AIDS Acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). AIDS is now a pandemic. In 2007, it was estimated that 33.2 million people lived with the disease worldwide, and that AIDS killed an estimated 2.1 million people, including 330,000 children. Today, there are an estimated 33.4 million people living with HIV and AIDS and each year around two million people die from AIDS related illnesses.
HISTORY OF AIDS The first recorded sample of HIV was discovered in 1959 in a blood specimen obtained at Leopoldville (now Kinshasa) in the Belgian Congo. The HIV is thought to have originally affected chimpanzees. All the early AIDS cases originated in the Central African states of Congo, Rwanda or Burundi. Monkeys harbor SIV or Simian Immunodeficiency Virus(SV-40 to be more specific), is thought to be the ancestor of HIV. The first cases of AIDS were reported in the United States in March 1981, when eight men in New York were diagnosed with a rare form of Kaposis sarcoma (a relatively benign cancer that usually occurs in older people) and numerous cases of a rare lung infection called pneumocystis carinii pneumonia (PCP) started popping up in New York and California among homosexual men.
HIV Virus• HIV is a retrovirus that attacks the immune systems protective CD4 cells. When the immune system loses too many CD4 cells, a person is less able to fight off infection and can develop serious opportunistic infections (OIs).• A person is diagnosed with AIDS when there are less than 200 CD4 cells and/or has one of 21 AIDS-defining OIs.
Types of HIVHIV has two major categories : HIV-1 and HIV-2. HIV-1, currently has about 10 subtypes, is most common worldwide and the only form found in the US. HIV-2 is less virulent and though currently confined to West Africa, it‟s spreading.
The different stages of HIV infection HIV infection can generally be broken down into four distinct stages:1. Primary infection2. Clinically asymptomatic stage3. Symptomatic HIV infection4. Progression from HIV to AIDS
Are HIV and AIDS the same thing? HIV and AIDS is not the same thing. When the immune system is weak because of HIV, a person becomes susceptible to a number of severe illnesses, also known as opportunistic infections. When this happens, along with at least one of 26 other defining conditions, a person is considered to have progressed to AIDS. It is from these opportunistic infections, not the AIDS diagnosis that people die. It is also important to note that not all people with HIV will develop AIDS.
Symptoms The symptoms of HIV usually vary according to the stage of the infection the patient is currently in. The early symptoms resemble flu symptoms and include fever, muscle aches, rash, swollen lymph nodes and glands. Symptoms of HIV in later stages, just before it progresses to AIDS, involve the following:• Easy bruising• Fever• Night sweats• Chronic yeast infections• Thrush or yeast infection of the mouth• Fatigue and extreme exhaustion• Unexplained weight loss
Susceptibility to CancerHIV – positive persons are susceptible to several types ofcancer, particularly Kaposi‟s Sarcoma (KS), an uncommonform that occurs under the skin and in the mucous membranesof the eyes, nose and mouth. Affected persons have lesionsthat appear as dark – colored raised blotches. Though thelesions are painless, once KS spreads to the lungs, lymphnodes and digestive tract, the victim experiences difficulty inbreathing, gastrointestinal bleeding and painful swellingaround the lymph nodes, especially in the legs.
HIV Test– HIV tests are usually performed on venous blood. Many laboratories use fourth generation screening tests which detect anti-HIV antibody (IgG and IgM) and the HIV p24 antigen. The detection of HIV antibody or antigen in a patient previously known to be negative is evidence of HIV infection. Individuals whose first specimen indicates evidence of HIV infection will have a repeat test on a second blood sample to confirm the results.– Routinely used HIV tests for infection in neonates and infants (i.e., patients younger than 2 years), born to HIV- positive mothers, have no value because of the presence of maternal antibody to HIV in the childs blood. HIV infection can only be diagnosed by PCR, testing for HIV pro-viral DNA in the childrens lymphocytes.– HIV tests include :• ELISA test• SPOT test• WESTERN BLOT (WB) test• CD4 and Viral Load testing
How is HIV/AIDS transmitted? 1. Sexual transmission – Heterosexual – Homosexual 2. Blood and blood products – IV drug use – Transfusions – Haemophilia – Other (knives) 3. Vertical transmission – During pregnancy – During birth – Breastfeeding
Sexual transmission– Sexual transmission occurs with the contact between sexual secretions of one person with the rectal, genital or oral mucous membranes of another. The risk for transmitting HIV through unprotected anal intercourse is greater than the risk from vaginal intercourse or oral sex.
Exposure to blood-borne– pathogens This transmission route is particularly relevant to intravenous drug users, hemophiliacs and recipients of blood transfusions and blood products. Sharing and reusing syringes contaminated with HIV-infected blood represents a major risk for infection with HIV.– This route can also affect people who give and receive tattoos and piercings.– According to the WHO, the overwhelming majority of the worlds population does not have access to safe blood and between 5% and 10% of the worlds HIV infections come from transfusion of infected blood and blood products.
Perinatal transmission– The transmission of the virus from the mother to the child can occur in utero during the last weeks of pregnancy and at childbirth. In the absence of treatment, the transmission rate between a mother and her child during pregnancy, labor and delivery is 25%.– However, when the mother takes antiretroviral therapy and gives birth by caesarean section, the rate of transmission is just 1%.– Breastfeeding also increases the risk of transmission by about 4 %.
Injecting drugs– Sharing injecting equipment is a very efficient way to transmit blood-borne viruses such as HIV and Hepatitis C. Sharing needles and “works” (syringes, spoons, filters and blood-contaminated water) is thought to be three times more likely to transmit HIV than sexual intercourse.
Most common misconceptions regarding HIV/AIDS are:• Sexual intercourse with a virgin will cure AIDS• HIV can infect only homosexual men and drug users• It is not passed through urine or saliva• One cannot become infected through casual contact such as hugging, kissing, sneezing, coughing, sharing a toilet seat, or simply by living in close contact with an infected person.
PREVENTION “Library and information services cannot sit on the fence when their nations’ young people are being decimated by the enemy from within who strikes silently and in darkness.” Kingo J. Mchambu 2002 Reaching out to the most vulnerable Why focus on prevention? There is no vaccine for HIV/AIDS. As treatment still remains unaffordable or inaccessible for many people in the world, for now, prevention is the best approach to fight the pandemic.
ABC APPROACHThe ABC Approach to prevent sexual transmission of HIV Abstain Be faithful Use a CondomLimits of the ABC-Approach Lack of resources Gender inequality Faithfulness of partners
EXPOSURE TO INFECTED BLOODBlood supplies Screening of blood products reduces the risk of transmissionAccidents Strategy of universal precautionsInjections and syringes A needle or syringe used for injection should never be shared with others.
PREVENT MOTHER-TO-CHILD-TRANSMISSION (MTCT) Preventing HIV infection among prospective parents Avoiding unwanted pregnancies among HIV positive women Preventing the transmission of HIV from HIV positive mothers to their infants during pregnancy, labor, delivery and breastfeeding.
TREATMENTAntiretroviral drugs (ARVs) Highly active antiretroviral therapy, or HAART is not a cure Slow down the process of replication of HIV in the human bodyPrevent and treat Opportunistic InfectionsPrevent mother-to-child-transmission• During pregnancy and delivery• Safer infant feedingAccess to services / availability of drugs Availability, Coverage, Impact
TREATMENTImportant role of institutions (hospitals, clinics, VCT centres)Conditions to support treatment Medication adherence planLiving positively• Adopt a healthy diet• Exercise regularly• Avoid alcohol and tobacco, or certainly minimize their consumption• Reduce stress• Avoid all forms of infection (when possible) because they may compromise your health and further weaken one’s immune system• Don’t use drugs other than those prescribed by your doctor• Visit the doctor regularly
Experimental and proposed treatments Vaccination against hepatitis A and B is advised for patients who are not infected with these viruses and are at risk of becoming infected. Researchers have discovered an abzyme that can destroy the protein gp120 CD4 binding site. This protein is common to all HIV variants as it is the attachment point for B lymphocytes and subsequent compromising of the immune system.
Why do people still develop AIDS today? Even though antiretroviral treatment can prevent the onset of AIDS in a person living with HIV, many people are still diagnosed with AIDS today. There are four main reasons for this: In many resource-poor countries antiretroviral treatment is not widely available. Even in wealthier countries, such as America, many individuals are not covered by health insurance and cannot afford treatment. Some people who became infected with HIV in the early years of the epidemic before combination therapy was available, have subsequently developed drug resistance and therefore have limited treatment options. Many people are never tested for HIV and only become aware they are infected with the virus once they have developed an AIDS related illness. These people are at a higher risk of mortality, as they tend to respond less well to treatment at this stage. Sometimes people taking treatment are unable to adhere to, or tolerate the side effects of drugs.
CASE STUDY WORLD AIDS CAMPAIGN - 2004 Year 2004‟s World AIDS Campaign, which culminated on World AIDS Day, December 1, 2004, explored how gender inequality fuels the AIDS epidemic, and was conceived to help accelerate the global response to HIV and AIDS by encouraging people to address female vulnerability to HIV. The campaign‟s slogan „Have you heard me today?‟ called for action against the inequalities that not only put women and girls at risk but whole communities. Young women and girls are 2.5 times more likely to be HIV – infected as their male counterparts.
Started on 1st December 1988, World AIDS Day is about raising money, increasing awareness, fighting prejudice and improving education. World AIDS Day is important in reminding people that HIV has not gone away, and that there are many things still to be done.
The Red Ribbon The red ribbon is an international symbol of AIDS awareness that is worn by people all year round and particularly around World AIDS Day to demonstrate care and concern about HIV and AIDS, and to remind others of the need for their support and commitment.
CONCLUSIONRemember AIDS does not discriminatecaste, creed, race, religion, educational or social status.Prevention of AIDS is our joint responsibility. Educationand awareness is the only weapon in our hand. Let usaccept the challenge to fight against AIDS. We mustsupport and care for the people with HIV / AIDS withcompassion and understanding.