The document summarizes the history and biology of HIV/AIDS. It describes how HIV/AIDS was initially recognized in the 1980s due to cases of rare opportunistic infections and cancers in homosexual men. Scientific research eventually identified HIV as the causative infectious retrovirus, which targets and destroys CD4+ T cells, leading to immunosuppression and AIDS if untreated. The global epidemic of HIV/AIDS was also discussed.
The document summarizes information about HIV/AIDS, including:
1. It describes what HIV is, how it attacks and destroys the immune system, and some of the infections and cancers it can lead to.
2. It explains how HIV looks under an electron microscope and some of its key characteristics and proteins.
3. It provides statistics on HIV prevalence around the world, noting that over 36 million people have HIV globally, with sub-Saharan Africa being most affected.
This document provides an overview of HIV/AIDS including:
1. The global and local magnitude of the HIV/AIDS problem, highlighting prevalence rates.
2. Details about the HIV virus such as its structure, history of discovery, and origin.
3. Modes of HIV transmission including unprotected sex, contaminated blood, mother-to-child transmission, and intravenous drug use.
4. Diagnosis methods for HIV including antibody tests and nucleic acid amplification tests to detect the virus directly.
HIV/AIDS originated from chimpanzees in Africa and likely entered the US in the 1970s. In the 1980s, clusters of illnesses in gay men led to the identification of HIV and the disease being named AIDS. The Ryan White CARE Act provided funding for people with HIV/AIDS. Currently over 1 million people live with HIV/AIDS in the US, with higher rates among African Americans and men who have sex with men. Prevention focuses on abstinence, monogamy, and condom use.
Human Immunodeficiency Virus (HIV) InfectionArwa M. Amin
Module: Pharmacology and Therapeutics III, (Therapeutics part)
Coordinator: Dr. Arwa M. Amin Mostafa
Academic Level: Undergraduate, B.Pharmacy
School: Dubai Pharmacy College
Year of first presented in Class: 2018
This Presentation is for Educational Purpose. It has no commercial value associated with it.
HIV/AIDS is caused by the human immunodeficiency virus (HIV) which attacks CD4+ cells in the immune system. There are two types, HIV-1 and HIV-2. HIV-1 is further divided into groups M, N, O, and P. HIV infects and destroys CD4+ T cells leading to immunosuppression and increased risk of opportunistic infections. HIV progresses from primary infection to clinical latency to early signs of infection like candidiasis and lymphadenopathy to late stage AIDS with life threatening infections when CD4+ counts fall below 200 cells/mm3. HIV is transmitted through unprotected sex, contaminated blood or needles, mother-to-child transmission, and other bodily
1. HIV attacks T-cells in the immune system, leading to AIDS in advanced stages. Children progress more rapidly than adults, with half of untreated children dying within 2 years.
2. In India, around 2.4 million people live with HIV, with 25,000 new infections annually in children, most occurring during pregnancy or birth. Approximately 5,000 infected children progress to AIDS each year.
3. HIV is diagnosed through PCR testing in children under 18 months or antibody testing along with clinical symptoms in older children. Management includes cotrimoxazole prophylaxis, antiretroviral therapy, treatment of opportunistic infections, adequate nutrition and immunization.
HIV destroys CD4 cells, weakening the immune system and leading to AIDS. AIDS occurs when the immune system is severely damaged, leaving the body vulnerable to infections and cancers. HIV is transmitted via sexual contact, needle sharing, transfusions, and from mother to child during birth or breastfeeding. While treatment can slow the progression of HIV, there is no vaccine and prevention through safe practices is critical to stemming the tide of the epidemic.
This document discusses the epidemiology and pathogenesis of HIV. It begins with global epidemiology statistics, including that there are 35.3 million people living with HIV worldwide. It then provides more specific statistics on new infections, deaths, at-risk groups, and prevalence by region. Regarding pathogenesis, it explains that HIV primarily attaches to CD4 receptors on cells and integrates its genetic material, leading to infection. It also discusses the body's immune response and how HIV evades detection through high mutation rates. Prevention methods discussed include behavior change, condoms, testing, and antiretroviral treatment and prophylaxis.
The document summarizes information about HIV/AIDS, including:
1. It describes what HIV is, how it attacks and destroys the immune system, and some of the infections and cancers it can lead to.
2. It explains how HIV looks under an electron microscope and some of its key characteristics and proteins.
3. It provides statistics on HIV prevalence around the world, noting that over 36 million people have HIV globally, with sub-Saharan Africa being most affected.
This document provides an overview of HIV/AIDS including:
1. The global and local magnitude of the HIV/AIDS problem, highlighting prevalence rates.
2. Details about the HIV virus such as its structure, history of discovery, and origin.
3. Modes of HIV transmission including unprotected sex, contaminated blood, mother-to-child transmission, and intravenous drug use.
4. Diagnosis methods for HIV including antibody tests and nucleic acid amplification tests to detect the virus directly.
HIV/AIDS originated from chimpanzees in Africa and likely entered the US in the 1970s. In the 1980s, clusters of illnesses in gay men led to the identification of HIV and the disease being named AIDS. The Ryan White CARE Act provided funding for people with HIV/AIDS. Currently over 1 million people live with HIV/AIDS in the US, with higher rates among African Americans and men who have sex with men. Prevention focuses on abstinence, monogamy, and condom use.
Human Immunodeficiency Virus (HIV) InfectionArwa M. Amin
Module: Pharmacology and Therapeutics III, (Therapeutics part)
Coordinator: Dr. Arwa M. Amin Mostafa
Academic Level: Undergraduate, B.Pharmacy
School: Dubai Pharmacy College
Year of first presented in Class: 2018
This Presentation is for Educational Purpose. It has no commercial value associated with it.
HIV/AIDS is caused by the human immunodeficiency virus (HIV) which attacks CD4+ cells in the immune system. There are two types, HIV-1 and HIV-2. HIV-1 is further divided into groups M, N, O, and P. HIV infects and destroys CD4+ T cells leading to immunosuppression and increased risk of opportunistic infections. HIV progresses from primary infection to clinical latency to early signs of infection like candidiasis and lymphadenopathy to late stage AIDS with life threatening infections when CD4+ counts fall below 200 cells/mm3. HIV is transmitted through unprotected sex, contaminated blood or needles, mother-to-child transmission, and other bodily
1. HIV attacks T-cells in the immune system, leading to AIDS in advanced stages. Children progress more rapidly than adults, with half of untreated children dying within 2 years.
2. In India, around 2.4 million people live with HIV, with 25,000 new infections annually in children, most occurring during pregnancy or birth. Approximately 5,000 infected children progress to AIDS each year.
3. HIV is diagnosed through PCR testing in children under 18 months or antibody testing along with clinical symptoms in older children. Management includes cotrimoxazole prophylaxis, antiretroviral therapy, treatment of opportunistic infections, adequate nutrition and immunization.
HIV destroys CD4 cells, weakening the immune system and leading to AIDS. AIDS occurs when the immune system is severely damaged, leaving the body vulnerable to infections and cancers. HIV is transmitted via sexual contact, needle sharing, transfusions, and from mother to child during birth or breastfeeding. While treatment can slow the progression of HIV, there is no vaccine and prevention through safe practices is critical to stemming the tide of the epidemic.
This document discusses the epidemiology and pathogenesis of HIV. It begins with global epidemiology statistics, including that there are 35.3 million people living with HIV worldwide. It then provides more specific statistics on new infections, deaths, at-risk groups, and prevalence by region. Regarding pathogenesis, it explains that HIV primarily attaches to CD4 receptors on cells and integrates its genetic material, leading to infection. It also discusses the body's immune response and how HIV evades detection through high mutation rates. Prevention methods discussed include behavior change, condoms, testing, and antiretroviral treatment and prophylaxis.
Hiv aids general consideration bangladesh and international prospective newHome
This document provides an overview of HIV/AIDS, including:
1) The first reported cases of HIV in 1981 involved 5 cases of pneumonia in young homosexual men.
2) HIV was later identified in 1983 from samples from patients. It was initially named LAV and HTLV-III before being designated HIV.
3) HIV is transmitted primarily via sexual contact, blood/blood products, and mother-to-child transmission. The risk of transmission varies based on exposure type.
4) HIV progresses from acute infection to a chronic carrier state to AIDS, as it destroys CD4 cells and weakens the immune system. This allows for opportunistic infections.
5) Bangladesh has seen rising HIV cases, though
HIV is a virus that attacks the immune system and can lead to AIDS if not treated. It was first reported in 1981 and has since infected over 60 million people worldwide. There are two types - HIV-1, which is more prevalent, and HIV-2, which progresses more slowly. HIV infects and kills CD4+ T cells, weakening the immune system. It enters cells by binding to CD4 receptors and integrating its RNA into the host cell's DNA. This reprograms the cell to produce more HIV viruses that then infect other cells, leading to lower CD4 counts and immunodeficiency. Ocular manifestations may be the first sign of HIV infection, with eye involvement seen in up to 90% of autopsy
AIDS is a disease caused by the HIV virus that weakens the immune system. There are currently around 33 million people living with HIV/AIDS worldwide. The virus originated in chimpanzees in central Africa and was first reported in the United States in 1981. HIV attacks CD4 cells and a person is diagnosed with AIDS when their CD4 count drops below 200 or they contract an opportunistic infection. HIV is transmitted through sexual contact, blood transfusions, needle sharing, and from mother to child during pregnancy or breastfeeding. Prevention focuses on abstinence, monogamy, condom use, safe needle practices, and preventing mother to child transmission. While treatment with antiretroviral drugs can suppress the virus,
The document summarizes the history, epidemiology, virology, immunology, transmission, clinical progression, and global impact of HIV/AIDS. It notes that HIV was first recognized in 1981 but has since been traced to 1959. It is caused by HIV-1 and HIV-2 viruses and is transmitted via bodily fluids. Left untreated, it progresses from primary infection to asymptomatic infection to AIDS as it depletes CD4 cells and allows opportunistic infections. Currently over 30 million people are living with HIV globally, with sub-Saharan Africa most severely impacted.
Scientists believe HIV originated from chimpanzees in Western Africa and was transmitted to humans when they hunted and ate infected animals, possibly as far back as the late 1800s. The first known case of HIV in a human was identified in 1959 in the Democratic Republic of the Congo. In the 1980s, HIV/AIDS began spreading rapidly in the United States, disproportionately affecting gay men in major cities, and by the 1990s AIDS had become a leading cause of death for Americans aged 25-44. While still incurable, medical advances have allowed people to live longer with HIV through treatments like antiretroviral therapy.
The document provides an overview of HIV/AIDS, including its history, origin, life cycle, types, statistics, transmission, prevention, and treatment. It begins with definitions of HIV/AIDS, noting it attacks CD4 cells and destroys the immune system. It then discusses the early origins and identification of AIDS in the 1980s and various theories for the origin of HIV. It provides details on the life cycle and types of HIV viruses. Statistics on global prevalence and transmission methods like unprotected sex, needle sharing, and mother-to-child are presented. The document concludes with sections on prevention, treatment, and ICTC centers.
HIV/AIDS is a disease that weakens the immune system and leaves individuals susceptible to opportunistic infections and tumors. It is transmitted through contact with certain bodily fluids and has become a global pandemic over recent decades. While treatments can slow the progression of the virus, there is currently no known cure. The disease disproportionately impacts marginalized groups and its stigma can be as destructive as the physical effects.
Identification of AIDS? And what is HIV infection and mode of transmission?Hassan Shaker
This presentation includes the following:
1) What are viruses and its classification
2) Over view of HIV infection
3) Development of HIV infection into AIDS.
4) HIV infection's clinical features and its complications.
5) Life cycle of HIV infection.
6) Mode of transmission of HIV infection.
7) How to diagnose HIV infection.
8) How to manage HIV infection.
9) Explain different preventive measures to prevent sexually transmitted viral infection
This document provides information on HIV/AIDS, including its history, epidemiology, definition, characteristics, transmission, pathogenesis, clinical manifestations by system, opportunistic infections, diagnosis, and treatment. Some key points are:
- HIV was first identified in the 1980s and has since infected over 38 million people worldwide. India has the third largest epidemic with over 2 million cases.
- Advanced HIV is defined as CD4 count <350 or WHO stage 3/4 disease. AIDS is defined as CD4 <200 or WHO stage 4 disease.
- HIV is transmitted sexually, through blood/blood products, or mother-to-child. It primarily targets CD4 cells and causes immunosuppression.
- Clinical
HIV - AIDS. Associated Infections and InvasionsEneutron
This document provides information on various infectious diseases associated with HIV/AIDS, including those that affect the central nervous system. It discusses toxoplasmosis, cytomegalovirus encephalitis, cryptococcal meningitis, primary CNS lymphoma, and progressive multifocal leukoencephalopathy. It also covers common skin and mucous membrane disorders like candidiasis, Kaposi's sarcoma, and aphthous ulcers. Treatment options are provided for several conditions. The document contains detailed but technical medical information on infectious diseases indicators and presentations in patients with low CD4 counts.
HIV/AIDS is caused by the HIV virus which weakens the immune system. There are two types of HIV viruses - HIV-1 which is present worldwide and HIV-2 which is mainly found in Africa. Common symptoms of HIV/AIDS include fever, diarrhea, cough and weight loss. The virus can be transmitted through unprotected sex or sharing needles but cannot be spread through casual contact. Detection tests include spot tests and viral load tests. Prevention methods include safe sex practices, avoiding infected needles, and getting adequate rest and nutrition.
HIV attacks and destroys CD4 cells, weakening the immune system and leading to AIDS. It is transmitted through bodily fluids like blood, breastmilk, semen and vaginal secretions. The infection progresses from HIV infection to AIDS in stages - first, the window period when antibodies are not detectable. It is then followed by asymptomatic phase that can last 10-15 years before HIV-related illnesses and infections emerge. Untreated, it culminates in AIDS when the immune system is severely compromised. Risk groups include those with multiple sexual partners and intravenous drug users. Testing involves pre- and post-test counseling and uses ELISA or Western Blot confirmatory tests.
This document provides an overview of HIV/AIDS, including its types, epidemiology, structure and life cycle, transmission, diagnosis, stages of infection, and treatment. It describes how HIV infects and destroys CD4 cells, progressively weakening the immune system until opportunistic infections define AIDS. Laboratory tests for diagnosis include antibody and viral detection assays, with CD4 counts and viral load used to monitor disease progression and response to antiretroviral therapy.
The document discusses AIDS (acquired immunodeficiency syndrome), which is caused by HIV (human immunodeficiency virus) infection. It defines AIDS and describes the pathophysiology, risk factors, clinical manifestations, diagnostic tests, medical management including antiretroviral drugs, and nursing management of patients with AIDS. It also summarizes a research study on the use of first-line antiretroviral therapy from an ART program clinic in Pune, India.
The document discusses Acquired Immunodeficiency Syndrome (AIDS). It begins by defining AIDS as a set of symptoms and infections resulting from damage to the human immune system by the human immunodeficiency virus (HIV). HIV is a retrovirus that targets CD4 T-cells and incorporates its genetic material into the host cell. The document then covers the epidemiology, risk factors, signs and symptoms, diagnosis, management and prevention of HIV/AIDS.
This document provides an overview of HIV/AIDS including key facts about the virus, transmission, prevalence, demographics affected, testing and treatment. It notes that HIV is caused by the human immunodeficiency virus (HIV) which attacks CD4 cells. Some of the highest risk groups for transmission are men who have sex with men, injection drug users, and in the US, African Americans have disproportionately high rates of infection. While there is no vaccine or cure, highly active antiretroviral therapy (HAART) can effectively suppress the virus and prolong the healthy lives of many infected individuals.
The document provides information on HIV/AIDS, including:
- HIV is a retrovirus that infects CD4+ T cells and macrophages, progressively destroying the immune system.
- The virus enters cells using envelope glycoproteins, and its RNA is converted to DNA by reverse transcriptase. The DNA integrates into the host cell's genome.
- As the virus replicates and destroys immune cells, it can eventually cause AIDS, characterized by opportunistic infections. Current antiretroviral treatment aims to suppress viral replication and boost the immune system.
1) HIV is a virus that destroys CD4 immune cells, leading to AIDS if left untreated. With medication, a person can live with HIV for decades without progressing to AIDS.
2) HIV was first observed in 1981 and is believed to have originated from chimpanzees in West Africa. It is transmitted through sexual contact, blood, and from mother to child.
3) Over 42 million people worldwide are currently living with HIV. While treatments have increased life expectancy, aging poses new health challenges for those with HIV due to increased risk of conditions like dementia, heart disease, and infections.
Here are three more potential causes of paralysis in patients with AIDS:
- Cryptococcal meningitis: The most common fungal infection of the CNS in AIDS patients. Can cause increased intracranial pressure, cranial neuropathies, and spinal cord compression.
- Progressive multifocal leukoencephalopathy (PML): Caused by JC virus reactivation in AIDS patients. Presents with cognitive impairment, visual changes, and sometimes motor deficits. MRI often shows multifocal white matter lesions.
- Vacuolar myelopathy: Caused by HIV itself. Presents with spastic paraparesis. MRI may show T2 hyperintensities in the lateral and posterior columns of the spinal cord. Treat
This document discusses HIV and opportunistic infections. It begins by defining HIV as a retrovirus that infects and destroys CD4+ T cells, leading to AIDS. It then lists some common opportunistic infections seen in patients with HIV/AIDS like Pneumocystis jirovecii pneumonia, toxoplasmosis, mycobacterial infections, cryptococcosis, and viral infections caused by herpes simplex virus and varicella zoster virus. It provides details of pharmacological treatments for various opportunistic infections with drugs like trimethoprim-sulfamethoxazole, pentamidine, azithromycin, clarithromycin, fluconazole, acyclovir,
This document discusses opportunistic infections that can occur in AIDS patients with low CD4 counts. It outlines the most common opportunistic infections such as PCP pneumonia, candida esophagitis, and cryptococcal meningitis. It also provides guidelines for prophylaxis of opportunistic infections for patients with CD4 counts below 200 or 100, including recommendations for Bactrim/Septra or Zithromax.
Hiv aids general consideration bangladesh and international prospective newHome
This document provides an overview of HIV/AIDS, including:
1) The first reported cases of HIV in 1981 involved 5 cases of pneumonia in young homosexual men.
2) HIV was later identified in 1983 from samples from patients. It was initially named LAV and HTLV-III before being designated HIV.
3) HIV is transmitted primarily via sexual contact, blood/blood products, and mother-to-child transmission. The risk of transmission varies based on exposure type.
4) HIV progresses from acute infection to a chronic carrier state to AIDS, as it destroys CD4 cells and weakens the immune system. This allows for opportunistic infections.
5) Bangladesh has seen rising HIV cases, though
HIV is a virus that attacks the immune system and can lead to AIDS if not treated. It was first reported in 1981 and has since infected over 60 million people worldwide. There are two types - HIV-1, which is more prevalent, and HIV-2, which progresses more slowly. HIV infects and kills CD4+ T cells, weakening the immune system. It enters cells by binding to CD4 receptors and integrating its RNA into the host cell's DNA. This reprograms the cell to produce more HIV viruses that then infect other cells, leading to lower CD4 counts and immunodeficiency. Ocular manifestations may be the first sign of HIV infection, with eye involvement seen in up to 90% of autopsy
AIDS is a disease caused by the HIV virus that weakens the immune system. There are currently around 33 million people living with HIV/AIDS worldwide. The virus originated in chimpanzees in central Africa and was first reported in the United States in 1981. HIV attacks CD4 cells and a person is diagnosed with AIDS when their CD4 count drops below 200 or they contract an opportunistic infection. HIV is transmitted through sexual contact, blood transfusions, needle sharing, and from mother to child during pregnancy or breastfeeding. Prevention focuses on abstinence, monogamy, condom use, safe needle practices, and preventing mother to child transmission. While treatment with antiretroviral drugs can suppress the virus,
The document summarizes the history, epidemiology, virology, immunology, transmission, clinical progression, and global impact of HIV/AIDS. It notes that HIV was first recognized in 1981 but has since been traced to 1959. It is caused by HIV-1 and HIV-2 viruses and is transmitted via bodily fluids. Left untreated, it progresses from primary infection to asymptomatic infection to AIDS as it depletes CD4 cells and allows opportunistic infections. Currently over 30 million people are living with HIV globally, with sub-Saharan Africa most severely impacted.
Scientists believe HIV originated from chimpanzees in Western Africa and was transmitted to humans when they hunted and ate infected animals, possibly as far back as the late 1800s. The first known case of HIV in a human was identified in 1959 in the Democratic Republic of the Congo. In the 1980s, HIV/AIDS began spreading rapidly in the United States, disproportionately affecting gay men in major cities, and by the 1990s AIDS had become a leading cause of death for Americans aged 25-44. While still incurable, medical advances have allowed people to live longer with HIV through treatments like antiretroviral therapy.
The document provides an overview of HIV/AIDS, including its history, origin, life cycle, types, statistics, transmission, prevention, and treatment. It begins with definitions of HIV/AIDS, noting it attacks CD4 cells and destroys the immune system. It then discusses the early origins and identification of AIDS in the 1980s and various theories for the origin of HIV. It provides details on the life cycle and types of HIV viruses. Statistics on global prevalence and transmission methods like unprotected sex, needle sharing, and mother-to-child are presented. The document concludes with sections on prevention, treatment, and ICTC centers.
HIV/AIDS is a disease that weakens the immune system and leaves individuals susceptible to opportunistic infections and tumors. It is transmitted through contact with certain bodily fluids and has become a global pandemic over recent decades. While treatments can slow the progression of the virus, there is currently no known cure. The disease disproportionately impacts marginalized groups and its stigma can be as destructive as the physical effects.
Identification of AIDS? And what is HIV infection and mode of transmission?Hassan Shaker
This presentation includes the following:
1) What are viruses and its classification
2) Over view of HIV infection
3) Development of HIV infection into AIDS.
4) HIV infection's clinical features and its complications.
5) Life cycle of HIV infection.
6) Mode of transmission of HIV infection.
7) How to diagnose HIV infection.
8) How to manage HIV infection.
9) Explain different preventive measures to prevent sexually transmitted viral infection
This document provides information on HIV/AIDS, including its history, epidemiology, definition, characteristics, transmission, pathogenesis, clinical manifestations by system, opportunistic infections, diagnosis, and treatment. Some key points are:
- HIV was first identified in the 1980s and has since infected over 38 million people worldwide. India has the third largest epidemic with over 2 million cases.
- Advanced HIV is defined as CD4 count <350 or WHO stage 3/4 disease. AIDS is defined as CD4 <200 or WHO stage 4 disease.
- HIV is transmitted sexually, through blood/blood products, or mother-to-child. It primarily targets CD4 cells and causes immunosuppression.
- Clinical
HIV - AIDS. Associated Infections and InvasionsEneutron
This document provides information on various infectious diseases associated with HIV/AIDS, including those that affect the central nervous system. It discusses toxoplasmosis, cytomegalovirus encephalitis, cryptococcal meningitis, primary CNS lymphoma, and progressive multifocal leukoencephalopathy. It also covers common skin and mucous membrane disorders like candidiasis, Kaposi's sarcoma, and aphthous ulcers. Treatment options are provided for several conditions. The document contains detailed but technical medical information on infectious diseases indicators and presentations in patients with low CD4 counts.
HIV/AIDS is caused by the HIV virus which weakens the immune system. There are two types of HIV viruses - HIV-1 which is present worldwide and HIV-2 which is mainly found in Africa. Common symptoms of HIV/AIDS include fever, diarrhea, cough and weight loss. The virus can be transmitted through unprotected sex or sharing needles but cannot be spread through casual contact. Detection tests include spot tests and viral load tests. Prevention methods include safe sex practices, avoiding infected needles, and getting adequate rest and nutrition.
HIV attacks and destroys CD4 cells, weakening the immune system and leading to AIDS. It is transmitted through bodily fluids like blood, breastmilk, semen and vaginal secretions. The infection progresses from HIV infection to AIDS in stages - first, the window period when antibodies are not detectable. It is then followed by asymptomatic phase that can last 10-15 years before HIV-related illnesses and infections emerge. Untreated, it culminates in AIDS when the immune system is severely compromised. Risk groups include those with multiple sexual partners and intravenous drug users. Testing involves pre- and post-test counseling and uses ELISA or Western Blot confirmatory tests.
This document provides an overview of HIV/AIDS, including its types, epidemiology, structure and life cycle, transmission, diagnosis, stages of infection, and treatment. It describes how HIV infects and destroys CD4 cells, progressively weakening the immune system until opportunistic infections define AIDS. Laboratory tests for diagnosis include antibody and viral detection assays, with CD4 counts and viral load used to monitor disease progression and response to antiretroviral therapy.
The document discusses AIDS (acquired immunodeficiency syndrome), which is caused by HIV (human immunodeficiency virus) infection. It defines AIDS and describes the pathophysiology, risk factors, clinical manifestations, diagnostic tests, medical management including antiretroviral drugs, and nursing management of patients with AIDS. It also summarizes a research study on the use of first-line antiretroviral therapy from an ART program clinic in Pune, India.
The document discusses Acquired Immunodeficiency Syndrome (AIDS). It begins by defining AIDS as a set of symptoms and infections resulting from damage to the human immune system by the human immunodeficiency virus (HIV). HIV is a retrovirus that targets CD4 T-cells and incorporates its genetic material into the host cell. The document then covers the epidemiology, risk factors, signs and symptoms, diagnosis, management and prevention of HIV/AIDS.
This document provides an overview of HIV/AIDS including key facts about the virus, transmission, prevalence, demographics affected, testing and treatment. It notes that HIV is caused by the human immunodeficiency virus (HIV) which attacks CD4 cells. Some of the highest risk groups for transmission are men who have sex with men, injection drug users, and in the US, African Americans have disproportionately high rates of infection. While there is no vaccine or cure, highly active antiretroviral therapy (HAART) can effectively suppress the virus and prolong the healthy lives of many infected individuals.
The document provides information on HIV/AIDS, including:
- HIV is a retrovirus that infects CD4+ T cells and macrophages, progressively destroying the immune system.
- The virus enters cells using envelope glycoproteins, and its RNA is converted to DNA by reverse transcriptase. The DNA integrates into the host cell's genome.
- As the virus replicates and destroys immune cells, it can eventually cause AIDS, characterized by opportunistic infections. Current antiretroviral treatment aims to suppress viral replication and boost the immune system.
1) HIV is a virus that destroys CD4 immune cells, leading to AIDS if left untreated. With medication, a person can live with HIV for decades without progressing to AIDS.
2) HIV was first observed in 1981 and is believed to have originated from chimpanzees in West Africa. It is transmitted through sexual contact, blood, and from mother to child.
3) Over 42 million people worldwide are currently living with HIV. While treatments have increased life expectancy, aging poses new health challenges for those with HIV due to increased risk of conditions like dementia, heart disease, and infections.
Here are three more potential causes of paralysis in patients with AIDS:
- Cryptococcal meningitis: The most common fungal infection of the CNS in AIDS patients. Can cause increased intracranial pressure, cranial neuropathies, and spinal cord compression.
- Progressive multifocal leukoencephalopathy (PML): Caused by JC virus reactivation in AIDS patients. Presents with cognitive impairment, visual changes, and sometimes motor deficits. MRI often shows multifocal white matter lesions.
- Vacuolar myelopathy: Caused by HIV itself. Presents with spastic paraparesis. MRI may show T2 hyperintensities in the lateral and posterior columns of the spinal cord. Treat
This document discusses HIV and opportunistic infections. It begins by defining HIV as a retrovirus that infects and destroys CD4+ T cells, leading to AIDS. It then lists some common opportunistic infections seen in patients with HIV/AIDS like Pneumocystis jirovecii pneumonia, toxoplasmosis, mycobacterial infections, cryptococcosis, and viral infections caused by herpes simplex virus and varicella zoster virus. It provides details of pharmacological treatments for various opportunistic infections with drugs like trimethoprim-sulfamethoxazole, pentamidine, azithromycin, clarithromycin, fluconazole, acyclovir,
This document discusses opportunistic infections that can occur in AIDS patients with low CD4 counts. It outlines the most common opportunistic infections such as PCP pneumonia, candida esophagitis, and cryptococcal meningitis. It also provides guidelines for prophylaxis of opportunistic infections for patients with CD4 counts below 200 or 100, including recommendations for Bactrim/Septra or Zithromax.
Module 3 opportunistic infections and hiv related conditiDavid Ngogoyo
The document summarizes common opportunistic infections seen in HIV-infected individuals in Kenya. It describes tuberculosis as the major opportunistic infection and a major cause of HIV-related morbidity and mortality. Pneumocystis pneumonia is also discussed, along with its clinical presentation and treatment. Cryptococcal meningitis and toxoplasmosis are two other opportunistic infections covered, along with their diagnosis and management.
This document discusses opportunistic infections (OIs) that occur in patients with AIDS. It defines AIDS according to CDC and NACO criteria involving OIs or low CD4 counts. Common OIs seen in India are described such as tuberculosis, candidiasis, cryptosporidiosis, herpes zoster, toxoplasmosis, and Pneumocystis pneumonia. Symptoms, diagnosis, and treatment of these OIs are outlined. The role of patient education in prevention and treatment adherence is also discussed.
This document discusses opportunistic pathogens and infections. It begins by defining an opportunistic pathogen as a microorganism that normally does not cause disease but can do so when the host's immune system is compromised. Examples of opportunistic bacteria that can cause infections in HIV/AIDS patients are provided, including Campylobacter, Flavobacterium, Pseudomonas, and Salmonella. The document also discusses two specific opportunistic pathogens in more detail: Pseudomonas aeruginosa and Escherichia coli (E. coli). It provides information on their characteristics, infections they can cause, and prevention strategies.
1. Opportunistic infections associated with HIV can affect the gastrointestinal, respiratory, neurological, and mucocutaneous systems. Common gastrointestinal infections include Cryptosporidium, Microsporidia, and Cytomegalovirus, presenting with diarrhea, abdominal pain, and weight loss.
2. Frequent respiratory infections are Pneumocystis jirovecii pneumonia and bacterial pneumonias. Pneumocystis presents with cough and difficulty breathing, while bacterial pneumonias cause more acute symptoms.
3. Common neurological opportunistic infections are Toxoplasmosis, Cryptococcosis, and HIV-associated dementia. Toxoplasmosis and Cryptococcos
Acquired immunodeficiency syndrome (AIDS) is caused by the human immunodeficiency virus (HIV). HIV is a retrovirus that infects CD4 T-lymphocytes and causes immunosuppression. The virus is transmitted via bodily fluids like blood, semen, vaginal secretions. HIV enters cells, converts its RNA to DNA then incorporates into the host cell's genome. This leads to a reduction in CD4 cells and impairment of immune function. Over time AIDS develops, characterized by opportunistic infections as the immune system is compromised.
Human Immunodeficiency Virus (HIV) infects CD4 T cells of the immune system and causes Acquired Immunodeficiency Syndrome (AIDS), resulting in increased susceptibility to opportunistic infections. HIV is transmitted through unprotected sex, sharing needles, or from mother to child. The disease progresses through four stages, from initial infection to AIDS, as CD4 cell counts decline and opportunistic infections develop. Diagnosis involves antibody and viral load testing, while treatment is with antiretroviral therapy to suppress HIV and prevent disease progression.
Since founding his Southern San Francisco orthodontics practice, William W. Fay DDS, Inc., Dr. Fay has expanded to an additional location in American Canyon. At his practice, William Fay, DDS, uses Forestadent self-litigating clear ceramic brackets.
This document provides information about HIV/AIDS, including its causes, symptoms, testing, treatment and prevention. It defines HIV as the virus that causes AIDS, with HIV being the infectious stage and AIDS being the late stage disease. Some key points include:
- HIV attacks CD4 cells and progresses from acute infection to asymptomatic infection to AIDS without treatment
- Common symptoms of AIDS include opportunistic infections like PCP, tuberculosis, and cancers like Kaposi's sarcoma
- Screening and confirmatory tests are used to diagnose HIV, and treatment involves antiretroviral drugs as lifelong therapy
- Prevention methods include safe sex practices, needle exchange, blood safety, and antiretroviral treatment of infected
This document discusses microorganisms and HIV/AIDS. It defines microorganisms as tiny organisms that usually require a microscope to see. It explains that HIV is a retrovirus that invades T cells and replicates, causing AIDS once the immune system is severely weakened. The four stages of HIV are also outlined, from initial infection to AIDS diagnosis when opportunistic infections take hold due to very low CD4 counts.
This document provides a template for project proposals to be submitted to the Haiti Emergency Relief Response Fund (ERRF). The template outlines the information that should be included in proposals, such as: contact details for the organization and project manager; a summary of the project title, location, duration and budget; the problem the project intends to address; measurable objectives and indicators for addressing the problem; and a description of the proposed activities and expected results. Proposals should provide context on the targeted population and area, and demonstrate coordination with other relevant clusters and projects. Examples are given of how to write objectives and indicators for projects addressing issues like water access, malnutrition, and non-food item distribution.
Acquired immunodeficiency syndrome (AIDS) is caused by the human immunodeficiency virus (HIV) which impairs the immune system. HIV specifically targets CD4+ T cells (helper T cells). The virus can be transmitted through bodily fluids like blood, semen, vaginal fluids. The natural course of HIV infection progresses from primary infection with flu-like symptoms, to asymptomatic latency period that can last 10 years, to symptomatic stage as the immune system deteriorates, and finally AIDS when opportunistic infections take hold. While there is no cure for HIV/AIDS, antiretroviral treatment can control the virus and prevent transmission.
This document discusses human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). It covers the definition, classification, structure, pathogenesis and transmission of HIV. It also describes the oral manifestations of HIV/AIDS, including oral candidiasis, oral hairy leukoplakia, Kaposi's sarcoma and periodontal diseases. The management of oral diseases in HIV/AIDS patients is discussed, along with diagnosis and treatment of HIV/AIDS. Infection control procedures for treating AIDS patients in dental offices are also summarized.
oppurtunistic infection in HIV/AIDS AND IRISBhupendra Shah
HIV can lead to acquired immunodeficiency syndrome (AIDS) by destroying CD4 cells. When CD4 cell counts drop below certain levels, opportunistic infections (OIs) like Pneumocystis pneumonia or tuberculosis can occur. Starting antiretroviral therapy (ART) can sometimes cause immune reconstitution inflammatory syndrome (IRIS), where the immune system's recovery causes inflammation and worsening of symptoms from a pre-existing OI. IRIS is managed by continuing ART alongside anti-inflammatory drugs.
HIV is a virus that weakens the immune system, and AIDS is the late stage of HIV infection defined by opportunistic infections. The document provides details on how HIV infects and damages cells, its history and global impact, treatments, and prevention strategies. It reports that over 30 million people have died of AIDS-related illnesses globally since the early 1980s, with sub-Saharan Africa particularly hard hit, though combination drug therapies have helped lower mortality in some areas.
The document discusses HIV/AIDS, providing definitions and descriptions. It begins by defining HIV as the human immunodeficiency virus that infects and damages cells of the immune system, specifically CD4+ T cells. It then defines AIDS as acquired immunodeficiency syndrome, which is the final stage of HIV infection where the immune system is severely damaged. The document goes on to provide a brief history of HIV/AIDS, describing its identification and naming over time. It concludes by outlining global statistics on people living with HIV/AIDS and discussing the Bangladesh situation.
AIDS stands for: Acquired Immunodeficiency Syndrome HIV stands for: Human immunodeficiency virus AIDS is a disease of the human immune system caused by the HIV
The document provides information about AIDS/HIV in 3 paragraphs:
1) It defines AIDS as acquired immune deficiency syndrome caused by the HIV virus. It affects immune cells called CD4+ T cells. HIV was first reported in 1981 in the US.
2) Pediatric AIDS contributes to 15-20% of cases in developing countries. HIV can be transmitted from mother to child during pregnancy, delivery, or breastfeeding. By 2007, over 2 million children lived with HIV.
3) HIV attacks and destroys CD4+ T cells, weakening the immune system. If untreated, HIV progresses to AIDS. Common opportunistic infections in children with AIDS include Pneumocystis pneumonia and MAC (Mycobacterium
The document provides information about HIV/AIDS in Pakistan, including:
1) It discusses the objectives and infrastructure of the Enhanced Sindh AIDS Control Program, including voluntary counseling and testing centers, STI clinics, and PPTCT centers.
2) It provides a brief history of HIV, noting it originated from chimpanzees and was first identified in the US in 1981. HIV attacks and destroys CD4 cells, eventually causing AIDS.
3) It discusses HIV transmission, noting the major routes are sexual contact, exposure to infected blood or blood products, and from mother to child during pregnancy, birth, or breastfeeding.
HIV/AIDS is caused by the HIV virus which weakens the immune system. It is transmitted through bodily fluids and affects millions worldwide. The disease progresses from acute infection to AIDS as CD4 counts decline. Symptoms range from flu-like illness to opportunistic infections. Diagnosis involves virus detection, antibody testing, and CD4 counts. While there is no cure, antiretroviral therapy using multiple drug classes can control the virus and prevent complications. Proper treatment and preventative measures are important for management.
HIV/AIDS is caused by the HIV virus which weakens the immune system. It is transmitted through bodily fluids and affects millions worldwide. The disease progresses from acute infection to AIDS as CD4 counts decline. Symptoms range from flu-like illness to opportunistic infections. Diagnosis involves virus detection, antibody testing, and CD4 counts. While there is no cure, antiretroviral therapy using multiple drug classes can control the virus and prevent complications. Proper treatment and preventative measures are important for management.
hiv / aids final managment -180417201129.pdfdeborayilma
HIV/AIDS is caused by the HIV virus which weakens the immune system. It is transmitted through bodily fluids and is a global epidemic affecting millions. While not curable, it can be managed through antiretroviral drug therapy. HIV progresses to AIDS when the immune system is severely damaged, making one susceptible to opportunistic infections. Diagnosis involves testing for antibodies, viral load, and CD4 count. Treatment aims to suppress the virus and prevent complications through combination antiretroviral regimens.
The document summarizes information about HIV and AIDS, including:
- HIV is a virus that attacks the immune system and can develop into AIDS if not treated. It is transmitted through bodily fluids and can be prevented by using condoms and avoiding risky behaviors.
- Over time, HIV can weaken the immune system to the point where opportunistic infections or cancers can occur. There is no cure for HIV/AIDS yet.
- HIV belongs to a family of retroviruses that use an enzyme to convert their RNA into host DNA, allowing them to infect and replicate within cells.
Chapter 18 AIDS, HIV Infection; Related Conditions MeganSimpson27
The document summarizes AIDS, HIV infection, and related conditions. It discusses how AIDS was first reported in 1981 and HIV was isolated in 1983. It then covers the definition and diagnosis of AIDS, how HIV is transmitted through bodily fluids, and its pathophysiology of selectively infecting CD4+ T cells and resulting in immune deficiency. The majority of those infected are males who have sex with males. While antiretroviral therapy has increased survival, there is still no vaccine and it remains a global public health issue.
HIV (Human Immunodeficiency Virus) infects cells of the immune system and destroys or impairs their function.
Infection progressive deterioration of the immune system breaking down the body's ability to fight out infections & diseases by opportunistic bacteria, viruses and fungi.
AIDS (Acquired Immune Deficiency Syndrome) refers to the most advanced stages of HIV infection and a collection of signs and symptoms caused by more than 20 opportunistic infections or related cancers.
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Acquired immune deficiency syndrome or acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). This condition progressively reduces the effectiveness of the immune system and leaves individuals susceptible to opportunistic infections and tumours. HIV is transmitted through direct contact of a mucous membrane or the bloodstream with a bodily fluid containing HIV, such as blood, semen, vaginal fluid, preseminal fluid, and breast milk. This transmission can involve anal, vaginal or oral sex, blood transfusion, contaminated hypodermic needles, exchange between mother and baby during pregnancy, childbirth, breast feeding or other exposure to one of the above bodily fluids.
Genetic research indicates that HIV originated in west-central Africa during the late nineteenth or early twentieth century. AIDS was first recognized by the U.S. Centres for Disease Control and Prevention in 1981 and its cause, HIV, identified in the early 1980s. Although treatments for AIDS and HIV can slow the course of the disease, there is no known cure or vaccine. Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but these drugs are expensive and routine access to antiretroviral medication is not available in all countries. Due to the difficulty in treating HIV infection, preventing infection is a key aim in controlling the AIDS pandemic, with health organizations promoting safe sex and needle-exchange programmes in attempts to slow the spread of the virus.
In the beginning, the U.S. Centres for Disease Control (CDC) did not have an official name for the disease, often referring to it by way of the diseases that were associated with it, for example, lymphadenopathy, the disease after which the discoverers of HIV originally named the virus. The earliest known positive identification of the HIV-1 virus comes from the Congo in 1959 and 1960 though genetic studies indicate that it passed into the human population from chimpanzees around fifty years earlier.
The HIV virus descends from the related simian immunodeficiency virus (SIV), which infects apes and monkeys in Africa. There is evidence that humans who participate in bush meat activities, commonly acquire SIV. To explain why HIV became epidemic, there are several theories, each invoking specific driving factors that may have promoted SIV, rapid transmission of SIV through unsterile injections, colonial abuses and unsafe smallpox vaccinations or prostitution and the concomitant high frequency of genital ulcer diseases (such as syphilis) in nascent colonial cities.
This document discusses immunodeficiency and HIV/AIDS. It defines immunodeficiency as a compromised immune system and describes how it is classified as either primary/congenital or secondary/acquired. HIV is described as a retrovirus that causes AIDS by infecting CD4 cells and impairing the immune system over time. The document outlines HIV transmission, structure, lifecycle, and global prevalence, with statistics provided on prevalence in Zambia.
The theme for the 2020 observance is “Ending the HIV/AIDS Epidemic: Resilience and Impact” (“Erradicar la epidemia del VIH/SIDA: Resiliencia e Impacto”). World AIDS Day was first observed in 1988.
This document provides an overview of HIV/AIDS, including:
- A brief history of HIV/AIDS diagnosis and treatment milestones.
- Current global and national HIV/AIDS statistics.
- Details on HIV virology, transmission modes, immunopathogenesis, clinical features and stages of infection.
- Information on laboratory diagnosis and treatment approaches like antiretroviral therapy.
The document serves as a comprehensive reference on HIV/AIDS covering its origins, epidemiology, virology and clinical management.
This document provides an overview of HIV/AIDS, including its history, epidemiology in India, virology, modes of transmission, immunopathogenesis, natural history and stages of infection, clinical features, opportunistic infections, laboratory diagnosis, treatment, and prevention. It describes how HIV was first identified in 1981 in the US and details key events in identifying the virus. It outlines that HIV is a retrovirus that primarily infects CD4+ T cells and discusses viral subtypes. Modes of transmission include sexual contact, blood/blood products, and mother-to-child. Clinical stages are defined based on CD4 count and symptoms. Opportunistic infections may occur at different stages.
HIV infects cells by binding to CD4 receptors and either CCR5 or CXCR4 coreceptors on the cell surface. Early in infection, HIV predominantly uses CCR5 (M-tropic/R5 viruses), while later in disease progression it often switches to using CXCR4 (T-tropic/X4 viruses). This coreceptor switch is associated with faster disease progression. HIV depletes CD4 T-cells, weakening the immune system over time and leading to AIDS if untreated.
This document provides an overview of HIV and AIDS. It discusses the background of HIV, including how it attacks the immune system. It describes the stages of HIV infection and provides a brief history of AIDS. The epidemiological triad of agent, host, and environment related to HIV transmission is examined. At-risk groups and behaviors are identified. Global and national statistics on prevalence and distribution are presented. Objectives of preventing and controlling HIV/AIDS through various strategies like education, testing, and treatment are outlined. Key findings around transmission modes, clinical features, and prevention/management approaches are summarized.
The umbilical cord connects the fetus to the placenta and measures approximately 50 cm in length and 2 cm in diameter at term. It contains one vein that carries oxygenated blood to the fetus and two arteries that carry deoxygenated blood away. The cord inserts into the placenta near its center in most cases. Abnormalities can include abnormal insertion points, short or long length, knots, torsion, hematoma, or having a single umbilical artery instead of two.
The placenta develops from fetal and maternal tissues to function as the respiratory, nutritive, excretory, barrier and endocrine organ of pregnancy. It transfers oxygen, nutrients and waste between the mother and fetus. The placenta can develop abnormalities in its shape, size, position or adhesion to the uterine wall which may cause complications like preterm birth or hemorrhage. Placental lesions like infarcts may also occur due to conditions like hypertension.
The document discusses the fetal membranes, which include the chorion and amnion. The chorion is the outer membrane that is attached to the placenta and uterine wall. The amnion lines the chorion and encloses the fetus and amniotic fluid. The amniotic fluid provides protection and nutrition for the fetus, and aids in temperature regulation and movement. It is composed primarily of water, carbohydrates, proteins and minerals. The amniotic fluid circulates continuously, with production from the fetal membranes, fetal urine and transudation from maternal and fetal blood.
The document summarizes the key stages in human reproduction from fertilization through early pregnancy development. It describes how sperm mature and are capacitated in the female reproductive tract. Upon ovulation, sperm meet and fertilize the ovum in the fallopian tubes. The zygote then undergoes cell division and develops into a blastocyst that implants in the uterus. The trophoblast cells of the blastocyst invade the uterine lining and develop into a placenta to exchange nutrients and waste with the mother's blood. Major developmental milestones in early pregnancy include chorion, amnion and decidua formation.
The document discusses several minor complaints that may occur during pregnancy, including gingivitis, ptyalism, heartburn, constipation, hemorrhoids, varicosities, dyspnea, urinary symptoms, leucorrhea, leg cramps, paraethesia, and backache. For each complaint, the causes and recommended treatments are provided.
This document discusses the diagnosis of pregnancy over three trimesters. In the first trimester, common symptoms include missed periods, morning sickness, frequent urination, and breast changes. Signs include enlarged, soft breasts and uterus, and a softer, purplish cervix. Pregnancy tests detect human chorionic gonadotropin in urine or blood. Ultrasounds can visualize the gestational sac after 4-5 weeks. In the second trimester, symptoms decrease while the abdomen enlarges and fetal movement is felt. Signs include skin changes and palpable fetal parts. The third trimester confirms pregnancy through palpation of fetal parts and auscultation of the fetal heart.
Antenatal care involves regular checkups during pregnancy to monitor the health of the mother and baby. Checkups include exams, tests, and education on nutrition, exercise, hygiene, warning signs and avoiding risks. The goals are to prevent or treat complications, detect issues, and ensure healthy development. Women receive more frequent exams as their due date approaches, and are instructed on a nutritious diet, moderate exercise, adequate rest, hygienic practices, and when to seek medical help if problems arise.
The document discusses postpartum mood disorders, including prevalence, risk factors, screening tools, diagnosis, and treatment options. It notes that postpartum mood disorders range from mild and temporary postpartum blues to more severe postpartum depression and postpartum psychosis. Screening tools like the Edinburgh Postnatal Depression Scale can help identify at-risk women. Treatment involves psychosocial therapies and may include antidepressant medication depending on severity. A multidisciplinary approach is important to address biological, psychological and social factors.
Uterine fibroids are benign smooth muscle tumors that develop in the uterus. They are the most common solid pelvic tumors, affecting 20-25% of women during their reproductive years. Fibroids can vary in size and location, and may cause heavy menstrual bleeding, pelvic pressure or pain. Treatment options include observation, medical therapy to reduce estrogen levels, or surgical removal of fibroids.
Version refers to changing the fetal lie or position in the uterus. There are three main types: external cephalic version, internal podalic version, and bipolar podalic version. External cephalic version involves manipulating the fetus externally to convert a breech presentation to head-first. Internal podalic version is performed under anesthesia when the cervix is fully dilated to grasp the fetus's feet and convert a transverse lie to breech. Bipolar podalic version uses both internal and external manipulation through a partially dilated cervix for special circumstances. Complications can include fetal distress, premature separation of the placenta, and maternal hemorrhage.
Vacuum extraction is a method to assist in childbirth using suction from a cup placed on the baby's head to help with traction during contractions. There are different types of cups including metal, soft, and bird's cups. Vacuum extraction is indicated when forceps cannot be used and has advantages over forceps like less need for anesthesia and less compression force applied. Complications can include maternal lacerations and cervical injuries or fetal issues like cephalhematomas and scalp lacerations.
Symphysiotomy is a surgical procedure that divides the symphysis pubis bone to widen the pelvis during childbirth. It is indicated when cephalopelvic disproportion makes vaginal delivery difficult or dangerous but cesarean section is not available or advised. The procedure involves making a small incision above the pubic bone and gradually separating the joint using a scalpel. Complications can include bleeding, injury to nearby organs, infection, and long-term issues like incontinence or an unstable pelvis.
This document discusses obstetric forceps, which are metal instruments used to extract a baby's head during delivery. It describes different types of forceps and their proper application techniques. Forceps are indicated for prolonged second stage of labor, maternal distress, or fetal distress. Correct application involves inserting one blade along each side of the baby's head. Potential complications include laceration, hemorrhage, nerve injury, or problems for the baby such as skull fractures. Failure to deliver with forceps may require removal and assessment to determine if cesarean section is needed.
This document discusses episiotomy, which is an incision made in the perineum during childbirth to widen the vaginal opening. It can help prevent tearing and complications. The two main types are median and mediolateral episiotomies. Median episiotomies involve a midline incision while mediolateral incisions extend laterally towards the ischial tuberosity. Episiotomies are usually performed when the vaginal opening is distended during crowning to prevent stretching injuries. They are sutured closed after delivery.
The document discusses Caesarean section, including indications, types, procedure, complications, and mode of delivery in subsequent pregnancies. A Caesarean section is a surgical procedure to deliver one or more babies through incisions in the abdomen and uterus. The rate of Caesarean sections has increased from 5% in 1970 to 25% in 1990 due to factors such as abandoning difficult procedures in favor of C-sections and increased use for breech births. Complications can include hemorrhage, infections, and injuries to the mother or baby.
Normal labour involves the spontaneous expulsion of a single, mature fetus through the birth canal within 3-18 hours without complications. It occurs when hormonal and mechanical factors cause the cervix to efface and dilate in stages from 3cm to full 10cm dilation. Labour proceeds through four stages: 1) cervical dilation, 2) expulsion of the fetus, 3) expulsion of the placenta, and 4) recovery. The fetus descends through the birth canal with increased flexion to facilitate delivery of the head.
The fetal skull consists of three parts: the vault, face, and base. The vault is made up of the frontal, parietal, and occipital bones which are separated by sutures. The face extends from the chin to the nose. Fontanelles are soft spots located where sutures meet which are important for assessing fetal position and flexion. The skull has various longitudinal and transverse diameters used to determine which will engage and pass through the birth canal during delivery.
The female pelvis is divided into the false pelvis and true pelvis. The true pelvis is further divided into the pelvic inlet, cavity, and outlet. The document describes the boundaries and diameters of each region including the anatomical transverse diameter of 13cm at the inlet. It also discusses the pelvic planes and axes, and the Caldwell-Moloy classification of pelvic types including the gynaecoid, anthropoid, android, and platypelloid pelvis.
This document outlines the active management of normal labour in 4 stages: antenatal preparation, first stage (history, exam, procedures), second stage (delivery of baby), third stage (delivery of placenta), and fourth stage (postpartum care of mother and baby). The goal is a healthy delivery with minimal effects. Key procedures include monitoring contractions/fetal heart with a partogram, positioning, nutrition, analgesia, perineal support, and immediate newborn care.
Thyrotoxicosis in pregnancy can cause complications like abortion and preterm labour. Clinical features include weight loss, heat intolerance, tremors, and fast heart rate. It is treated with antithyroid drugs like propylthiouracil or carbimazole. Epilepsy in pregnancy commonly presents as grand mal seizures, which are treated with phenobarbitone or phenytoin along with folic acid. Rhesus isoimmunization occurs when an Rh-negative mother develops antibodies against Rh-positive blood from her baby. It can be prevented by giving the mother anti-D immunoglobulin after delivery or pregnancy events involving blood transfer from baby to mother. Affected babies may require monitoring, phot
3. 107 cases of Pneumocystis carinii pneumonia reported in the United States before the AIDS epidemic AIDS epidemic has resulted in 166,368 cases up to 1999 HIV and AIDS History of an infectious agent Pneumocystis pneumonia www.freelivedoctor.com
4. HIV and AIDS With dissemination to extrapulmonary sites, Pneumocystis carinii tends to produce foci with prominent calcification, as seen in the kidney www.freelivedoctor.com
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6. Before 1981: 40 - 120 cases per year in United States HIV and AIDS an infectious agent – Kaposi’s Sarcoma 1981-1999: 46,684 definite cases in United States www.freelivedoctor.com
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12. HIV and AIDS Obvious agent: A virus …… that is now in the blood supply Primary route of transmission: Sex AIDS is a sexually-transmitted viral disease www.freelivedoctor.com
13. HIV and AIDS The Cellular Picture In advanced disease: the loss of another cell type CD8+ cytotoxic killer cells Loss of one cell type throughout the course of the disease CD4+ T4 helper cells A fall in the CD4+ cells always precedes disease Suggests an infectious agent A virus But initially difficult to grow Rapidly kills cells on which it grows www.freelivedoctor.com
22. www.freelivedoctor.com Impact of AIDS on life expectancy in five African countries, 1970–2010 Life expectancy at birth (years) Source: United Nations Population Division (2004). World Population Prospects: The 2004 Revision, database. Botswana South Africa Swaziland Zambia Zimbabwe 1970–1975 1975–1980 1980–1985 1985–1990 1990–1995 1995–2000 2000–2005 2005–2010 70 65 60 55 50 45 40 35 30 25 20 4.1
23. Botswana Zimbabwe Lesotho Swaziland www.freelivedoctor.com HIV prevalence (%) in adults in Africa, 2005 2.5
24. H uman I mmunodeficiency V irus www.freelivedoctor.com
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26. HIV and AIDS The cellular and immunological picture - The course of the disease virus CD4 cells antibody www.freelivedoctor.com
27. HIV and AIDS The cellular and immunological picture - The course of the disease CD8 cells www.freelivedoctor.com
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29. HIV and AIDS 2. A strong immune response www.freelivedoctor.com
30. HIV and AIDS 3. A latent state www.freelivedoctor.com
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32. HIV and AIDS 4. The beginning of disease www.freelivedoctor.com
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34. HIV and AIDS Good correlation between number of HIV particles measured by PCR and progression to disease www.freelivedoctor.com
35. HIV and AIDS Viral load predicts survival time www.freelivedoctor.com
36. HIV and AIDS CD4 cell count is not a good predictor of progression to disease www.freelivedoctor.com
37. Cofactors Not all cases of Kaposi’s are associated with HIV Not all HIV infected persons suffer from Kaposi’s 20% of homosexual HIV+ males get Kaposi’s Few IV drug users or hemophiliacs get Kaposi’s Kaposi’s sarcoma associated herpes virus Human herpes virus-8 HIV and AIDS www.freelivedoctor.com
38. HIV and AIDS So far it seems that >50% of HIV-infected persons have progressed to AIDS There is NO strong evidence there is any other infectious agent involved than HIV Three Views of AIDS Gallo : Infection by HIV is sufficient to cause AIDS Montagnier : HIV may be harmless in the absence of other co-factors Duesberg / Mullis : HIV is too silent to be the etiologic agent of AIDS. It is a much maligned by-stander www.freelivedoctor.com
39. HIV - The Virus Membrane: host derived Retrovirus Three genes GAG – POL – ENV Three polyproteins www.freelivedoctor.com
40. HIV - The Virus vaccine problem Retrovirus ENV gene www.freelivedoctor.com Two glycoproteins: gp160 gp120 and gp41 gp41 is fusogen that spans the membrane sugars
41. HIV - The Virus GAG gene Group-Specific Antigens Retrovirus Polyprotein www.freelivedoctor.com p17: inner surface - myristoylated p24: nucleocapsid p9: nucleocapsid associated with RNA
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43. The Genome of HIV Three structural genes LTRs Extra open reading frames are clue to latency These ORFs code for small proteins - antibodies in AIDS patients www.freelivedoctor.com
47. HIV - Life History Entry into the cell T4 (CD4+) cells are major target Human HeLa Cell Human HeLa Cell transfected with CD4 antigen NOT INFECTED INFECTED But NOT the whole answer since this does not happen if CD4 is transfected into a MOUSE cell www.freelivedoctor.com
48. HIV - Life History Why do CD4-transfected human cells become infected but CD4-transfected mouse cells do not? Human cells must possess a co-factor for infection that mouse cells do not www.freelivedoctor.com Co-Receptors CD8+ Cells MIP-1 alpha MIP-1 beta RANTES Chemokines Block HIV infection of macrophages
49. HIV - Life History CD4 CD4 CD4 HIV CCR5 CCR5 chemokine Mutant CCR5 macrophage Chemokine receptors are necessary co-receptors along with CD4 antigen www.freelivedoctor.com
50. HIV and AIDS Some people do not get AIDS Long term survivors Exposed uninfected persons The chemokine receptor story www.freelivedoctor.com
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56. HIV - Life History HIV infection is not manifested as disease for years During apparent clinical latency, virus is being replicated and cleared Latency – Cellular – The problem of memory T4 cells Only activated T4 cells can replicate virus Most infected T4 cells are rapidly lyzed but are replaced Some T4 cells revert to resting state as memory cells which are long-lived Memory T4 cells cannot replicate the virus unless they become activated Clinical Latency www.freelivedoctor.com
57. Dynamics of CD4 T cells in an HIV infection Cell death apoptosis etc Uninfected activated T cell Cell death immune destruction www.freelivedoctor.com Chronically-infected memory T cells with provirus Return to resting state Reactivation Uninfected unactivated memory T cell pool Infection Long lived! Long lived!
58. Long term latent HIV T4 resting memory cell It may be impossible to cure the patient of HIV Even if combination therapy stops HIV replication www.freelivedoctor.com Immune response T4 activated HIV production
59. Inexorable decline of CD4+ T4 cells Of great importance to therapeutic strategy Why do all of the T4 cells disappear? At early stages of infection only 1 in 10,000 cells is infected Late 1 in 40 www.freelivedoctor.com
60. But few cells are infected: Early stage of infection 1:10,000 Late 1:40 Why do all T4 cells disappear? 1. PUNCTURED MEMBRANE Virus destroys the cell as a result of budding www.freelivedoctor.com
61. Why do all T4 cells disappear? - 2 But syncytia not common Most T4 cells are not HIV+ Could “sweep up” uninfected cells Uninfected CD4 cell Gp120 negative Cells Fuse Killing of CD4 cells 2. Syncytium Formation Infected CD4 cell Gp120 positive www.freelivedoctor.com
62. Killing of CD4 cells 3. Cytotoxic T cell-mediated lysis Why do all T4 cells disappear? BUT: Most cells are not infected www.freelivedoctor.com Cytotoxic T cell
63. www.freelivedoctor.com Killing of CD4+ cells 4. Binding of free Gp120 to CD4 antigen makes uninfected T4 cell look like an infected cell Complement-mediated lysis Could account for the loss of uninfected T4 cells
64. CD8 cell (no CD4 antigen) Macrophage CXCR4 chemokine receptor Why do all T4 cells disappear? Induction of apoptosis www.freelivedoctor.com Binding to CXCR4 results in expression of TNF-alpha on the cell surface ? G protein signal ? Binding to CXCR4 results in expression of TNF-alpha receptor II HIV gp120 chemokine
65. CD8 cell Macrophage CXCR4 Why do all T4 cells disappear? Induction of apoptosis www.freelivedoctor.com Death CD8 T cell apoptotic bodies
66. Macrophages may be infected by two routes CD4 Fc receptor HIV gp120 binds to macrophage CD4 antigen Virus is opsonized by anti gp120 antibodies which bind to macrophage Fc receptors - an enhancing antibody vaccine problem www.freelivedoctor.com HIV gp120 HIV Anti-gp120
67. Macrophages - The Trojan Horse Carry virus into different organs (brain) Non-proliferating mature macrophages sustain HIV production for a long time without being killed by virus Macrophages form a reservoir outside the blood www.freelivedoctor.com Early HIV isolated during infection are macrophage tropic (have a macrophage chemokine co-receptor (CCR5)) Virus probably infects patient via macrophages in semen etc Infection by HIV leads to altered cytokine production “slim disease” Slim disease very like Visna in sheep - also infects macrophages
68. Population Polymorphism HIV genome 9749 nucleotides Therefore EVERY new virus has at least one mutation! Every possible single mutation arises daily 1% of all possible double mutations arise daily The HIV that infects a patient is very different from that seen by the time AIDS appears HIV is a retrovirus Retroviruses use host cell RNA polymerase II to replicate their genome vaccine problem Pol II has a high error rate 1:2,000-10,000 www.freelivedoctor.com
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75. Anti-HIV Strategies H ighly A ctive A nti- R etroviral T herapy HAART: Two nucleoside analog RT inhibitors and 1 protease inhibitor Now also: Two nucleoside analog RT inhibitors and 1 non nucleoside www.freelivedoctor.com
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Editor's Notes
AIDS is a disease caused by a virus, A RETROVIRUS. Much of our knowledge about the disease and our attempts to counter it are based on this fact We know more about this virus than any other virus Yet despite our burgeoning knowledge base, the way in which the virus participates in disease seems more and more complicated, leading to more and more complicated anti-viral strategies It was very early in the development of the AIDS pandemic that the involvement of an infectious agent became clear and, to see why, we must go back to the very beginning of the epidemic. To the late 1970’s
Before the AIDS pandemic, Kaposi’s sarcoma was found primarily in elderly Jewish men and immuno-compromised patients
It was originally suggested that there was an immuno-suppressive factor in semen Now we know this disease as AIDS
The clusters of infected patients showed that the disease was in groups of sexual partners
But HIV was difficult to grow from the infected patients blood. It killed the cells on which it grows and it could not be grown on ordinary cultured T4 cells
Although the obvious agent was a virus, it was difficult to grow. It did not grow on cultured T4 cells, the only cells at that time that were know to be infected by HIV. Cultured T4 cells are resting, unactivated T4 cells. The great step forward made by Gallo and his collaborators was to use interleukin 2 to activate T4 cells. Then they could support HIV replication Gall showed that cells could support the replication of virus but there was no long term production. The assay was reverse transcriptase. Gallo had discovered HTLV-1 and know that it could give a similar cellular picture: Leukemia in some patients and immuno-suppression in others. This immuno-suppression was the result also of the specific loss of T4 cells. Feline leukemia virus also shows immuno-suppression in many cats. Gal also showed that there was reverse transcriptase in the blood of infected patients, suggesting infection by a retrovirus It was clear from the start that it is a major characteristic of HIV that it causes a fall in the number of T4 cells. WHEREVER AIDS OCCURS, HIV PRECEDES IT
This time course of HIV infection applies to persons not receiving chemotherapy.
HIV is now NOT replicating in resting T4 cells and most are resting in the peripheral circulation. At this time most replication is in lymph nodes in macrophages and dendritic cells. Symptoms are ‘flu or mononucleosis-like.There is a cellular immune response within weeks. Antiviral antibodies and cytotoxic T cells rise to high levels and persist for years. They are very effective at keeping the virus in the circulation at low levels. The CD8 cells rises transiently while CD4 cells fall but5 again recover (almost at least). The loss of these CD4 cells may result from DIRECT INFECTION of T cells in the circulation. Although antibodies lower HIV in blood, infection persists in the lymph nodes and in macrophages
Persistent infection with no or minor symptoms: Night sweats, generalized lymphadenopathy, diarrhea Virus persists as provirus in resting memory T cells. Reactivation of cells occurs contributing to overall viral load but this does not at this stage significantly affect CD4 cell number. Nevertheless, CD4 cells drop in number throughout infection
Also neuroplogical manifestations, lymphoid neoplasms Opportunistic infects occur when CD4 cells drop below 300 cells per cu mm Mechanism of this loss is still uncertain
Clinically most Kaposi’s is indolent and many infected individuals die of other causes. The AIDS-associated form is much more progressive involving many sites (skin, lymph, lungs, intestine) Human herpes virus-8 or Kaposi’s sarcoma-associated herpes virus found in many AIDS patients. In AIDS anti-HHV-8 antibodies are found only in those that have Kaposi’s or will get Kaposi’s. Blood from hemophiliacs with HIV infection does not show antibodies against the herpes virus
Clearly there are cases of immuno-suppression without HIV – that is to be expected, diseases of different etiology. Clearly for other diseases such as Kaposi’s, HIV is a cofactor rather than a cause. The data argue for a specific sexually transmitted agent of Kaposi’s in which immune suppression is a DOMINANT COFACTOR
The establishment that the disease is caused by a virus and therefore the ability to produce antibodies against viral antigens led to the first tests for HIV, the ELIZA and Western blot tests. However, there is a 1 to 2 month time lag before antibodies are produced. This can be overcome by using a test that identifies viral RNA rather than antibodies produced against viral protein e.g PCR. The very fact that we can use an antibody test shows us that there is a good immune response and it is neutralizing antibody which gives hope for a vaccine . But the virus is not completely neutralized which argues that a vaccine may be difficult to develop. The virus goes underground within the cells and because it is a retrovirus , is prone to genetic drift . As it changes it overcomes the immune system. As we shall see retroviral vaccines pose special problems and HIV is more complicated than other retroviruses
The size of the HIV genome is similar to that of other retroviruses but it is more complex. There is no oncogene but there are extra open reading frames which do code for protein. In all 15 proteins are encoded in HIV and they are made because antibodies to them can be found in patients. These extra open reading frames are not typical of retroviruses such as RSV. These extra open reading frames give a clue to the complex lifestyle of HIV. Note that some of them are encoded in two or more exons so there will have to be multiple splice events to make the final RNA. Could these be a site for intervention in the replication of the virus?
Syncytia are only possible if fusion occurs at ambient pH, this is very important as the formation of syncytia between infected and uninfected cells can allow spread of the virus without having to travel between cells. This must be borne in mind when thinking about vaccine strategies since humoral antibody will have no effect on this kind of spread. A vaccine must, clearly, be effective against INFECTED CELLS as well as virions. How fusion occurs is not known but involves the fusogen, gp41 which undergoes a conformational change But there is something more than just binding to CD4 antigen for infection. Early on it was known that if we transfect a MOUSE cell with the gene for CD4 antigen, it is NOT infected. Something else exists in a HUMAN cell, that allows infection
Human HeLa cells are not infected by HIV because they do not have CD4 antigen. When CD4 gene was transfected into the HeLa cells, they became able to bind HIV and were infected.
What is extra to CD4 in human cells are the chemokine CO-RECEPTORS. It was discovered that infection of human cells could be blocked with high concentrations of chemokines, proteins that are secreted by CD8 cells in many inflammatory responses.
In long term non-progressors the CD4 cells fall after infection but recover to near normal and remain there, so far for more than 15 years
A chemokine receptor may be one reason why these people remain healthy. What part this co-receptor plays in the biology of HIV we shall see later. The T cells or macrophages of non-progressors are very resistant to HIV because they have a mutant chemokine receptor. In some rather rare mutations of CCR5 (macrophage co-receptor), it is virtually impossible for the virus to enter the cell. Other long term non-progressors appear to make high levels of chemokines that block the chemokine receptor and therefore block binding of HIV to the cell.
Because of their work, these women are repeatedly exposed to HIV (remember that their clients are probably infected at a rate of 25% or more). Yet they show no sign of disease after more than 15 years. All of us can present a large number of antigen peptides in association with our class I MHC antigens…but not all peptides can be presented by all people so the antigens to which we can raise an immune response is limited albeit large. All of us can raise antibodies or induce a T cell response to HIV but the actual antigen peptide recognized differs. If an individual is lucky enough to present an HIV peptide than cannot undergo mutation in the virus without loss of viral infectivity, that individual produces an immune response from which the virus cannot escape
Protease is necessary for cutting up proteins in viral maturation … could be site of chemotherapeutic intervention
Thus we have a very complex life cycle. In some cells the virus goes latent while in others such as macrophages, it seems not to. Why such a complex life cycle? What is the molecular basis of this?
Although clearly connected with immune deficiency, wasting and brain diseases (dementia) appear to be linked to macrophage infection and are distinct from the severe immuno-suppression caused by T4 cell depletion
During infection virus is not totally controlled. This is an inevitable result of being a retrovirus. This is a great problem for a vaccine. During course of the disease, many subtypes arise and the tropism shifts from macrophage to CD4-infecting strains. Also from non-syncytium-inducing to syncytium-inducing. A GREAT PROBLEM FOR A VACCINE