AIDS is caused by the HIV virus, which damages immune cells called CD4+ T cells. This leaves the body vulnerable to opportunistic infections and cancers. It is transmitted via bodily fluids like blood, semen, vaginal fluid and breast milk. While treatments can slow the virus, there is currently no cure. Prevention methods focus on safe sex practices, needle safety, blood screening and education.

1. AIDS
DEFINITION :
1. Aids Is Acronym Of Acquired Immunodeficiency Syndrome.
2. Aids is a chronic , life threatening condition caused by human immunodeficiency
virus (HIV) ,which is A retrovirus . By damaging/destroying the cells of the immune
system, HIV interfere with the body’s ability to fight off viruses, bacteria and fungi that
causes the disease.

2. CLASSIFICATION :
CD4+ CELL COUNT
CATEGORIES
CLINICAL
CATEGORIES
Category
1:
>500 cells
/microliter.
Category 2 :
200-499
cells
/microliter.
Category 3 :
<200 cells
/microliter.
Category A
: no
symptoms,
primary
HIV
infection.
Category
C :shows
symptoms
of Aids.
Category B
: defect in
cell
mediated
immunity.

3. ETIOLOGY:
Sexual
transmission
main mode
of spread
accounts
75% of total
Via blood
and blood
products
accounts 25%
intravenous
drug abusers
hemophiliacs.
Perinatal
transmission of
infection from
infected
mother to
newborn
through:
maternal blood
breast milk
Occupational
transmission
health care
workers,
laboratory
workers,
people
engaged in the
disposal .
waste of
sharp.
Other body
fluids:
saliva,
tear, sweat,
urine,
CSF,synovial
fluid
,pericardial
fluid, pleural
and peritoneal
fluid

4. STRUCTURE OF HIV VIRUS :ETIOLOGICAL
AGENT

5.  HIV-1 STRAIN
 Accounts 95% of
all cases.
 Fast progress
 VPA gene
 Plasma viral load
is higher
 HIV STRAIN
accounts
remaining 5%
 low progress
 VPX gene
 plasma viral load
is lower
HIV VIRUS

6. EPIDEMIOLOGY :
1. Developing countries comprises of majority of cases and Africa alone
constitutes 50% globally.
2. About 2.5 million new cases are getting added every year.
3. In India, Maharashtra and Tamilnadu together comprises of 50% of all
HIV positive cases and Manipur accounts for 8% of cases.
4. 1 in every 100 sexually active adults worldwide is infected with HIV.

7. 1.Wasting syndrome :
involuntary loss of body's weight by more than 10% malabsoption.
2.Persistent generalized lymphanopathy:
Presence of enlarged lymph nodes >1cm at two or more extra inguinal
sites for >3months without an obvious cause.
3.CNS manifestations :
Inflammatory, demyelinating and degenerative conditions may occur.
Meningitis, demyelinating lesions of spinal cord , and peripheral
neuropathy and lymphoma of the brain.
CLINICAL MANIFESTATIONS :

8. 4.CARDIOVASCULAR MANIFESTATIONS :
HIV associated cardiomyopathy, pericardial effusion in advanced disease
as a result to opportunistic infection, lymphoma and Kaposi's disease.
5. MUSCULOSKELETAL LESIONS :
includes osteoporosis,osteopenia,septic arthritis,osteomtlitis.
6. ENDOCRINE LESIONS :
There may be abnormality of thyroid function,hypogonadism, and
inappropriate release of ADH hormone.

9. PATHOPHYSIOLOGY :
BINDING TO CD4+ CELLS
INTERNALIZATION
UNCOATING
REVERSE TRANSCRIPTASE

10. INTEGRATED PROVIRAL RNA
PRODUCTIVE INFECTION LATENT INFECTION
MATURE HIV PRODUCTION
CELL LYSIS .

11. PATHOGENESIS :
1.Selective tropism for CD4+ molecule receptor.
2.Internalization – gp41 glycoprotein envelop of HIV virus gets
internalized with the cd4+ cell’s membrane.
3.Uncoating and viral DNA formation – Enzyme reverse transcriptase
forms single stranded DNA, using it DNA polymerase makes double
stranded DNA by destroying the original DNA.

12. 4.Viral integration : Viral integrate protein inserts the viral DNA into nucleus of the
host the cell and integrates in the host cell DNA.
5.Viral replication : Host cell DNA transcripts for the viral RNA with tat gene.
multiplication is facilitate by cytokines from t cell.
6. Latent period and immune attack : Immune system does not attack against the
virus and soon the virus overpowers the host immune system.

13. 7. CD4+ t cell destruction : Viral particles form buds from the cell wall of the host cell
then they detaches from it by damage of the cell membrane causing death of the host cell
by apoptosis.
8.Viral dissemination: Release of viral particles from infected host cell spreads the
infection to more CD cell. Through circulation, they gets entry in lymphoid tissues.

14. DIAGNOSIS:
TEST FOR ESTABLISHING HIV INFECTION :
1. antibody tests - 2.direct detection of HIV-
a) Elisa a)p24 antigen capture assay
b) Western clot b)HIV RNA assay
c)DNA - PCR
d)culture of HIV.
TESTS FOR DEFECTS IN IMMUNITY :
1.cd4+ t cell count : fall
2.cd8+ cell count increase
3.hypergammaglobulinaemia
4.lymphopenia

15. 6.platelet count : thrombocytopenia
3.TESTS FOR DETECTION OF OPPORTUNISTIC INFECTION AND
SECONDARY TUMORS:
1.fnac
2.biopsy.

16. TREATMENT:
Protease inhibitors:
ritonavir,
nelphinavir.
HAART-(highly
active anti-
retrovial therapy):
includes reverse
transcriptase
inhibitors &
protease
inhibitors.
Reverse
transcriptase
inhibitors:
zedovudine,
stavudine,
trizivir,
foscarnet,
didexymidine(ddt).

17. PREVENTION :
1.Use of appropriate contraceptives .
2.Proper sterilization of surgical equipment.
3.Use of disposable instruments for and body puncture practice.
4.Avoiding intra-venous drug use and sharing of needles, razores,ect.
5.Creating social awareness.