This document provides an overview of Acquired Immunodeficiency Syndrome (AIDS). It discusses that AIDS is caused by the human immunodeficiency virus (HIV) which damages the immune system. The document outlines the infectious agent, epidemiology, transmission, life cycle, clinical stages, symptoms, opportunistic infections, oral manifestations, diagnosis, treatment and prevention of HIV/AIDS. It provides details on how HIV attaches to and infects cells, its effects on the immune system over time, and approaches to managing the infection.

1. ACQUIRED
IMMUNODEFICIENCY
SYNDROME
GUIDED BY;- PRESENTED BY;-
DR.PRADEEP TANGADE DR.PRABHAT KUMAR SINGH
DR.THANVEER K 1ST YEAR POSTGRADUATE
DR.VIKAS SINGH DEPT.OF PUBLIC HEALTH
DENTISTRY
DR.ANKITA JAIN
AIDS

2. CONTENTS
Introduction
Infectious Agent
Epidemiology
Transmission of AIDS
Life cycle of HIV
Clinical stages
Symptoms of HIV

3. Opportunistic Infection
Oral manifestations of HIV/AIDS
Laboratory diagnosis of HIV infection
Treatment
Prevention
Conclusion
References

4. INTRODUCTION
 AIDS is a chronic immune system disease caused by
the human immunodeficiency virus (HIV).
 HIV damages the immune system and interferes
with the body’s ability to fight infection and disease.
 H = Infects only Human beings
 I = Immunodeficiency virus weakens the immune
system and increases the risk of infection
 V = Virus that attacks the body

5. INFECTIOUS AGENT
 Human immunodeficiency virus (HIV).
 Retrovirus.
 Two serologically and geographically distinct types with
similar epidemiological characteristics, HIV-1 and HIV-2,
have been identified.
 The pathogenicity of HIV-2 may be lower than that of
HIV-1.
 lower rates of mother-to-child transmission for HIV-2.
 HIV-1 is the most prevalent HIV type throughout the
world.
 HIV-2 has been found in Africa.

6. EPIDEMIOLOGY
 Since the first cases of AIDS were identified in 1981, close to 30
million people have died as a result of HIV infection. This makes
AIDS one of the most destructive epidemics in recorded history. The
epidemic remains extremely dynamic, and no country in the world
is unaffected.
 Male > Females
 Occur in all ages and ethnic groups
 All areas of the country are affected
 AIDS is now the second leading cause of death for all men aged 25-
44 years

8. TRANSMISSION OF
AIDS
1. Sexual contact with infected individual: All
forms of sexual intercourse (homosexual and
heterosexual). 75% of transmission.
2. Sharing of unsterilized needles by intravenous
drug users and unsafe medical practices: 5-
10% of transmission.
3. Transfusions and Blood Products: Risk is low
today. 3-5% of transmission.
4. Mother to Infant (Perinatal): children become
infected in utero, during delivery, or by breast-
feeding. 5-10% of transmission.

9. STRUCTURE OF THE HUMAN
IMMUNODEFICIENCY VIRUS : HIV IS A
RETROVIRUS

10. LIFE CYCLE OF
HIV
1. Attachment: Virus binds to surface
molecule (CD4) of T helper cells and
macrophages.
Coreceptors: Required for HIV infection.
CXCR4 and CCR5 mutants are resistant
to infection.
2. Fusion: Viral envelope fuses with cell
membrane, releasing contents into the cell.

11. HIV LIFE CYCLE: ATTACHMENT
REQUIRES CD4 RECEPTOR PLUS A
CORECEPTOR

12. 3. Reverse Transcription: Viral RNA is converted
into DNA by unique enzyme reverse transcriptase.
Reverse transcriptase
RNA ---------------------> DNA
Reverse transcriptase is the target of several HIV
drugs.

13. 4. Integration: Viral DNA is inserted into host cell
chromosome by unique enzyme integrase.
Integrated viral DNA may remain latent for years
and is called a provirus.
5. Replication: Viral DNA is transcribed and RNA
is translated, making viral proteins.
Viral genome is replicated.
6. Assembly: New viruses are made.
7. Release: New viruses bud through the cell
membrane.

14. CLINICAL STAGES
Clinical Stage I:
 Asymptomatic infection
 Persistent generalized
lymphadenopathy (PGL)

15. Clinical Stage II :
 Weight loss, <10% of body weight
 Minor mucocutaneous manifestations (e.g.,
seborrheic dermatitis, prurigo, fungal nail infections,
oropharyngeal ulcerations, angular cheilitis)
 Herpes zoster, within the last five years
 Recurrent upper respiratory tract infections (e.g.
bacterial sinusitis)

16. Clinical Stage III:
 Weight loss, >10% of body weight
 Unexplained chronic diarrhea, > 1 month
 Unexplained prolonged fever (intermittent or
constant) >1 month
 Oral candidiasis (thrush)
 Oral hairy leukoplakia
 Pulmonary tuberculosis within the past year
 Severe bacterial infections (e.g. pneumonia,
pyomyositis)

17. Clinical Stage IV :
 Pnemocystis carinii pneumonia (PCP)
 Toxoplasma of the brain
 Cryptosporidiosis with diarrhea >1 month
 Cryptococcosis, extrapulmonary
 Cytomegaloviral disease of an organ other than the liver,
spleen, or lymph node
 Herpes simplex virus infection, mucocutaneous (>1
month) or visceral (any duration)
 Progressive multifocal leukoencephalopathy (PML)
 Any disseminated endemic mycosis (e.g. histoplasmosis,
coccidioidomycosis)

18.  Candidiasis of the esophagus, trachea, bronchi, and lungs
 Atypical mycobacteriosis, disseminated
 Non-typhoid Salmonella septicemia
 Extrapulmonary tuberculosis
 Lymphoma
 Kaposi’s sarcoma (KS)
 HIV encephalopathy, as defined by the Centers for Disease
Control

20. OPPORTUNISTIC
INFECTIONS
200-500 cells/cmm CD4
count
type
pneumococcal pneumonia bacterial
pulmonary tuberculosis bacterial
Kaposi’s sarcoma Viral
Herpes zoster viral
Thrush fungal
Cryptosporidium parasitic
Oral hairy leukoplakia viral
Oro-pharyngeal candida fungal
Infections that occur more often or are more severe in people with
weak immune systems than in people with healthy immune
systems.

21. OPPORTUNISTIC
INFECTIONS
<200 cells/cmm
CD4 count
type
pneumocystis carinii
pneumonia
fungal (previously thought
to be parasitic)
candida esophagitis fungal
recurrent/disseminated viral
herpes simplex
viral
toxoplasmosis parasitic
histoplasmosis fungal
Coccidioidomycosis fungal
progressive multifocial
leukoencephalopathy
viral
microsporidiosis parasitic
extrapulmonary tuberculosis bacterial

22. OPPORTUNISTIC
INFECTIONS
<50 cells/cmm
CD4 count
type
cytomegalovirus viral
mycobacterium avium
complex
bacterial

23. ORAL MANIFESTATIONS
OF HIV/AIDS

25. LABORATORY
DIAGNOSIS OF
H.I.V
INFECTION

26. SPECIFIC TESTS FOR
HIV
 Antigen Detection : p24
Antigen
 Virus isolation
 Detection of viral nucleic acid
 Antibody Detection

27. NON SPECIFIC TESTS
 TLC AND DLC
 T - lymphocyte Subset
assays
 Platelete count
 IgG & IgA levels

29. OUTCOME
MANAGEMENT
Maintain Health
Initiate & maintain Antiretroviral
drugs and therapy
Prevent infection

30. Maintain Health
CBC
Chemistries
Annual Screening
TB Skin tests/Chest x-ray
Pregnancy
Testing for pathogens known to cause
opportunistic infections
CD4 & viral load testing (every 3-6 months )

31. Antiretroviral Therapy
There’s no cure for HIV/AIDS, but many
different drugs are available to control the
virus called Antiretroviral therapy, or ART.
Each class of drug blocks the virus in
different ways.
ART is now recommended for everyone,
regardless of CD4 T cell counts.
It’s recommended to combine three drugs
from two classes to avoid creating drugs-
resistant strains of HIV.

33. Prevention Of HIV
Infections
Vaccines
Education and counselling
Free needles for IV Drugs users
Improved blood supply
Screening and treating pregnant
women

35. CONCLUSION
Remember AIDS does not discriminate cast,
creed, religion, education or social status.
Prevention of AIDS is our joint responsibility
Education and awareness is only weapon in
our hand..

36. REFERENCES
 Essential Pathology - Harsh Mohan {4th Edition}
 Internet {Google, Slideshare}
 https://www.slideshare.net/ngogoyo/0102-biology-of-hiv
 https://www.niaid.nih.gov/diseases-conditions/hiv-replication-
cycle
 K.D. Tripathi., Essentials of Medical Pharmacology: 7th edition,
Jaypee Brothers Medical Publishers (2013), New Delhi.