This document summarizes information about AIDS/HIV, including global and Indian statistics showing 14 million cases globally in 1993 with 2/3 in sub-Saharan Africa. It discusses the etiology as HIV-1 and HIV-2, modes of transmission as sexual contact, blood/blood products, IV drug use, and vertical transmission. It describes the 4 clinical stages per the CDC classification from acute infection to presence of other diseases. It covers investigations like EIA, Western Blot, and viral culture. It discusses treatments including antiretrovirals like zidovidine and lamivudine. It also outlines various oral manifestations of HIV like candidiasis, hairy leukoplakia, Kaposi's sarcoma

1. AIDS
Acquired Immunodeficiency
Syndrome

2. AIDS
 GLOBAL /INDIAN STATASTICS
 ETIOLOGY/RISK FACTORS
 CLINICAL STAGES
 INVESTIGATIONS
 TREATMENT
 ORAL MANIFESTATIONS
 TREATMENT
 CURRENT TRENDS

3. GLOBAL /INDIAN STATASTICS
 1993-WHO-14MILLION CASES-GLOBAL
 2/3 CASES-SUB SAHARA AFRICAN
,NORTH&LATIN AMERICA

4. ETIOLGY
 H I V 1[Human Immunodeficiency virus]
[70-80%]
 H I V 2

5. Etio-pathogenesis

6. Transmission-modes
 SEXUAL CONTACT
[SEMEN,VAGINAL SECREATION]
 BLOOD &BLOOD PRODUCTS
 IV DRUG USE
 VERTICAL TRANSMISSION Pregnant mother to
baby]-PERINATAL

7. CLINICAL STAGES[CDC CLASSFN]
 GROUP I-ACUTE INFECTION
 GROUP II-ASYMPTOMATIC INFECTION
 GROUP III-PGL[presence of enlarged
lymph nodes]
 Group IV-OTHER DISEAES

8. Group I
 Acute infection
 Starts few weeks after exposure and HIV
Infection
 Low grade fever,malaise,headache and
lymphadenopathy are symptoms

9. GROUP-II
 Asymptomatic infection
 Free of symptoms

10. GROUP-III
 PGL[Persistent generalized
lymphadenopathy]
 Enlarged lymph nodes
 More than 1cms in diameter
 2 or more extra inguinal nodes
 More than 3 months in the absence of any
illness or medication

11. GROUP-IV [OTHER DISEASE]
Subgroup –A
CONSTITUTIONAL
DISEASE
Subgroup-B
NEUROLOGICAL
DISEASE
 Subgroup-c
Secondary infectious
diseases
C-1.Specified
secondary infectious
diseases as per
CDC[Centers for
disease control]
C-2. other .Specified
secondary infectious

12. CDC CLASSIFICATION-cod
SUBGROUP-D
 SECONDARY CANCERS
SUBGROUP-E
 OTHER CONDITIONS

13. HIV-
STAGING[CD4+TLymphocytes]
 1
CD4+CELL
CATEGORY
CD4+CELLS/micro L Cd4+ cells%
1 >500
=
>29%
=
2 200-499 14-28%
3 >200 <14

14. Investigations
 EIA
[Enzyme immuno assay]
Confirmatory tests
WESTERN BLOT [Radio immunoassay]
Indirect immunofluorescence
viral culture

15. Treatment[antiretrovirals]
 Zidovidine -1-1.2gm/day
 Lamividine
Combination drugs

16. Oral Lesions-HIV
 Infectious disease
 Neoplasms
 Neurological disease
 Infectious diseases
 Fungal
 Viral
 Bacterial

17. Fungal Infections
Oral candidiasis Local& systemic
antifungal
amphotericin B[IV]
Fluconazole[IV]
Histoplasmosis amphotericin B[IV]
Fluconazole[IV]
Cryptococcosis ,,
Geotricosis ,,

18. VIRAL-HIV
 Herpes simplex viral infections[HSV]
ACYCLOVIR-IV-30mg/kg daily
Resistant cases
Foscarnet

19. VIRAL-HIV
 CMV-Infections-systemic admn.
 Ganciclovir
 Foscarnet

20. VIRAL-HIV
 EBV Infections
 VZV Infections
ACYCLOVIR
FOSCARNET
15-30mg/kg

21. Viral-HIV
 PAPILLOMA VIRUS Infections
Local excision papillomatous growth

22. ORAL HAIRY LEUKOPLAKIA
 HL Associated with EBV infection
 Epithelial hyperplasia presenting with
corrugated white patch on lateral border of
tongue
 H.P.:INTRANUCLEAR INCLUSIONS IN
KERATOCYTES

23. ORAL HAIRY LEUKOPLAKIA
[EBV]
 ORAL-ACYCLOVIR-2.5-3mg/day
 Ganciclovir [IV]
 Deciclovir[IV]
 TOPICAL vitamin A-RETINOIC ACID

24. RAS-ULCERS
 TOPICAL STERIODS
DEXAMETHASONE CREAM,GEL ,RINSE
TETRACYCLINE RINSE
METRANIDAZOLE
RESISTENT CASES-LOW DOSES OF SYSTEMIC STERIODS

25. HIV-GINGIVITIS/PERIODONTITIS
 LOCAL& SYSTEMIC ANTIMICROBIALS
CHLORHEXIDINE RINSE
PERIODONTAL THERAPY

26. NEOPLASMS
KAPOSI SARCOMA
HODGKINS LYMPHOMA

27. Kaposi Sarcoma
 Diagnostic lesions of HIV
 Malignant vascular tumor
 Classic form given by Moriez kaposi
 Oral mucosa, skin and nodal lesions

28. Kaposi Sarcoma
 ORAL LESIONS
 SITE: Posterior Hard palate
 Flat red, purple macules with variable size and
irregular configurations on hard palate
 Facial gingiva second common site for KS
 Skin lesions
 Red-purple macules on lower extremities
 H.P:spindle cells,extravasstion of
RBC,Hemosiderin are classic features

29. Kaposi Sarcoma
Treatment
 Surgical excision
 Radiotherapy:16-30cGy-8-20doses
 Chemotherapy:vinblastine/vincristine with
methotrexate,bleomycin combination
 Immune therapy: aipha INTER FERON

30. Neoplasms
 Hodgkin’s and Non hodgkin’ s lymphoma
Radiotherapy
Chemotherapy

32. PSEUDOMEMBRANOUS CANDIDIASIS ERYTHEMATOUS CANDIDIASIS

33. HYPERPLASTIC CANDIDIASIS

34. PIGMENTED LESION

35. HAIRY LEUKOPLAKIA

36. MAJOR APHTHOUS ULCER

37. HSV INFECTIONS

38. HERPES ZOSTER INFECTION

39. TUBERCULOUS LYMPHADENITIS

40. KAPOSI’S SARCOMA