This document discusses HIV/AIDS, including its causes, transmission, stages of infection, diagnosis, and treatment. It is caused by the HIV retrovirus, which attacks the immune system. There are now over 33 million people living with HIV globally. The stages of infection progress from acute infection to asymptomatic infection to symptomatic infection and finally AIDS. Diagnosis involves antibody testing and CD4 counts. Treatment involves highly active antiretroviral therapy (HAART) to suppress viral load and increase CD4 counts. Prevention focuses on awareness, safe practices like safe sex and clean needles, and avoiding mother-to-child transmission.

1. HIV/AIDS
Mrs. Namita Batra Guin
Associate Professor
Dept. of Community Health Nursing

2. • FATAL DISEASE
• Caused by retrovirus- Human immuno-
deficiency virus. Attacks the immune system.
• Modern day pandemic.
• 2.7 million people infected with HIV in 2007,
• 33 million people living with HIV, including
millions who have developed AIDS.

3. HIV infection
• HIV breaks down the body’s immune system,
leaving victim vulnerable to life threatening
opportunistic infections.
• Implies the entire course of HIV infection,
from asymptomatic infection to early
symptoms to AIDS

4. AIDS
• Acquired immuno-deficiency syndrome.
• Most severe form of continuum of illness
associated with HIV infection.
• If untreated, it causes slow degeneration of
the immune system with the development of
opportunistic infections and malignancies.
• AIDS refers to the last stage of HIV infection

5. EPIDEMIOLOGICAL DETERMINANTS
• AGENT: retrovirus. Has unique ability
to destroy human T4 helper cells.
Virus spreads throughout the body,
can cross blood brain barrier and can
destroy brain cells.
• Can be kiiled by heat and can be
inactivated by ether, acetone and
ethanol.

6. EPIDEMIOLOGICAL DETERMINANTS
• Reservoir of infection: cases and
carriers. Once infected, virus remains
in body life long. Symptomless carrier
can infect other people for years.
• Sources of infection: greatest conc. in
blood, semen and CSF. Lower conc. in
tears, saliva, breast milk, urine and
cervical and vaginal secretions. Also
isolated from : bone marrow, lymph
nodes and skin etc.

7. EPIDEMIOLOGICAL DETERMINANTS
• HOST:
– AGE- sexually active persons aged 20-49 years
– SEX- equal in both the sexes.
– HIGH RISK GROUP- male homosexuals, bisexuals,
heterosexual partners (including prostitutes), I.V.
drug abusers, transfusion recipients of blood
and blood products, hemophiliacs and clients of
STD.
– IMMUNOLOGY- immune system disorders are
associated with HIV infection/AIDS

8. MODES OF TRANSMISSION
• Sexual transmission
• Blood contact
• Maternal-fetal transmission
• INCUBATION PERIOD: uncertain
(few months to 6 or more years)

9. STAGES OF HIV INFECTION
• Primary HIV infection:
– Acute HIV infection
– Approximately 50-90% of persons experience a brief flu
like symptoms about 2-4weeks following exposure to HIV.
– During this, there is sudden decrease in CD4 cells and
increase in viral load for a brief period before returning to
baseline.
– Typical Symptoms include:
• Fever
• Adenopathy
• Pharyngitis
• Rash

11. STAGES OF HIV INFECTION
• HIV asymptomatic:
– Infected person have antibodies but no overt signs
of disease except persistent generalized
lymphadenopathy.
– Viral level reaches a set point
– On an average 8-10years pass before major HIV
related complication develops.
– Apparently good health because level of CD4
remain high enough.

12. STAGES OF HIV INFECTION
• HIV symptomatic:
– CD4 count gradually falls
– Exhibit one or more of the following signs:
• Unexplained diarrhoea lasting for more than 1 month
• Fatigue, malaise, fever
• Loss of body weight
• Night sweats
• Other milder infections like:- oral thrush, enlarged
spleen etc.
• Pts. Having two or more of these manifestations and
decrease no. of CD4 cells is considered as HIV
symptomatic.

13. STAGES OF HIV INFECTION
• AIDS:
– CD4 counts lower than 200
– Significantly impaired immune system.
– Tuberculosis, Kaposi sarcoma usually seen.
Common fungal infection like:- Candida
esophagitis, Cryptococcus meningitis, parasitic
infection – Pneumocystis carinii, toxoplasma
gondii encephalitis.
– Hairy leukoplakia
– Pruritic dermatitis
– Severe or recurrent skin infections.

14. ORAL CANDIDIASIS

15. ESOPHAGEAL CANDIDIASIS

16. LEUKOPLAKIA

17. KAPOSI SARCOMA

18. DIAGNOSIS
• Cinical
– Major signs- weight loss, chronic
diarrhoea, prolonged fever for more
than 1 month.
– Minor signs- persistent cough for
more than 1 month, generalized
pruritic dermatitis, H/o herpes
zoster,oropharyngeal cadidiasis,
chronic progressive or disseminated
herpes simplex infection, generalized
lymphadenopathy.

19. DIAGNOSIS
• Laboratory:
– ELISA- enzyme linked
immunosorbent assay- for detecting
antibody to HIV.
– Western Blot- used to confirm the
positive result on ELISA.
– CBC- Anemia, neutropenia and
thrombocytopenia.
– CD4 lymphocyte percentage.

20. TREATMENT
• HAART: Highly Active Anti-Retroviral Therapy.
• Consist of medications of four different
classifications as they prevent replication at
four different points.
• Drugs- Nucleoside/nucleotide reverse
transcriptase inhibitors (NRTI),Non
nucleoside reverse transcriptase inhibitors
(NNRTI),Protease inhibitors (PI) and Entry
inhibitors

21. TREATMENT
• Goals of treatment-
– Prolong life and improve quality of life.
– Reduce viral load as low as possible for as long as
possible.
– Increase the CD4 count to allow immune
reconstitution.
– Maintain options for future treatment by
preventing the development of treatment
resistant virus .
– Avoid drug toxicity.

22. TREATMENT
• Therapy usually consists of:
– 2 NRTI combined with either NNRTI or boosted
Protease inhibitor.
– Ritonavir usually used as booster.
– Two NRTI used are- zidovudine, lamivudine
combined with NNRTI- efavirenz

23. PREVENTION
• Take blood from licensed blood bank
• Make sure the blood has the stamp of HIV FREE on it
• Avoid single unit BT
• Avoid sharing needles
• Take your own disposable syringe
• Creating awareness on HIV/AIDS and safe sex.
• Women having AIDS should avoid becoming
pregnant.
• IEC material should be widely available for creating
awareness.
• High risk people should not donate blood

24. HIV/AIDS does not discriminate
• Everybody is vulnerable. The virus is
not restricted to any age group, race,
social class, gender, or religion. In many
countries of Asia and the Pacific
HIV/AIDS has spread to the general
population.

25. No country is immune to the
epidemic
• The HIV/AIDS epidemic can spread very
quickly
• Low HIV prevalence rates in the general
population of a country can conceal
serious epidemics in smaller, high-risk
groups or in certain areas
• The epidemic can quickly cross over
from high-risk groups to the general
population

26. Awareness is the only way
• There are no cures or vaccines for HIV/AIDS.
Currently awareness/education is the only
way to prevent infection.
• Preventive education also means preventing
stigma, denial, and discrimination.
• HIV/ADS is associated with sex, disease, and
death, and with behaviours that may be
illegal, forbidden or taboo, such as pre- and
extramarital sex, sex work, sex between men,
and injecting drug use. Awareness will reduce
the HIV vulnerability.