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This was presented by me in class on 13th August... and i thought i would put it here.

Published in: Education, Health & Medicine
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  1. 1. HIV / AIDS -Malini Sundar Rajan 7th semester BE Biotechnology PESIT
  2. 2. 2 Endemic, Epidemic and Pandemic – The Difference  Endemic: a disease that exists permanently in a particular region or population. Malaria is a constant worry in parts of Africa.  Epidemic: An outbreak of disease that attacks many peoples at about the same time and may spread through one or several communities.  Pandemic: When an epidemic spreads throughout the world. AIDS
  3. 3. 3 Scope of the HIV/AIDS Pandemic 00002-E-4 – 1 December 2003 Adults and children estimated to be livingAdults and children estimated to be living with HIV/AIDS as of end 2003with HIV/AIDS as of end 2003 Total: 34 – 46 million Western Europe 520 000520 000 –– 680 000680 000 North Africa & Middle East 470 000470 000 –– 730 000730 000 Sub-Saharan Africa 25.025.0 –– 28.2 million28.2 million Eastern Europe & Central Asia 1.21.2 –– 1.8 million1.8 million South & South-East Asia 4.64.6 –– 8.2 million8.2 million Australia & New Zealand 12 00012 000 –– 18 00018 000 North America 790 000790 000 –– 1.2 million1.2 million Caribbean 350 000350 000 –– 590 000590 000 Latin America 1.31.3 –– 1.9 million1.9 million East Asia & Pacific 700 000700 000 –– 1.3 million1.3 million
  4. 4. 4 Global HIV/AIDS in 2003  40 million people are living with HIV/AIDS.  2.5 million are children under 15 years.  14,000 new infections each day
  5. 5. 5 Impact of Global HIV Negative economic impact on countries Overwhelmed healthcare systems Decreasing life expectancy Deteriorating child survival rates Increasing numbers of orphans
  6. 6. 6 HIV and AIDS Human Immunodeficiency Virus H = Human I = Immunodeficiency V = Virus
  7. 7. 7 HIV  Retrovirus, enveloped ssRNA, RT (RNA dependent DNA polymerase).  Lentiviruses (HIV1 and 2), and Oncoviruses (HTLVI, HTLVII).  Fastidius, requires intimate contact.  Attacks CD4 + cells.
  8. 8. 8
  9. 9. 9 HIV life cycle
  10. 10. 10 HIV and AIDS Acquired ImmunoDeficiency Syndrome A = not inherited I = immune system D = deficiency – inability to protect against illness S = syndrome, a group of symptoms or illnesses that occur as a result of HIV infection
  11. 11. 11 HIV and AIDS  When the immune system becomes weakened by HIV, the illness progresses to AIDS.  Some blood tests, symptoms or infections indicate progression of HIV to AIDS.
  12. 12. 12 HIV-1 and HIV-2  HIV-1 and HIV-2  Transmitted through the same routes  Associated with similar opportunistic infections  HIV-1 is more common worldwide.  HIV-2 is found primarily in West Africa, Mozambique and Angola.
  13. 13. 13 HIV-1 and HIV-2 Differences between HIV-1 and HIV-2  HIV-2 is less easily transmitted.  HIV-2 develops more slowly.  MTCT is relatively rare with HIV-2.
  14. 14. 14 Variation in HIV-1  Most error-prone reverse transcriptase.  Variability of the gp 120 antigen.  Failure of the immune system to control the infection.
  15. 15. 15 Natural History of HIV Infection
  16. 16. 16 Natural History of HIV Infection HIV can be transmitted during each stage  Seroconversion  Infection with HIV, antibodies develop  Asymptomatic  No signs of HIV, immune system controls virus production  Symptomatic  Physical signs of HIV infection, some immune suppression  AIDS  Opportunistic infections, end-stage disease
  17. 17. 17 Natural History of HIV Infection  Severity of illness is determined by amount of virus in the body (increasing viral load) and the degree of immune suppression (decreasing CD4 count).  Higher the viral load, the sooner immune suppression occurs.
  18. 18. 18 Natural History of HIV Infection Immune suppression  HIV attacks white blood cells, called CD4 cells, that protect body from illness.  Over time, the body’s ability to fight common infections is lost.  Opportunistic infections occur.
  19. 19. 19 Natural History of HIV Infection Direct infection of organ systems Brain (HIV dementia) Gut (wasting) Heart (cardiomyopathy)
  20. 20. 20 _______________Head_________________ _ Toxoplasmosis (Toxo) Cryptococcal meningitis _______________Eyes__________________ Cytomegalovirus (CMV) ___________Mouth and Throat__________ Candidiasis (Yeast) ________________Lungs_______________ _ Pneumocystis carinii pneumonia (PCP) Tuberculosis (TB) Histoplasmosis _________________Gut_________________ Cytomegalovirus (CMV) Cryptosporidiosis Mycobacterium avium complex (MAC) ________________Skin_________________ Herpes simplex Shingles _______________Genitals______________ Genital herpes Human papillomavirus (HPV) Vaginal candidiasis (Yeast) HIV-Related Opportunistic Infections
  21. 21. 21 Progression of HIV Infection  HIGH viral load (number of copies of HIV in the blood)  LOW CD4 count (type of white blood cell)  Increasing clinical symptoms (such as opportunistic infections)
  22. 22. 22 Natural History of HIV Infection-Summary  HIV multiplies inside the CD4 cells, destroying them.  As CD4 cell count decreases and viral load increases, the immune defences are weakened.  People infected with HIV become vulnerable to opportunistic infections.  HIV is a chronic viral infection with no known cure.  Without ARV treatment, HIV progresses to symptomatic disease and AIDS.
  23. 23. 23 Transmission of HIV HIV is transmitted by  Direct contact with infected blood  Sexual contact: oral, anal or vaginal  Direct contact with semen or vaginal and cervical secretions  Mothers infected with HIV to infants during pregnancy, delivery and breastfeeding
  24. 24. 24  Coughing, sneezing  Insect bites  Touching, hugging  Water, food  Kissing  Public baths/pools Transmission of HIV HIV cannot be transmitted by:  Toilets  Handshakes  Work or school contact  Telephones  Cups, glasses, plates, or other utensils
  25. 25. 25 Prevention of HIV Transmission Public health strategies to prevent HIV transmission  Screen all blood and blood products.  Follow universal precautions.  Educate in safer sex practises.  Identify and treat STIs.  Provide referral for treatment of drug dependence.  Apply the comprehensive PMTCT approach to prevent perinatal transmission of HIV.
  26. 26. 26 Antiretroviral Therapy A. Nucleoside Reverse Transcriptase Inhibitors 1. Zidovudine (AZT, ZDV) 2. ddI (didanosine) 3. ddC (zalcitabine) 4. d4T (stavudine) 5. 3TC (lamivudine) B. Non-nucleoside Reverse Transcriptase Inhibitors 1. Nevirapine 2. Delavirdine C. Protease Inhibitors (PI's) 1. Indinavir (Crixivan) 2. Ritonavir (Norvir) 3. Nelfinavir mesylate (Viracept) 4. Saquinavir (Invirase)
  27. 27. 27 References  Introduction to Microbiology – A Case- History Approach, by Ingraham and Ingraham  PMTCT Generic Training Package Module 1, from WHO website. 
  28. 28. 28 Thank You