections
● CNS manifestations and secondary neoplasias
CLINICAL FEATURES OF AIDS

12. Weight loss
Along with
diarrhoea
And fever for over
one month

13. Generalised
lymphadenopathy
● Lymphadenopath
y reflects the
immune response
to the virus in the
lymphoid tissue

14. ● It is generally
characterized by
follicular or germinal
center hyperplasia.
● Lymphoid tissue
involvement is a
common denominator of
all patients with HIV
infection

15. Opportunistic infections
● Opportunistic infections (OIs) are infections
that occur more often or are more severe in
people with weakened immune systems than
in people with healthy immune systems.
● People with weakened immune systems
include people living with HIV.
● OIs are caused by a variety of germs
(viruses, bacteria, fungi, and parasites)

16. Opportunistic
Infections
In
AIDS

18. Fungal infections
Candidiasis
Most common clinical
manifestation .
Invasive candidiasis is
infrequent but can
occur in
● Drug induced neutropenia
● Indwelling catheters

19. Fungal infections
Coccidiomycosis
Histoplasmosis
Cryptococcosis
Meningitis is a
common
manifestation of
cryptococcosis.

20. Protozoal and
helminthic infections
Toxoplasmosis
Pneumonia and CNS
infection
Cryptosporidiosis
Responsible for
persistent diarrhoea
and weight loss

21. Protozoan and
helminthic infections
Pneumocytosis
Caused by Pneumocystis
jiroveci .
Responsible for
pneumonia and
disseminated infections.
Has been controlled to a
great extent by the
introduction of HAART

23. Bacterial Infections
Salmonella infection
Causes diarrhoea
Nocardiosis
Pneumonia
Meningitis
Disseminated
infections
Nocardia bacterium

24. Bacterial infections
Mycobacteriosis
Mycobacterium avium
-intracellulare
(Atypical mycobacteria)
● Disseminated
infections occur late.
● Diarrhoea

25. Bacterial infections
Mycobacterium
tuberculosis
● Clinical
manifestations
appear early
● Infection maybe
pulmonary or extra
pulmonary

26. Viral infections
Cytomegalovirus
Affects -
● pulmonary tract
● GIT - mucosal ulcerations
● Eyes - chorioretinitis ( <50 microliter)

27. Blueberry muffin rash associated with
congenital cytomegalovirus

28. Viral infection
Herpes simplex virus
Mucocutanteous ulceration of
● Mouth
● Esophagus
● External genitalia
● Perianal region

30. Viral infection
JC virus
Human papovavirus
Responsible for
PROGRESSIVE
MULTIFOCAL
LEUKOENCEPHALOPATHY

31. Viral infection
Varicella- zoster
virus
Causes localised
or disseminated
infections

33. Thank you