HIV infection

1. HIV INFECTION

2. contents
01 Difinition
02 Epidemiology
03 Aetiology
04 Classification
05 Diagnosis
06 Criteria
07 Treatment
08 Complication

3. Difinition
01

4. HIV infection is caused by a retrovirus that
infects and replicates in human lymphocytes
and macrophages, eroding the integrity of the
human immune system over a number of
years, culminating in immune deficiency and a
susceptibility to a series of opportunistic and
other infections as well as the development of
certain malignancies.

5. Epidemiology
02
Approximately 84 million people have become infected with HIV
and 40 million people have died of AIDS-related illness since the
start of the epidemic. New cases peaked in 1999 (3.16 million)
and have gradually decreased since then.

6. United Nations Programme on HIV/AIDS ( UNAIDS), 2010-2015

7. Aetiology
The human immunodeficiency retroviruses can be broadly divided
into two groups: HIV-1 and HIV-2, both of which cause AIDS.
Infection with HIV-1 is associated with a progressive decrease in CD4
T-cell count and an increase in viral load leading to clinical AIDS. The
stage of infection can be determined by measuring the patient's CD4
T-cell count and correlating clinical findings, such as AIDS-defining
illnesses. HIV-2 infection has a more indolent course and is largely
limited to West Africa. Within the main types of HIV viruses there are
many genetically distinct subgroups as the virus mutates and
changes over time.

8. Pathophysiology
HIV replication and
mechanism of action of
antiretroviral drugs

9. Natural course of HIV infection

10. Classification
•HIV type 1 (HIV 1) is the virus responsible for the global epidemic.
•HIV type 2 (HIV 2) is less pathogenic and restricted in the most part to
West Africa.

11. Diagnosis
1. History and exam
 Pressnce of risk factors
 Fever and night sweats
 Weight loss
 Skin rashes and post-inflammatory scars
 Oral ulcers, angular cheilitis, oral thrush, oral leukoplakia
 diarrhoea
Risk factors
People who inject drugs
Gay men and other men
who have sex with men
Commercial
sex worker
Transgender women
Unprotected receptive anal
intercourse

12. Clinical manifestation of acute HIV infection

13. Oral candidiasis

14. Oral hairy leukoplakia shingles

15. Hair changes in HIV Seborreic dermatitis

16. Diagnosis
2. Investigation
 Serum HIV enzyme-linked immunosorbent assay (ELISA)
 Serum HIV rapid tests
 HIV non invasive tests
 Serum Western blot
3. Differential diagnosis
 Infectious mononucleosis
 Cytomegalovirus infection
 Influenza infection
 Common cold
 Viral hepatitis

17. Algorithm for HIV diagnosis

18. Criteria
CDC surveilllance case definition HIV infection stage based on age-specific CD4+ T-lymphocyte count or
CD4+ T lymphocyte percentage of total lymphocytes

19. Wourld Health Organization immunologic classfication for established HIV infection

20. Treatment
Treatment does not have to be delayed while awaiting results of
resistance testing. While awaiting results of resistance testing, we
suggest one of the following regimens
• Dolutegravir plus tenofovir and either emtricitabine or lamivudine
• Bictegravir-tenofovir alafenamide-emtricitabine
• Ritonavir-boosted darunavir plus tenofovir and
either emtricitabine or lamivudine.

21. Complication
 Acute seroconversion
 Severe acute syndrome
 Rapid progressors
 AIDS
 Immune suppression pre-AIDS
 HIV related oppotunistic infections

22. References
 UPTODATE
 BMJ
 AMBOSS

23. Thanks!
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