Human Immunodeficiency Virus (HIV) is an enveloped RNA virus that causes acquired immunodeficiency syndrome (AIDS). It belongs to the retrovirus family and there are two types, HIV-1 and HIV-2. HIV infects and destroys CD4+ T cells of the immune system, ultimately weakening the body's ability to fight infections and disease. Common routes of transmission include sexual contact, contaminated blood transfusions, and from mother to child during pregnancy, childbirth or breastfeeding. While antiretroviral treatment can slow the progression of the disease, there is currently no cure for HIV/AIDS.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The presentation is about the disease, hepatitis, its causing agent, symptoms, treatment and cure. the presentation focusses on the virus causing the disease, its morphology and life cycle. It has also discussed the different types of hepatitis disease and the virus causing them
MANAGEMENT OF HIV FALLS UNDER THREE MAJOR CATEGORIES
1.POST EXPOSURE PROPHYLAXIS(P.E.P)
2.TREATMENT/MANAGEMENT OF HIV-AIDS
3.TREATMENT OF ADJOINING CONDITIONS
eg-
-Fungal Infections
-Bacterial infections
-Viral infections
-NEOPLASIAS
-misc.( recurrent apthos ulcers, xerostomia,salivary G. enlargement)
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The presentation is about the disease, hepatitis, its causing agent, symptoms, treatment and cure. the presentation focusses on the virus causing the disease, its morphology and life cycle. It has also discussed the different types of hepatitis disease and the virus causing them
MANAGEMENT OF HIV FALLS UNDER THREE MAJOR CATEGORIES
1.POST EXPOSURE PROPHYLAXIS(P.E.P)
2.TREATMENT/MANAGEMENT OF HIV-AIDS
3.TREATMENT OF ADJOINING CONDITIONS
eg-
-Fungal Infections
-Bacterial infections
-Viral infections
-NEOPLASIAS
-misc.( recurrent apthos ulcers, xerostomia,salivary G. enlargement)
It Contains Pathogenesis of viral diseases like AIDS, Hepatitis, Influenza and Rabies.
It contains detail pathogenesis with various verified sources.
You can refer references to visit the sources used.
A detailed description of HIV covering virology, morphology, pathogenesis, clinical stages and manifestations, laboratory diagnosis, and diagnostic strategy, and therapeutic options and prevention.
THE BASIC INFORMATION ABOUT WHAT IS HIV AND HOW IT DESTRUCT THE IMMUNE SYSTEM. THEN LEADS TO AIDS. PRESENTATION ALSO EXPLAINS THE DIAGNOSIS OF HIV, ITS TREATMENT
WHY WE DONT HAVE VACCINE FOR HIV AND WHAT ARE THE PRESENT SCENARIO OF VACCINE DEVELOPMENT..
I HOPE IT WILL EXPLAIN WELL ABOUT HIV INFECTION AND AIDS, MAY PROVE USEFUL FOR YOU GUYS.....
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
2. Human Immunodeficiency Virus
Acquired Immunodeficiency syndrome first described in 1981
HIV-1 isolated in 1984, and HIV-2 in 1986
Belong to the lentivirus subfamily of the retroviridae
Enveloped RNA virus, 120nm in diameter
HIV-2 shares 40% nucleotide homology with HIV-1
Genome consists of 9200 nucleotides (HIV-1):
gag core proteins - p15, p17 and p24
pol - p16 (protease), p31 (integrase/endonuclease)
env - gp160 (gp120:outer membrane part, gp41: transmembrane part)
Other regulatory genes ie. tat, rev, vif, nef, vpr and vpu
5. Replication
The first step of infection is the binding of gp120 to the
CD4 receptor of the cell, which is followed by
penetration and uncoating.
The RNA genome is then reverse transcribed into a DNA
provirus which is integrated into the cell genome.
This is followed by the synthesis and maturation of virus
progeny.
6. HIV-1 Genotypes
There are 3 HIV-1 genotypes; M (Main), O (Outlayer), and N (New)
M group comprises of a large number subtypes and recombinant forms
Subtypes - (A, A2, B, C, D, F1, F2, G, H, J and K)
Recombinant forms - AE, AG, AB, DF, BC, CD
O and N group subtypes not clearly defined, especially since there are
so few N group isolates.
As yet, different HIV-1 genotypes are not associated with different
courses of disease nor response to antiviral therapy.
However, certain subgroups may be difficult to detect by certain
commercial assays.
10. Clinical Features
1. Seroconversion illness - seen in 10% of individuals a few weeks
after exposure and coincides with seroconversion. Presents with
an infectious mononucleosis like illness.
2. Incubation period - this is the period when the patient is
completely asymptomatic and may vary from a few months to a
more than 10 years. The median incubation period is 8-10 years.
3. AIDS-related complex or persistent generalized lymphadenopathy.
4. Full-blown AIDS.
11. Opportunistic Infections
Protozoal pneumocystis carinii (now thought to be a fungi),
toxoplasmosis, crytosporidosis
Fungal candidiasis, crytococcosis
histoplasmosis, coccidiodomycosis
Bacterial Mycobacterium avium complex, MTB
atypical mycobacterial disease
salmonella septicaemia
multiple or recurrent pyogenic bacterial infection
Viral CMV, HSV, VZV, JCV
12. Opportunistic Tumours
The most frequent opportunistic tumour, Kaposi's sarcoma,
is observed in 20% of patients with AIDS.
KS is observed mostly in homosexuals and its relative
incidence is declining. It is now associated with a human
herpes virus 8 (HHV-8).
Malignant lymphomas are also frequently seen in AIDS
patients.
14. Other Manifestations
It is now recognised that HIV-infected patients may
develop a number of manifestations that are not explained
by opportunistic infections or tumours.
The most frequent neurological disorder is AIDS
encephalopathy which is seen in two thirds of cases.
Other manifestations include characteristic skin eruptions
and persistent diarrhoea.
15. Epidemiology
1. Sexual transmission - male homosexuals and constitute the largest risk
group in N. America and Western Europe. In developing countries,
heterosexual spread constitute the most important means of transmission.
2. Blood/blood products - IV drug abusers represent the second largest AIDS
patient groups in the US and Europe. Haemophiliacs were one of the first
risk groups to be identified: they were infected through contaminated factor
VIII.
3. Vertical transmission - the transmission rate from mother to the newborn
varies from around 15% in Western Europe to up to 50% in Africa.
Vertical transmission may occur transplacentally route, perinatally during
the birth process, or postnatally through breast milk.
4. In 2003, an estimated 4.8 million people (range: 4.2–6.3 million) became
newly infected with HIV. This is more than in any one year before. Today,
some 37.8 million people (range: 34.6–42.3 million) are living with HIV,
which killed 2.9 million (range: 2.6–3.3 million) in 2003, and over 20
million since the first cases of AIDS were identified in 1981.
16.
17. HIV Pathogenesis
The profound immunosuppression seen in AIDS is due to the
depletion of T4 helper lymphocytes.
In the immediate period following exposure, HIV is present at a high
level in the blood (as detected by HIV Antigen and HIV-RNA assays).
It then settles down to a certain low level (set-point) during the
incubation period. During the incubation period, there is a massive
turnover of CD4 cells, whereby CD4 cells killed by HIV are replaced
efficiently.
Eventually, the immune system succumbs and AIDS develop when
killed CD4 cells can no longer be replaced (witnessed by high HIV-
RNA, HIV-antigen, and low CD4 counts).
18. HIV half-lives
Activated cells that become infected with HIV produce virus
immediately and die within one to two days.
Production of virus by short-lived, activated cells accounts for the vast
majority of virus present in the plasma.
The time required to complete a single HIV life-cycle is approximately
1.5 days.
Resting cells that become infected produce virus only after immune
stimulation; these cells have a half-life of at least 5-6 months.
Some cells are infected with defective virus that cannot complete the
virus life-cycle. Such cells are very long lived, and have an estimated
half-life of approximately three to six months.
Such long-lived cell populations present a major challenge for anti-
retroviral therapy.
19.
20. Laboratory Diagnosis
Serology is the usual method for diagnosing HIV infection.
Serological tests can be divided into screening and confirmatory
assays. Screening assays should be as sensitive whereas confirmatory
assays should be as specific as possible.
Screening assays - EIAs are the most frequently used screening
assays. The sensitivity and specificity of the presently available
commercial systems now approaches 100% but false positive and
negative reactions occur. Some assays have problems in detecting
HIV-1 subtype O.
Confirmatory assays - Western blot is regarded as the gold standard
for serological diagnosis. However, its sensitivity is lower than
screening EIAs. Line immunoassays incorporate various HIV antigens
on nitrocellulose strips. The interpretation of results is similar to
Western blot it is more sensitive and specific.
21. ELISA for HIV antibody
Microplate ELISA for HIV antibody: coloured wells
indicate reactivity
22. Western blot for HIV antibody
There are different criteria for
the interpretation of HIV
Western blot results e.g. CDC,
WHO, American Red Cross.
The most important antibodies
are those against the envelope
glycoproteins gp120, gp160,
and gp41
p24 antibody is usually present
but may be absent in the later
stages of HIV infection
23. Other diagnostic assays
It normally takes 4-6 weeks before HIV-antibody appears
following exposure.
A diagnosis of HIV infection may be made earlier by the
detection of HIV antigen, pro-DNA, and RNA.
However, there are very few circumstances when this is
justified e.g. diagnosis of HIV infection in babies born to
HIV-infected mothers.
24. Prognostic tests
Once a diagnosis of HIV infection had been made, it is
important to monitor the patient at regularly for signs of
disease progression and response to antiviral chemotherapy.
HIV viral load - HIV viral load in serum may be measured by assays
which detect HIV-RNA e.g. RT-PCR, NASBA, or bDNA. HIV viral load
has now been established as having good prognostic value, and in
monitoring response to antiviral chemotherapy.
HIV Antigen tests - they were widely used as prognostic assays. It was
soon apparent that detection of HIV p24 antigen was not as good as serial
CD4 counts. The use of HIV p24 antigen assays for prognosis has now
been superseded by HIV-RNA assays.
25. Anti-Retorvirual Susceptibility Testing
It is now generally accepted that anti-viral susceptibility testing should
be a routine part of the management of HIV-infected patients.
It is reported that the outcome would be better if the results are
interpreted by an expert in this area.
There are two types of antiviral susceptibility assays:
Phenotypic – very difficult and expensive to carry out. Thought to give a
better idea of the actual situation in vivo.
Genotypic – the RT and Protease genes are sequenced. This can be done
in-house and the results interpreted automatically by the HIV sequence
database in the US.
http://resdb.lanl.gov/Resist_DB/default.htm
Commercial systems (Trugene, ABI and others) available which relies on
their own database and interpretation by a panel of experts that meet
regularly.
26.
27. Treatment
Zidovudine (AZT) was the first anti-viral agent shown to have
beneficial effect against HIV infection. However, after prolonged
use, AZT-resistant strains rapidly appears which limits the effect of
AZT.
Combination therapy has now been shown to be effective,
especially for trials involving multiple agents including protease
inhibitors. (HAART - highly active anti-retroviral therapy)
The rationale for this approach is that by combining drugs that are
synergistic, non-cross-resistant and no overlapping toxicity, it may
be possible to reduce toxicity, improve efficacy and prevent
resistance from arising.
28. Anti-Retroviral Agents
Nucleoside analogue reverse transcriptase inhibitors e.g. AZT,
ddI, lamivudine
Non-nucleoside analoque reverse transcriptase, inhibitors e.g.
Nevirapine
Protease Inhibitors e.g. Indinavir, Ritonavir
Fusion inhibitors e.g. Fuzeon (IM only)
HAART (highly active anti-retroviral therapy) regimens
normally comprise 2 nucleoside reverse transcriptase inhibitors
and a protease inhibitor. e.g. AZT, lamivudine and indinavir.
Since the use of HAART, mortality from HIV has declined
dramatically in the developed world.
29. Prevention
The risk of contracting HIV increases with the number of sexual partners. A
change in the lifestyle would obviously reduce the risk.
The spread of HIV through blood transfusion and blood products had virtually
been eliminated since the introduction of blood donor screening in many
countries.
AZT had been shown to be effective in preventing transmission of HIV from
the mother to the fetus. The incidence of HIV infection in the baby was
reduced by two-thirds.
The management of health care workers exposed to HIV through inoculation
accidents is controversial. Anti-viral prophylaxis had been shown to be of
some benefit but it is uncertain what is the optimal regimen.
Vaccines are being developed at present but progress is hampered by the high
variability of HIV. Since 1987, more than 30 HIV candidate vaccines have
been tested in approximately 60 Phase I/II trails, involving more than 10,000
healthy volunteers. A phase III trial involving a recombinant gp120 of HIV
subtype B was reported in Feb 2005 to be ineffective in preventing HIV
infection.