notes

4. HIV STANDS FOR:
 H –HUMAN
 I-IMMUNODEFICIENCY
 V-VIRUS

5. AIDS STANDS FOR:
 A-ACQUIRED
 I-IMMUNO
 D-DEFICIENCY
 S-SYNDROME

6. Cont’d
 The first recorded sample of HIV was
discovered IN 1959 in a blood specimen
obtained at Leopoldville,in Belgian Congo.

7.  The virus is thought to have originally
affected “CHIMPANZEES”.
The crossover from animals to humans may
have occurred in the 1950s through an
accident or bite.

8.  The first case of AIDS was reported in USA
in 1981.
 Amongst male homosexuals in Los Angeles
and New York.

9.  In 1983 the etiological agents, the HIV had
been identified .
 Every day over 7500 people become
infected with HIV all over the world.

10.  In 2007 ,the total number of people living
with AIDS & the highest percentage of HIV
infection per capita was in SUB-SAHARAN
AFRICAN COUNTRIES.

11.  There are currently an estimated 40 million
people living with this disease & about 20
million had died with the highest prevalence
rates attributed to “youth” between 15-24
years.

12. PREVALENCE RATE OF HIV
INFECTION
 IN PUNJAB:-
 MALE %- 0.37%, i.e 36,111
 FEMALE %-0.26%, i.e 20,816
 CHILDREN- 3,909.

13.  THE HIGHEST RATE OF HIV INFECTION
IS IN: “ANDHRA PRADESH”
 MALE %-1.07%, i.e 3,01,116.
 FEMALE % -0.73% i.e 1,98,504.
 CHILDREN- 20,207

14.  THE LOWEST RATE OF HIV INFECTION
IS IN: “SIKKIM”
 MALE %-0.07%, i.e 148.
 FEMALE % -0.O5% i.e 83.
 CHILDREN-114.

15.  AIDS is caused by the virus HIV which
targets cells of the immune system by
weakening them.
 The virus weakens the persons ability to
fight infections & can be passed from one
person to another through bodily fluids.

16.  AIDS is the advanced stage, when the
immune system becomes irreparably
damaged endangering multiple infections..

17. Modes of HIV/AIDS
Transmission

18. Through Bodily Fluids
 Blood products
 Semen
 Vaginal fluids
 Breast Milk

19. Through IV Drug Use
 Sharing Needles
 Without sterilization
 Increases the chances of contracting HIV

20. Through Sex
 Intercourse
 Oral
 Anal
 Between homosexuals

21. Mother-to-Baby
 Before Birth
 During Birth
 Postpartum
 After the birth

22. Four Stages of HIV

23. Stage 1 - Primary
 Short, flu-like illness - occurs one to six
weeks after infection
 no symptoms at all
 Infected person can infect other people

24. Stage 2 - Asymptomatic
 Lasts for an average of ten years
 This stage is free from symptoms
 There may be swollen glands
 The level of HIV in the blood drops to very low
levels
 HIV antibodies are detectable in the blood

25. Stage 3 - Symptomatic
 The symptoms are mild
 The immune system deteriorates
 Emergence of opportunistic infections
and cancers

26. Stage 4 - HIV  AIDS
 The immune
system weakens
 The illnesses
become more
severe leading to
an AIDS diagnosis

27. WHO CLASSIFICATION
MAJOR SIGNS
 Weight loss > 10% of body weight
 Chronic diarhoea for more than 1 month
 Prolonged fever for more than 1 month

28. Cont’d
MINOR SIGNS
 Persistent cough for more than 1 month
 Generalized pruritic dermatitis
 History of herpes zoster
 Generalized lymphadenopathy

29. Opportunistic Infections
associated with AIDS
Bacterial
 Tuberculosis (TB)
 Strep pneumonia
Viral
 Kaposi Sarcoma
 Herpes
 Influenza (flu)

30. Opportunistic Infections
associated with AIDS
Parasitic
 Pneumocystis carinii
Fungal
 Candida
 Cryptococcus

31. Anonymous Testing
 No name is used
 Unique identifying number
 Results issued only to test
recipient
23659874515
Anonymous

32. Confidential Testing
 Person’s name is recorded along with HIV
results
 Name and positive results are reported to the
State Department and the Centers for Disease
Control and Prevention
 Results issued only to test recipient

33. Testing Options for
HIV

34. Blood Detection Tests
 Enzyme-Linked Immunosorbent Assay/Enzyme
Immunoassay (ELISA/EIA)
 Radio Immunoprecipitation Assay/Indirect
Fluorescent Antibody Assay (RIP/IFA)
 Polymerase Chain Reaction (PCR)
 Western Blot Confirmatory test

35. Urine Testing
 Urine Western Blot
 As sensitive as testing blood
 Safe way to screen for HIV
 Can cause false positives in
certain people at high risk for
HIV

36. Oral Testing
 Orasure
 The only FDA approved
HIV antibody.
 As accurate as blood
testing
 Draws blood-derived
fluids from the gum
tissue.
 NOT A SALIVA TEST!

37. TREATMENT

38. TREATMENT
 Anti retro-viral regimens are complex &
have major side-effect & carries serious
potential consequences from the
development of viral resistance due to lack
of adherence to a drug regimen.

39. GOALS
 Maximal & durable suppression of viral
load.
 Restoration & preservation of
immunological function.
 Improve quality of life.
 Reduction of HIV relative morbidity &
mortality.

40. DRUGS
 These drugs are classified into 3
categories.
1. Nucleoside analog reverse transcriptase
inhibitors.(NsRTIs).
eg. Zidovudine(500-600mg, orally daily in 2
divided doses.)
Stavudine(40mg orally twice daily)

41. Cont’d..
2. Non-nucleoside reverse transcriptase
inhibitors.
Eg. Nevirapine(200mg orally daily for 2wks,
then 200mg orally twice daily).
Delavirdine(400mg daily orally TDS)

42. Cont’d..
3. Protease inhibitors
Eg. Nelfinavir( 750mg orally TDS)
Indinavir(800mg orally daily).

44. POST EXPOSURE
PROPHYLAXIS
TREATMENT
 4 weeks of treatment of Ziduvudine(AZT)
monotherapy decreases the chances of
becoming infected by 79%(according to
studies done by US govt.)

45. Contd..
 The following treatment is recommended
by US center for disease control &
prevention for health care workers
accidentally exposed to HIV.
 Double combination of treatment with
Ziduvudine & Lamivudine daily for 4 weeks.

46. Contd..
 If the source individual has advance AIDS
the protease inhibitors i.e NELFINAVIR
should be added to previous regimen.
 If the source individual has failed on
AZT/3TC therapy, STAVUDINE +
DIDANOSINE should be used instead of
AZT/3TC.

48. 4 ways to protect yourself?
 Abstinence
 Monogamous Relationship
 Protected Sex
 Sterile needles

49. Abstinence
 It is the only 100 % effective method of
not acquiring HIV/AIDS.
 Refraining from sexual contact: oral, anal,
or vaginal.
 Refraining from intravenous drug use

50. Monogamous relationship
 A mutually monogamous (only one sex partner)
relationship with a person who is not infected with
HIV
 HIV testing before intercourse is necessary to
prove your partner is not infected

51. Protected Sex
 Use condoms (female or male) every time
you have sex (vaginal or anal)
 Always use latex or polyurethane condom
(not a natural skin condom)
 Always use a latex barrier during oral sex

52. When Using A Condom
Remember To:
 Make sure the package is not expired
 Make sure to check the package for damages
 Do not open the package with your teeth for risk
of tearing
 Never use the condom more than once
 Use water-based rather than oil-based
condoms

53. Sterile Needles
 If a needle/syringe is shared, it must be
disinfected:
 Fill the syringe with undiluted bleach and wait at
least 30 seconds.
 thoroughly rinse with water
 Do this between each person’s use

54. FROM MOTHER TO CHILD
TRANSMISSION
 Preventing HIV infection among
prospective parents making HIV testing &
other prevention available in services
related to sexual health such as antenatal
& postpartum care.

55.  Avoiding unwanted pregnancies among
HIV positive women providing appropriate
counseling & support to women living with
HIV to enable them to make informed
decisions about their reproductive lives.
Cont’d….

56.  Preventing the transmission of HIV from
HIV positive mothers to their infants during
pregnancy, labour, delivery & breast-
feeding.

57. FROM BLOOD
 Do not donate blood, plasma, body organs,
or sperms if you are infected.
 Before any blood transfusion always check
the blood for HIV, Hbs Ag, HCV & other
blood born diseases.
 Do not touch the blood & its product with
bare hands.

58. PREVENTIVE EDUCATION
RELATED TO SEX
 Effective educational programs have been
initiated to educate the public regarding
safer sexual practices i.e:-
 Practice abstinence is 100% effective
method of not acquiring HIV/AIDS.

59. Cont’d…
 Reduce the no. of sexual partners to one.
 Always use latex condoms; if allergic to
latex, use female condoms (non-latex).

60. Cont’d..
Avoid anal intercourse because this
practice may injure tissues.
Do not ingest urine or semen.

61. PREVENTION
 A- Abstinence for youth, including the delay
of sexual debut & abstinence until
marriages.
 B- Being tested for HIV & being faithful in
marriage & monogamous relationships.
 C- Correct & consistent use of condoms for
those who practice high risk behaviours.

62. NACO

63.  NACO is a division of ministry of health &
family welfare that provides leadership to
HIV/AIDS control programme in India
through 35 HIV/AIDS prevention & control
programmes.

64.  In 1986,following the detection of first AIDS
case in the country,the National AIDS
Committee was constituted in ministry of
health & family welfare.

65.  An epidemic spread, need was felt for a
nationwide program & an organisation to
steer the programme.
 In 1992 India first NACP(1992-99) was
launched & NACO was constituted to
implement the programme.

66.  NACO advocates & promote condom use
as a safer sex for prevention of STD/RTI &
HIV.
 NACO envisions an India where every
person living with HIV has access to quality
care & is treated with dignity.

67.  NACO believes that people need to be
aware, motivated, equipped & empowered
with knowledge that they can protect
themselves from impact of HIV.

68.  NACO is thus committed to contain the
spread of HIV in India by building an allen
comparing response reaching out to
diverse population.

69. RESOURCE PERSONS
 WELCOME- Ms.Manpreet Saini
 ENCLOSING THEME- Ms.Neelam Dhiman
 INTRODUCTION-Ms.Bincy yohannan
 CAUSES,

70. Thank You!

71.  SUPERVISED BY: Mrs. Manju Chawla.
Ms. Tarandeep Kaur

72. RESOURCE PERSONS-
 Welcome-Ms. Manpreet saini.
 Enclosing of theme-Ms. Neelam Dhiman.
 Introduction to AIDS-Ms. Bincy.
 Causes, clinical manifestations and
diagnosis – Ms. Gurpreet Kaur Nijjar.
 Treatment and prevention-Ms. Keerti
Verma.

73.  NACO- Ms. Sulochana Kumari.
 Pre-test and Post-test- Ms. Vijita Jose