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I have learned about AIDS in infectious disease in shenyang medical college.please be aware of AIDS 7 help to stop this disease.

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  • 在第 14 届世界艾滋病大会开幕式期间,关心艾滋病的人士手举蜡烛,在帕劳群岛的圣 · 乔迪举行夜间集会,呼吁研制出便宜的药品援助贫困的发展中国家治疗艾滋病。 
  • AIDS

    1. 1. AIDS (Acquired Immune Deficiency Syndrome)
    2. 2.                                                 在南非一教区医院中 , 一艾滋病病人在家庭成员的陪伴下,死于肾功能衰竭 .
    3. 3. 河南新蔡爱滋村 , 一个艾滋病家庭漂亮的小女孩
    4. 4. 在第 14 届世界艾滋病大会开幕式期间,关心艾滋病的人士手举蜡烛,在帕劳群岛的圣 · 乔迪举行夜间集会,呼吁研制出便宜的药品援助贫困的发展中国家治疗艾滋病。                                                                           
    5. 5. Definition <ul><li>Sever & often fatal chronic disease </li></ul><ul><li>HIV (Human immunodeficiency Virus) </li></ul><ul><li>CD4+T lymphocyte </li></ul><ul><li>Opportunistic infection & malignant tumor </li></ul><ul><li>Sexual contact &injection transmission </li></ul>
    6. 6. Etiology <ul><li>Causative organism: HIV </li></ul><ul><ul><li>HIV-1 & HIV-2 </li></ul></ul><ul><ul><li>Single-strand RNA, retroviridae, genome9.7kb </li></ul></ul><ul><ul><li>3 structural gene </li></ul></ul><ul><ul><ul><li>env gene: envelope Pro.-- gp120, gp41 </li></ul></ul></ul><ul><ul><ul><li>gag gene: core pro. --P24 & medium P </li></ul></ul></ul><ul><ul><ul><li>pol gene: polymerase, retrotranscriptase. </li></ul></ul></ul><ul><ul><li>gene homologous of HIV-2 40-50% </li></ul></ul><ul><ul><li>comparing with HIV-1 </li></ul></ul>
    7. 9. Etiology <ul><li>Resistance: </li></ul><ul><ul><li>sensitive to heat: 56 o C30 min </li></ul></ul><ul><ul><li>>25% alcohol </li></ul></ul><ul><li>Isolation: </li></ul><ul><li>blood cell, plasma, lymph nodes, semen, </li></ul><ul><li>saliva, tears, breast milk. </li></ul><ul><li>Target cell: </li></ul><ul><li>CD4+T, M, B cell,Nerve cell </li></ul>
    8. 11. Epidemiology <ul><li>Source of infection: </li></ul><ul><ul><li>patients </li></ul></ul><ul><ul><li>asymptomatic carriers </li></ul></ul><ul><li>Route of transmission: </li></ul><ul><ul><li>sexual contact transmission: </li></ul></ul><ul><ul><ul><li>homosexual or bisexual: Western world </li></ul></ul></ul><ul><ul><ul><li>heterosexual: Africa </li></ul></ul></ul><ul><ul><li>injection transmission: </li></ul></ul><ul><ul><ul><li>intravenous drug abusers </li></ul></ul></ul><ul><ul><ul><li>blood or its components transfusion </li></ul></ul></ul>
    9. 12. Epidemiology <ul><li>Route of transmission: </li></ul><ul><ul><li>vertical spread: </li></ul></ul><ul><ul><ul><li>placenta: from mother to infant </li></ul></ul></ul><ul><ul><ul><li>breast milk </li></ul></ul></ul><ul><ul><li>other route: </li></ul></ul><ul><ul><ul><li>organ transplants, artificial insemination </li></ul></ul></ul><ul><ul><ul><li>needle-stick, hospital staff </li></ul></ul></ul>
    10. 13. Epidemiology <ul><li>Susceptibility of population: </li></ul><ul><ul><li>at-risk groups </li></ul></ul><ul><ul><ul><li>male homosexual or bisexual </li></ul></ul></ul><ul><ul><ul><li>intravenous drug abusers </li></ul></ul></ul><ul><ul><ul><li>blood transfusion </li></ul></ul></ul><ul><ul><ul><li>> 40 yrs. male </li></ul></ul></ul>
    11. 15. Pathogenesis <ul><li>HIV is a cytotoxic virus </li></ul><ul><li>HIV interfer with CD4 function & reduce its number </li></ul>
    12. 16. 动态演示 HIV 病毒的感染过程
    13. 17. Clinical manifestation <ul><li>Incubation period: 2 to 10 yrs. </li></ul><ul><li>First period-Illness of infection </li></ul><ul><ul><li>Symptoms: fever, headache, anorexia, nausea, enlargement of lymph nodes </li></ul></ul><ul><ul><li>HIV +, P24 Ag +, CD4/CD8 inverted ratio </li></ul></ul><ul><ul><li>Last 2 weeks </li></ul></ul>
    14. 18. Clinical manifestation <ul><li>Second period- Asymptomatic contact </li></ul><ul><ul><li>Initial HIV inf. or after illness of inf. </li></ul></ul><ul><ul><li>No symptoms </li></ul></ul><ul><ul><li>HIV +, Anti- core Ag +, anti-envelope Ag + </li></ul></ul><ul><ul><li>Last 2 to 10 yrs. </li></ul></ul>
    15. 19. Clinical manifestation <ul><li>Third period- PGL </li></ul><ul><li>(Persistent Generalized Lymphoadenopathy) </li></ul><ul><ul><li>Enlargement of lymph nodes </li></ul></ul><ul><ul><li>outside the inguinal area </li></ul></ul><ul><ul><li>more than 2 areas </li></ul></ul><ul><ul><li>more that 3 months </li></ul></ul>
    16. 20. Clinical manifestation <ul><li>Fourth period- Manifest AIDS </li></ul><ul><ul><li>ARC(AIDS-related complex): fever, loss of weight, anorexia, diarrhea plu PGL </li></ul></ul><ul><ul><li>nervous system symptoms: headach, convulsion, paralysis, progress dementia </li></ul></ul><ul><ul><li>Rare opportunistic infection </li></ul></ul><ul><ul><li>Unusual malignant tumors </li></ul></ul><ul><ul><li>Pneumonia </li></ul></ul>
    17. 21. Clinical manifestation <ul><li>Clinical Classification: </li></ul><ul><ul><li>Class A: illness of infection, asymptomatic infection, PGL </li></ul></ul><ul><ul><li>Class B: pneumonia, ski infection </li></ul></ul><ul><ul><li>Class C: Nervous system symptoms, </li></ul></ul><ul><ul><li>opportunistic inf. </li></ul></ul><ul><ul><li>unusual malignant tumors </li></ul></ul>
    18. 22. Clinical manifestation <ul><li>Grade according to CD4+T cell count </li></ul><ul><ul><li>Grade A: CD4 > 0.5  10 9 /L, Total lymphacyte >2.0  10 9 /L, CD4+>29% </li></ul></ul><ul><ul><li>Grade B: CD4 2.0-.04  10 9 /L, Total lymphacyte 1.0-1.9  10 9 /L, CD4+14~28% </li></ul></ul><ul><ul><li>Grade C: CD4< 2.0  10 9 /L, Total lymphacyte <1.0  10 9 /L, CD4+<14% </li></ul></ul>
    19. 23. Clinical manifestation <ul><li>Common manifestation of AIDS </li></ul><ul><ul><li>Lung infection: P. Carinii pneumonia </li></ul></ul><ul><ul><li>Gastrointestinal infection: candidiasis of mouth or oesophagus </li></ul></ul><ul><ul><li>Central nervous system infection: </li></ul></ul><ul><ul><li>Ski infection: Kaposi’s sarcoma - red or violet macules or papules </li></ul></ul>
    20. 24. Kaposi’s sarcoma
    21. 26. candidiasis of mouth
    22. 27. Laboratory Findings <ul><li>Blood picture: WBC and RBC decrease </li></ul><ul><li>Immunologic test: CD4+T decrease, CD4/CD8 <1 </li></ul><ul><li>Serological test: anti-HIV pos., Ag(gp120, p24), anti-gp120, anti-p24. </li></ul><ul><li>HIV isolation </li></ul>
    23. 28. Clinical Diagnosis <ul><li>High risk population: >2 pos </li></ul><ul><ul><li>loss of weight >10% </li></ul></ul><ul><ul><li>chronic cough or diarrhea > 1 mon </li></ul></ul><ul><ul><li>intermittent or persistent fever >1 mon </li></ul></ul><ul><ul><li>PGL </li></ul></ul><ul><ul><li>herps infection </li></ul></ul><ul><ul><li>candidias infection in month </li></ul></ul>
    24. 29. Laboratory Diagnosis <ul><li>Anti-p24 or gp120 pos twice, WB or SRIP definite </li></ul><ul><li>P24 Ag pos </li></ul><ul><li>HIV isolation from blood, PBMS, cfs, or HIV RNA by Northern blot or HIV pre-DNA by PCR </li></ul>
    25. 30. Treatment <ul><li>There is no cure for AIDS at this time. </li></ul><ul><li>However, a variety of treatments are available that can help keep symptoms at bay and improve the quality of life of those who have already developed symptoms. </li></ul>
    26. 31. Treatment <ul><li>Anti-virus </li></ul><ul><ul><li>AZT(antiretrovirals ): CD4<0.5 109/L </li></ul></ul><ul><ul><li>AZT plu IFN(Kaposi’s sarcoma) </li></ul></ul><ul><ul><li>Pentamidine( pneumocystis carinii pneumnia) </li></ul></ul><ul><li>Immune therapy </li></ul><ul><li>complication therapy </li></ul>
    27. 32. complication therapy <ul><li>also called Cocktail therapy </li></ul><ul><li>Taking two or more antiretroviral drugs at a time is called combination therapy. Taking a combination of three or more anti-HIV drugs is sometimes referred to as Highly Active Antiretroviral Therapy (HAART). </li></ul><ul><li>If only one drug was taken, HIV would quickly become resistant to it and the drug would stop working. Taking two or more antiretrovirals at the same time vastly reduces the rate at which resistance would develop, making treatment more effective in the long term. </li></ul>
    28. 33. Prevention <ul><li>Control source of infection </li></ul><ul><ul><li>isolation </li></ul></ul><ul><ul><li>sterilization </li></ul></ul><ul><ul><li>international quarantine </li></ul></ul><ul><li>Cut the route of transmission </li></ul><ul><li>Vaccination?(gp120) </li></ul>
    29. 34. <ul><li>HIV infecfion is mainly located in : </li></ul><ul><li>a.Thailand </li></ul><ul><li>b.U.S.A </li></ul><ul><li>c.Africa </li></ul><ul><li>d.Japan </li></ul><ul><li>e.Europe </li></ul>
    30. 35. <ul><li>Which cell is the target cell of HIV? </li></ul><ul><li>a.CD8+ cells </li></ul><ul><li>b.Mononuclear cells </li></ul><ul><li>c.CTL </li></ul><ul><li>e.NK cells </li></ul><ul><li>f.CD4+ cells </li></ul>
    31. 36. <ul><li>How many years may the asymptomatic infecfion last After the infection of HIV ? </li></ul><ul><li>a.1year </li></ul><ul><li>b.20years </li></ul><ul><li>c.2~10years </li></ul><ul><li>d.2~10years or more </li></ul><ul><li>e.1~20years </li></ul>
    32. 37. <ul><li>The most main route of transmission for AIDS is: </li></ul><ul><li>Sexual contace </li></ul><ul><li>Receiving blood and blood products </li></ul><ul><li>Abuser of intravenous drug </li></ul><ul><li>Receiving organs or tissues </li></ul><ul><li>Eating uncooked food </li></ul>
    33. 38. <ul><li>Which drug is used for the treatment of pneumocystis carinii pneumnia. </li></ul><ul><li>pentamidine </li></ul><ul><li>Bleomycin </li></ul><ul><li>spiromycin </li></ul><ul><li>clindamycin </li></ul><ul><li>Gancyclovir </li></ul>