IT IS A PRESENTATON PROVIDING BASIC KNOWLEDGE AND ADDING DETAILS ABOUT CURRENT TRENDS IN DEALING WITH THE EPIDEMIC WITH SPECIAL FOCUS N INDIA.

1. HIV/AIDS
AN OVERVIEW…
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2. INTRODUCTION TO HIV/AIDS
HISTORY
BACKGROUND
DEVELOPMENTS TILL DATE
FACTS & FIGURES
HIV IN INDIA
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3. • “Human Immunodeficiency Virus”
• A unique type of virus (a retrovirus)
• Invades the helper T cells (CD4 cells) in
the body of the host (defense mechanism
of a person)
• Difference between HIV & AIDS
• Preventable, manageable but not curable.
• Types of Virus (HIV-1 & HIV-2)
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6. • MODES OF HIV TRANSMISSION
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7. HIV IS NOT SPREAD BY:
• Air or water
• Insects, including mosquitoes or ticks
• Saliva, tears, or sweat
• Casual contact, like shaking hands,
hugging or sharing dishes/drinking glasses
• Drinking fountains
• Toilet seats
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8. • The earliest confirmed case of AIDS in
humans comes from Congo in the year
1959(HIV-1)
• First known infection of HIV-2 in 1978.
• 1981- Epidemic started to spread in US(121)
• Early names of HIV
Human T cell lymphotrophic virus (HTLV-III)
Lymphadenopathy associated virus (LAV)
AIDS associated retrovirus (ARV)
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9. • In 2011, around 330,000 children age
(<15) became infected with HIV and an
estimated 230,000 died from AIDS.
• Almost all of these infections were as a
result of mother-to-child transmission
• Most infections could be avoided through
PMTCT interventions
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10. • Without treatment, 50% of children with
HIV die by age 2 (30% by age 1)
• Among mothers that take a regimen of
antiretroviral drugs (ARVs) for the
prevention of mother-to-child
transmission (PMTCT), the risk of HIV
transmission can be reduced to less than 5
percent.
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11. • The X-RD structure was revealed in 1989
• Structure of HIV Protease- A Symmetrical
Molecule
•
HIV protease is a symmetrical molecule
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12. Design of New Ligands
5 Years for first three drugs
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13.  About 68% are in Sub Saharan Africa
 About 700 are in children under 15 years of age
 About 5 200 are in adults aged 15 years and older, of whom:
– ─ almost 47% are among women
– ─ about 33% are among young people (15-24)
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14. Treatment Options
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15. • Nucleoside Reverse Transcriptase
inhibitors
– AZT (Zidovudine)
• Non-Nucleoside Transcriptase inhibitors
– Viramune (Nevirapine)
• Protease inhibitors
– Norvir (Ritonavir)
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17. • Resolution of HIV-induced symptoms
• Marked reduction of HIV load in plasma
• Increase in CD-4 cell counts
• Control of active O.I.’s (e.g.: MAC, CMV)
• Reduction in the incidence of new O.I.’s
• Reduction of hospital days, and need for
home IV therapies/ nutrition
• 50% reduction in mortality rate in NY
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18. • Pill burden
• Food and storage restrictions
• Drug- drug interactions
• Severe side-effects
• Reduction in Quality of Life measures
• Viral resistance
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19.  The burden of pediatric HIV disease is high,
despite PMTCT
 2.3 million children currently living with HIV
 This represents 7.5% of the total number of people with HIV
 370,000 new pediatric infections globally in 2009
 This represents 15% of the total number of new infections
each year
 Treatment and PMTCT interventions can reduce
MTCT rates to <5%
 But in 2009 only 50% of HIV+ pregnant women had access
to PMTCT
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21. • For adults CD4 cell
count raised to 500.
• For children treatment
options for all below 5yr
• In case of pregnant
women all are treated.
• Treatment for all
serodiscordant couples.
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23. • Reaching 15 million people with life-saving ART.
• Eliminating new HIV infections among children and
substantially reducing AIDS-related maternal deaths.
• Reducing tuberculosis deaths in people living with
HIV by 50%.
• Reducing sexual transmission of HIV by 50%.
• Reducing transmission of HIV among people who
inject drugs by 50%.
• Eliminating parallel systems for HIV-related services,
in order to strengthen integration of the AIDS
response in global health and development efforts.
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24. • Strategic use of ARVs for HIV treatment and
prevention;
• Eliminating HIV in children and expanding access to
paediatric treatment;
• An improved health sector response to HIV among key
populations;
• Further innovation in HIV prevention, diagnosis,
treatment and care;
• Strategic information for effective scale up;
• Stronger links between HIV and related health
outcomes.
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25. • 1986: 1st case of HIV detected in Chennai.
• 1990: HIV/AIDS Cell set up in MoHFW.
• 1992: NACP-I launched.
• 1992: National AIDS Control Organisation
(NACO) established within MoHFW.
• 1999-2006: NACP-II launched.
• 2007-2012: NACP-III launched.
• NACP IV (2012-2017) on the anvil with
projected outlay of more than US$ 2 billion
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26. • The Government of India estimates that
about 2.40 million Indians are living with
HIV (1.93 ‐3.04 million) with an adult
prevalence of 0.31% .
• Children (<15 yrs) account for 3.5% of all
infections, while 83% are the in age group
15-49 years.
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27. • The four high prevalence states of South
India (Andhra Pradesh – 500,000,
Maharashtra – 420,000, Karnataka –
250,000, Tamil Nadu – 150,000) account for
55% of all HIV infections in the country.
• West Bengal, Gujarat, Bihar and Uttar
Pradesh are estimated to have more than
100,000 PLHA each and together account for
another 22% of HIV infections in India.
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30. Estimated Adult HIV Prevalence & Number of PLHIV, India, 2007-11
0.33
0.31 0.30
0.28 0.27
22.5 21.9 21.4 21.1 20.9
0.35
0.30
0.25
0.20
0.15
0.10
0.05
0.00
25.0
20.0
15.0
10.0
5.0
0.0
2007 2008 2009 2010 2011
Adult HIV Prevalence (%)
Number of PLHIV (Lakhs)
Number of PLHA (Lakhs) Adult HIV Prevalence (%)
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31. Top 10 countries: People living with HIV
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