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.

2. Human Immuno Deficiency Virus (HIV)
A retrovirus that causes AIDS by infecting helper T cells of
the immune system. The most common serotype, HIV-1,
is distributed worldwide, while HIV-2 is primarily
confined to West Africa.

3. Acquired Immuno Deficiency Syndrome (AIDS)
A severe immunological
disorder caused by the
retrovirus HIV, resulting in a
defect in cell-mediated
immune response that is
manifested by increased
susceptibility to opportunistic
infections and to certain rare
cancers, especially Kaposi's
sarcoma. It is transmitted
primarily by exposure to
contaminated body fluids,
especially blood and semen.

4. RISK FACTORS
 Unprotected sexual contact
 Inject drugs or steroids where
needles/syringes are shared
 Sexually Transmitted Disease (STDs) -
syphilis, genital herpes, chlamydia,
gonorrhea, bacterial vaginosis, or
trichomoniasis
 Have been diagnosed with hepatitis,
tuberculosis, or malaria
 From infected mother to fetus
 Through breast feeding
 Infected blood transfusion
 Engage in unprotected sex with someone
who has any of the risk factors listed
above

5. PATHOPHYSIOLOGY

6. STAGES OF HIV INFECTION
 Stage I – Primary HIV Infection
 Stage II – HIV Asymptomatic
 Stage III – HIV Symptomatic
 Stage IV - AIDS

7. STAGE I : Primary HIV infection
 This stage lasts for a few weeks
 Accompanied by a short flu-like illness
 Diagnosis of HIV infection is frequently missed.
 During this stage there is a large amount of HIV in the
peripheral blood
 Immune system begins to respond to the virus by
producing HIV antibodies and cytotoxic lymphocytes.
This process is known as seroconversion.
 CD4(Cluster of differentiation 4) cell + T Lymphocyte
count will be normal i.e., 500 – 1500 cells/cubic mm

8. Clinical Manifestations:
 Asymptomatic
 Persistent generalized
lymphadenopathy

9. STAGE II : HIV Asymptomatic
 This stage lasts for an average of ten years
 Free from major symptoms, although there may be
swollen glands
 People remain infectious and HIV antibodies are
detectable in the blood, so antibody tests will show a
positive result.
 CD4 cells + T lymphocytes – little above 500
cells/cubic mm

10. Clinical Manifestations:
 Moderate unexplained weight loss
 Recurrent respiratory tract infections (sinusitis,
tonsillitis, otitis media, pharyngitis)
 Herpes zoster
 Angular chelitis
 Recurrent oral ulceration
 Papular pruritic eruptions
 Seborrhoeic dermatitis
 Fungal nail infections

11. STAGE III : HIV Symptomatic
 Immune system becomes severely damaged by HIV.
 The lymph nodes and tissues become damaged
 HIV mutates and becomes more pathogenic - more T
helper cell destruction
 The body fails to keep up with replacing the T helper
cells that are lost
 Immune system fails and symptoms develop
 Initially many of the symptoms are mild, but as the
immune system deteriorates the symptoms worsen.
 Multi-system disease and infections can occur in
almost all body systems
 CD4 cells + T lymphocytes – 200 – 499 cells/cubic mm

12. Clinical Manifestations:
 Unexplained severe weight loss
 Chronic diarrhoea for longer than one month
 Unexplained* persistent fever (intermittent or constant for
longer than one month)
 Persistent oral candidiasis
 Oral hairy leukoplakia
 Pulmonary tuberculosis
 Severe bacterial infections (e.g. pneumonia, empyema,
bone or joint infection, meningitis, bacteraemia)
 Acute necrotizing ulcerative stomatitis, gingivitis or
periodontitis
 Unexplained* anaemia (below 8 g/dl), neutropenia (below
0.5 billion/l) and/or chronic thrombocytopenia (below 50
billion/l)

13. STAGE IV : AIDS
 Individual develops increasingly severe opportunistic
infections and cancers
 CD4 cells + T lymphocytes - <200 cells/cubic mm

14. Clinical Manifestations:
 HIV wasting syndrome
 Pneumocystis pneumonia
 Recurrent severe bacterial pneumonia
 Chronic herpes simplex infection (orolabial, genital or anorectal
of more than one month’s duration or visceral at any site)
 Oesophageal candidiasis (or candidiasis of trachea, bronchi or
lungs)
 Extrapulmonary tuberculosis
 Kaposi sarcoma
 Cytomegalovirus infection (retinitis or infection of other organs)
 HIV encephalopathy
 Meningitis
 Progressive multifocal leukoencephalopathy
 Recurrent septicaemia
 Invasive cervical carcinoma
 Symptomatic HIV-associated nephropathy or HIV-associated
cardiomyopathy

15. DIAGNOSIS
 ELISA – Enzyme Linked Immuno Sorbent Assay
 EIA – Enzyme Immuno Assay
 Western Blot
 Viral Load
 CD4/CD8 Ratio

16. MEDICAL MANAGEMENT
 HAART – Highly Active Anti Retroviral Therapy
 Antibacterials
 Antidiarrheals
 Immunotherapy
 Chemotherapy
 Nutrition Therapy
 Antidepressant Therapy

17. HAART
 Nucleoside Reverse Transcriptase Inhibitors (NRTI)
e.g. Stavudine
 Non Nucleoside Reverse Transcriptase Inhibitors
(NNRTI) e.g. Nevirapine
 Protease Inhibitors (PI)
E.g. Indinavir
 Fusion Inhibitors
E.g. Zidovudine

18. Quick Facts About HIV
Transmission
 HIV cannot survive for very long
outside of the body
 HIV cannot be transmitted through
routine daily activities such as using
a toilet seat, sharing food utensils or
drinking glasses, shaking hands, or
through kissing.
 The virus can only be transmitted
from person to person, not through
animals or insect bites
 People infected with HIV who are
taking antiretroviral therapy can still
infect others through unprotected
sex and needle-sharing