HIV is transmitted through sexual contact, blood exposure, and vertically from mother to child. It targets CD4+ cells. Children experience more rapid disease progression than adults, with half of untreated children dying within 2 years. Clinical manifestations in children commonly include failure to thrive, recurrent bacterial infections, and lymphocytic interstitial pneumonitis. Opportunistic infections indicate severe immune deficiency from HIV.
This document summarizes HIV infection in pediatric patients. It describes the natural history of the disease, including three patterns of progression. It discusses clinical manifestations, opportunistic infections like Pneumocystis pneumonia, and respiratory diseases seen in HIV-infected children. It also outlines the WHO clinical staging criteria for pediatric HIV/AIDS.
HIV INFECTION. presentation. fareedah Muheeb Abisola group 2.pptxF.A Muheeb
Vertical transmission is the main way children get HIV. It can occur before birth, during delivery, or through breastfeeding. Left untreated, pediatric HIV can cause life-threatening infections and developmental delays. Diagnosis involves virus detection tests until 18 months when antibodies develop. Treatment involves combination antiretroviral therapy with drugs from at least two classes. Appropriate treatment can suppress the virus and reduce complications.
This document discusses immunodeficiency and HIV/AIDS. It defines immunodeficiency as a compromised immune system and describes how it is classified as either primary/congenital or secondary/acquired. HIV is described as a retrovirus that causes AIDS by infecting CD4 cells and impairing the immune system over time. The document outlines HIV transmission, structure, lifecycle, and global prevalence, with statistics provided on prevalence in Zambia.
The document provides information about AIDS/HIV in 3 paragraphs:
1) It defines AIDS as acquired immune deficiency syndrome caused by the HIV virus. It affects immune cells called CD4+ T cells. HIV was first reported in 1981 in the US.
2) Pediatric AIDS contributes to 15-20% of cases in developing countries. HIV can be transmitted from mother to child during pregnancy, delivery, or breastfeeding. By 2007, over 2 million children lived with HIV.
3) HIV attacks and destroys CD4+ T cells, weakening the immune system. If untreated, HIV progresses to AIDS. Common opportunistic infections in children with AIDS include Pneumocystis pneumonia and MAC (Mycobacterium
The document summarizes the history, epidemiology, virology, immunology, transmission, clinical progression, and global impact of HIV/AIDS. It notes that HIV was first recognized in 1981 but has since been traced to 1959. It is caused by HIV-1 and HIV-2 viruses and is transmitted via bodily fluids. Left untreated, it progresses from primary infection to asymptomatic infection to AIDS as it depletes CD4 cells and allows opportunistic infections. Currently over 30 million people are living with HIV globally, with sub-Saharan Africa most severely impacted.
Natural History of a Typical HIV Infection1.pptAdamsAtebe
This document summarizes the natural history of typical HIV infection in three phases: acute retroviral syndrome, chronic phase, and AIDS. It describes the median incubation period of 10 years from infection to AIDS, progression due to increasing viral load and CD4 cell destruction. Key aspects of each phase are outlined, including symptoms, viral levels, opportunistic infections, and factors associated with long-term survival. The WHO disease staging system is also presented.
The document discusses HIV/AIDS in children. It defines HIV as a virus that infects and weakens the immune system, and AIDS as the syndrome that occurs when the immune system is severely damaged by HIV. HIV is usually transmitted from mother to child during pregnancy, childbirth or breastfeeding. Children with HIV may show no symptoms for years but can eventually develop infections like pneumonia or develop AIDS. There are screening tests to detect HIV in children but no vaccine or cure currently exists. Antiretroviral treatment can slow disease progression.
This document summarizes HIV infection in pediatric patients. It describes the natural history of the disease, including three patterns of progression. It discusses clinical manifestations, opportunistic infections like Pneumocystis pneumonia, and respiratory diseases seen in HIV-infected children. It also outlines the WHO clinical staging criteria for pediatric HIV/AIDS.
HIV INFECTION. presentation. fareedah Muheeb Abisola group 2.pptxF.A Muheeb
Vertical transmission is the main way children get HIV. It can occur before birth, during delivery, or through breastfeeding. Left untreated, pediatric HIV can cause life-threatening infections and developmental delays. Diagnosis involves virus detection tests until 18 months when antibodies develop. Treatment involves combination antiretroviral therapy with drugs from at least two classes. Appropriate treatment can suppress the virus and reduce complications.
This document discusses immunodeficiency and HIV/AIDS. It defines immunodeficiency as a compromised immune system and describes how it is classified as either primary/congenital or secondary/acquired. HIV is described as a retrovirus that causes AIDS by infecting CD4 cells and impairing the immune system over time. The document outlines HIV transmission, structure, lifecycle, and global prevalence, with statistics provided on prevalence in Zambia.
The document provides information about AIDS/HIV in 3 paragraphs:
1) It defines AIDS as acquired immune deficiency syndrome caused by the HIV virus. It affects immune cells called CD4+ T cells. HIV was first reported in 1981 in the US.
2) Pediatric AIDS contributes to 15-20% of cases in developing countries. HIV can be transmitted from mother to child during pregnancy, delivery, or breastfeeding. By 2007, over 2 million children lived with HIV.
3) HIV attacks and destroys CD4+ T cells, weakening the immune system. If untreated, HIV progresses to AIDS. Common opportunistic infections in children with AIDS include Pneumocystis pneumonia and MAC (Mycobacterium
The document summarizes the history, epidemiology, virology, immunology, transmission, clinical progression, and global impact of HIV/AIDS. It notes that HIV was first recognized in 1981 but has since been traced to 1959. It is caused by HIV-1 and HIV-2 viruses and is transmitted via bodily fluids. Left untreated, it progresses from primary infection to asymptomatic infection to AIDS as it depletes CD4 cells and allows opportunistic infections. Currently over 30 million people are living with HIV globally, with sub-Saharan Africa most severely impacted.
Natural History of a Typical HIV Infection1.pptAdamsAtebe
This document summarizes the natural history of typical HIV infection in three phases: acute retroviral syndrome, chronic phase, and AIDS. It describes the median incubation period of 10 years from infection to AIDS, progression due to increasing viral load and CD4 cell destruction. Key aspects of each phase are outlined, including symptoms, viral levels, opportunistic infections, and factors associated with long-term survival. The WHO disease staging system is also presented.
The document discusses HIV/AIDS in children. It defines HIV as a virus that infects and weakens the immune system, and AIDS as the syndrome that occurs when the immune system is severely damaged by HIV. HIV is usually transmitted from mother to child during pregnancy, childbirth or breastfeeding. Children with HIV may show no symptoms for years but can eventually develop infections like pneumonia or develop AIDS. There are screening tests to detect HIV in children but no vaccine or cure currently exists. Antiretroviral treatment can slow disease progression.
This document summarizes HIV prevalence and transmission in the Bundelkhand region of India. It finds that from 2001-2009, 3847 people were counseled and tested, with 294 (205 male, 89 female) testing positive. Most positive patients had little education and were married. The top occupations of those testing positive were truck/bus drivers and laborers. The majority lived in Jhansi. HIV is transmitted via bodily fluids and treatments aim to suppress viral loads and boost CD4 counts.
The document outlines key topics related to paediatric HIV including epidemiology, transmission, pathogenesis, clinical manifestations, diagnosis, and management. It discusses mother-to-child transmission, care for HIV-exposed infants, opportunistic infections, and use of antiretroviral therapy. The goal is to provide an overview of paediatric HIV and strategies to prevent transmission from mother to child and properly manage infected children.
This document provides an overview of pediatric HIV/AIDS in Uganda, including:
- HIV causes immune system depletion by destroying CD4 cells.
- Uganda has a high prevalence of HIV, especially among women ages 15-24.
- Children can show signs of infection like oral thrush or recurrent infections.
- Diagnosis involves viral testing for children under 18 months and antibody tests after.
- Clinical staging from asymptomatic to conditions like pneumonia or dermatitis is used.
- Treatment involves antiretroviral therapy and prophylaxis.
This document summarizes key information about human immunodeficiency virus (HIV). It was first identified in 1981 and causes AIDS. HIV is a retrovirus that infects and kills CD4+ T cells. Major transmission routes are sexual contact and transmission from mother to child. Untreated infection progresses from primary infection to asymptomatic infection and then symptomatic infection before developing AIDS, which is characterized by opportunistic infections. Common opportunistic infections in people with AIDS include Pneumocystis pneumonia and Kaposi's sarcoma. The document also outlines clinical features, course of infection, and investigations for diagnosing HIV infection.
- The document discusses pediatrics HIV, including definitions of HIV and AIDS, epidemiology, etiology, transmission, risk factors, pathogenesis, natural history and clinical manifestations, diagnosis, staging, management including ART, OI prophylaxis, infant feeding recommendations, and contraindications for various treatments. Some key points include that vertical transmission is the most common route of transmission in pediatrics, ART should be started as early as possible in all HIV-infected children, and cotrimoxazole preventive therapy is recommended for HIV-exposed infants from 4-6 weeks of age.
Human Immunodeficiency Virus (HIV)- Kaya Kalp International Sex & Health Clin...Steve Wozniax
Human Immunodeficiency Virus (HIV) is a lentivirus that causes Acquired Immunodeficiency Syndrome (AIDS). HIV weakens the immune system by infecting vital cells like CD4+ T cells. This makes the body vulnerable to various infections and illnesses. The virus can be transmitted through unprotected sexual contact, contaminated needles, and from mother to child during pregnancy, childbirth or breastfeeding. There is no cure for HIV, but early diagnosis and treatment with antiretroviral therapy (HAART) can significantly improve life expectancy.
HIV infection and AIDS was first recognized in the United States in 1981. Globally, 38 million people were living with HIV in 2019. The human immunodeficiency virus (HIV) is the etiologic agent of AIDS and belongs to the family of lentiviruses. HIV is transmitted through sexual contact or exposure to infected blood or blood products. Treatment involves lifelong antiretroviral therapy to suppress the virus and prevent disease progression.
1. HIV/AIDS remains a major global public health issue, with sub-Saharan Africa disproportionately affected.
2. HIV targets CD4 cells and progressively destroys the immune system, leaving the body vulnerable to opportunistic infections.
3. The virus has several stages in its lifecycle within the human body, allowing it to evade detection and establish chronic, long-term infection.
HIV positive mother and her bABY, RISK OF TRANSMISSION, ANTENATAL CARE, INTRA...LalrinchhaniSailo
Globally, an estimated 1.3 million women and girls living with HIV become pregnant each year. In the absence of intervention, the rate of transmission of HIV from a mother living with HIV to her child during pregnancy, labour, delivery or breastfeeding ranges from 15% to 45%. As such, identification of HIV infection should be immediately followed by an offer of linkage to lifelong treatment and care, including support to remain in care and virally suppressed and an offer of partner services.
In 2019, 85% of women and girls globally had access to antiretroviral therapy (ART) to prevent mother-to-child transmission (MTCT). However, high ART coverage levels do not reflect the continued transmission that occurs after women are initially counted as receiving treatment. Achieving retention in care and prevention of incident HIV infections in uninfected populations remain high priorities to reach global elimination targets. Since the global shift to, and accelerated rollout of, highly effective, simplified interventions based on lifelong ART for pregnant women living with HIV, virtual elimination of MTCT – also known as vertical transmission – has been shown to be feasible.
Human Immunodeficiency Virus (HIV) is an enveloped RNA virus that causes acquired immunodeficiency syndrome (AIDS). It belongs to the retrovirus family and there are two types, HIV-1 and HIV-2. HIV infects and destroys CD4+ T cells of the immune system, ultimately weakening the body's ability to fight infections and disease. Common routes of transmission include sexual contact, contaminated blood transfusions, and from mother to child during pregnancy, childbirth or breastfeeding. While antiretroviral treatment can slow the progression of the disease, there is currently no cure for HIV/AIDS.
This document discusses HIV and TB co-infection. It notes that HIV increases the risk of developing active TB due to immunosuppression. Diagnosing TB is more difficult in HIV patients as sputum smears can be negative and symptoms are atypical. WHO recommends treating TB first before beginning antiretroviral therapy for co-infected patients, and directly observed treatment to ensure adherence. Clinical trials are exploring optimal antiretroviral regimens for co-infected patients.
This document discusses oral and periodontal manifestations of HIV. It begins with an introduction and overview of HIV/AIDS epidemiology. It then covers the virus structure, modes of transmission, pathogenesis, classification and staging systems. It discusses natural evolution of HIV infection and resistance of the virus. The main part discusses various oral manifestations strongly associated with HIV including oral candidiasis, oral hairy leukoplakia, herpetic lesions, Kaposi's sarcoma, and non-Hodgkin's lymphoma. It also briefly discusses opportunistic infections and the role of dentists in managing HIV-infected patients.
The document provides information on paediatric HIV including:
- The natural history of paediatric HIV infection fits into 3 categories from rapid to long term progression.
- Over 90% of the 2.1 million children living with HIV are in sub-Saharan Africa due to high maternal infection rates and PMTCT inefficiency.
- Predictors of rapid disease progression in infants include high maternal viral load, early infant infection, and low CD4 counts.
This document provides information on nursing care for HIV/AIDS children. It discusses HIV transmission, clinical manifestations at different stages, opportunistic infections, antiretroviral therapy, nutrition management, immunizations, and nursing assessments and interventions. Key points include transmission from mother to child, asymptomatic onset but development of symptoms over time, opportunistic infections as immune system weakens, antiretroviral therapy to suppress virus, and holistic nursing care to support health and development.
It Contains Pathogenesis of viral diseases like AIDS, Hepatitis, Influenza and Rabies.
It contains detail pathogenesis with various verified sources.
You can refer references to visit the sources used.
This document discusses Acquired Immunodeficiency Syndrome (AIDS). It defines AIDS as a condition caused by the human immunodeficiency virus (HIV) that weakens the immune system. HIV is transmitted through sexual contact, exposure to infected body fluids, or from mother to child. A person may not notice symptoms initially or may experience brief flu-like symptoms before entering a prolonged asymptomatic phase. Late stage symptoms occur as the virus interferes more with the immune system, increasing risk of infections. Diagnosis involves HIV testing to detect antibodies or genetic material from the virus. There is currently no cure for AIDS but treatment involves antiretroviral therapy to slow disease progression.
This document provides an overview of Acquired Immunodeficiency Syndrome (AIDS) caused by the Human Immunodeficiency Virus (HIV). It discusses the identification and emergence of AIDS in 1981, the global impact and transmission of HIV, clinical manifestations of AIDS, and methods for controlling and managing the epidemic.
AIDS was first recognized in 1981 when previously healthy homosexual men in Los Angeles and New York developed rare pneumonias and cancers. In 1983, HIV was isolated as the causative agent of AIDS. HIV attacks CD4+ T cells of the immune system, ultimately weakening the body's ability to fight infections and certain cancers. The virus continues to spread globally in an ongoing pandemic.
Hiv infection progresses from asymptomatic infection to AIDS, the most severe stage. It is caused by the HIV virus which depletes CD4+ T cells, weakening the immune system. Left untreated, opportunistic infections develop. HIV is transmitted via blood, sex, or perinatally. Treatment involves antiretroviral therapy to suppress the virus indefinitely and treat any infections, with the goals of prolonging life, improving quality of life, and restoring immune function. Nursing care focuses on medication adherence, nutrition, symptom management, and psychological support.
This document summarizes HIV prevalence and transmission in the Bundelkhand region of India. It finds that from 2001-2009, 3847 people were counseled and tested, with 294 (205 male, 89 female) testing positive. Most positive patients had little education and were married. The top occupations of those testing positive were truck/bus drivers and laborers. The majority lived in Jhansi. HIV is transmitted via bodily fluids and treatments aim to suppress viral loads and boost CD4 counts.
The document outlines key topics related to paediatric HIV including epidemiology, transmission, pathogenesis, clinical manifestations, diagnosis, and management. It discusses mother-to-child transmission, care for HIV-exposed infants, opportunistic infections, and use of antiretroviral therapy. The goal is to provide an overview of paediatric HIV and strategies to prevent transmission from mother to child and properly manage infected children.
This document provides an overview of pediatric HIV/AIDS in Uganda, including:
- HIV causes immune system depletion by destroying CD4 cells.
- Uganda has a high prevalence of HIV, especially among women ages 15-24.
- Children can show signs of infection like oral thrush or recurrent infections.
- Diagnosis involves viral testing for children under 18 months and antibody tests after.
- Clinical staging from asymptomatic to conditions like pneumonia or dermatitis is used.
- Treatment involves antiretroviral therapy and prophylaxis.
This document summarizes key information about human immunodeficiency virus (HIV). It was first identified in 1981 and causes AIDS. HIV is a retrovirus that infects and kills CD4+ T cells. Major transmission routes are sexual contact and transmission from mother to child. Untreated infection progresses from primary infection to asymptomatic infection and then symptomatic infection before developing AIDS, which is characterized by opportunistic infections. Common opportunistic infections in people with AIDS include Pneumocystis pneumonia and Kaposi's sarcoma. The document also outlines clinical features, course of infection, and investigations for diagnosing HIV infection.
- The document discusses pediatrics HIV, including definitions of HIV and AIDS, epidemiology, etiology, transmission, risk factors, pathogenesis, natural history and clinical manifestations, diagnosis, staging, management including ART, OI prophylaxis, infant feeding recommendations, and contraindications for various treatments. Some key points include that vertical transmission is the most common route of transmission in pediatrics, ART should be started as early as possible in all HIV-infected children, and cotrimoxazole preventive therapy is recommended for HIV-exposed infants from 4-6 weeks of age.
Human Immunodeficiency Virus (HIV)- Kaya Kalp International Sex & Health Clin...Steve Wozniax
Human Immunodeficiency Virus (HIV) is a lentivirus that causes Acquired Immunodeficiency Syndrome (AIDS). HIV weakens the immune system by infecting vital cells like CD4+ T cells. This makes the body vulnerable to various infections and illnesses. The virus can be transmitted through unprotected sexual contact, contaminated needles, and from mother to child during pregnancy, childbirth or breastfeeding. There is no cure for HIV, but early diagnosis and treatment with antiretroviral therapy (HAART) can significantly improve life expectancy.
HIV infection and AIDS was first recognized in the United States in 1981. Globally, 38 million people were living with HIV in 2019. The human immunodeficiency virus (HIV) is the etiologic agent of AIDS and belongs to the family of lentiviruses. HIV is transmitted through sexual contact or exposure to infected blood or blood products. Treatment involves lifelong antiretroviral therapy to suppress the virus and prevent disease progression.
1. HIV/AIDS remains a major global public health issue, with sub-Saharan Africa disproportionately affected.
2. HIV targets CD4 cells and progressively destroys the immune system, leaving the body vulnerable to opportunistic infections.
3. The virus has several stages in its lifecycle within the human body, allowing it to evade detection and establish chronic, long-term infection.
HIV positive mother and her bABY, RISK OF TRANSMISSION, ANTENATAL CARE, INTRA...LalrinchhaniSailo
Globally, an estimated 1.3 million women and girls living with HIV become pregnant each year. In the absence of intervention, the rate of transmission of HIV from a mother living with HIV to her child during pregnancy, labour, delivery or breastfeeding ranges from 15% to 45%. As such, identification of HIV infection should be immediately followed by an offer of linkage to lifelong treatment and care, including support to remain in care and virally suppressed and an offer of partner services.
In 2019, 85% of women and girls globally had access to antiretroviral therapy (ART) to prevent mother-to-child transmission (MTCT). However, high ART coverage levels do not reflect the continued transmission that occurs after women are initially counted as receiving treatment. Achieving retention in care and prevention of incident HIV infections in uninfected populations remain high priorities to reach global elimination targets. Since the global shift to, and accelerated rollout of, highly effective, simplified interventions based on lifelong ART for pregnant women living with HIV, virtual elimination of MTCT – also known as vertical transmission – has been shown to be feasible.
Human Immunodeficiency Virus (HIV) is an enveloped RNA virus that causes acquired immunodeficiency syndrome (AIDS). It belongs to the retrovirus family and there are two types, HIV-1 and HIV-2. HIV infects and destroys CD4+ T cells of the immune system, ultimately weakening the body's ability to fight infections and disease. Common routes of transmission include sexual contact, contaminated blood transfusions, and from mother to child during pregnancy, childbirth or breastfeeding. While antiretroviral treatment can slow the progression of the disease, there is currently no cure for HIV/AIDS.
This document discusses HIV and TB co-infection. It notes that HIV increases the risk of developing active TB due to immunosuppression. Diagnosing TB is more difficult in HIV patients as sputum smears can be negative and symptoms are atypical. WHO recommends treating TB first before beginning antiretroviral therapy for co-infected patients, and directly observed treatment to ensure adherence. Clinical trials are exploring optimal antiretroviral regimens for co-infected patients.
This document discusses oral and periodontal manifestations of HIV. It begins with an introduction and overview of HIV/AIDS epidemiology. It then covers the virus structure, modes of transmission, pathogenesis, classification and staging systems. It discusses natural evolution of HIV infection and resistance of the virus. The main part discusses various oral manifestations strongly associated with HIV including oral candidiasis, oral hairy leukoplakia, herpetic lesions, Kaposi's sarcoma, and non-Hodgkin's lymphoma. It also briefly discusses opportunistic infections and the role of dentists in managing HIV-infected patients.
The document provides information on paediatric HIV including:
- The natural history of paediatric HIV infection fits into 3 categories from rapid to long term progression.
- Over 90% of the 2.1 million children living with HIV are in sub-Saharan Africa due to high maternal infection rates and PMTCT inefficiency.
- Predictors of rapid disease progression in infants include high maternal viral load, early infant infection, and low CD4 counts.
This document provides information on nursing care for HIV/AIDS children. It discusses HIV transmission, clinical manifestations at different stages, opportunistic infections, antiretroviral therapy, nutrition management, immunizations, and nursing assessments and interventions. Key points include transmission from mother to child, asymptomatic onset but development of symptoms over time, opportunistic infections as immune system weakens, antiretroviral therapy to suppress virus, and holistic nursing care to support health and development.
It Contains Pathogenesis of viral diseases like AIDS, Hepatitis, Influenza and Rabies.
It contains detail pathogenesis with various verified sources.
You can refer references to visit the sources used.
This document discusses Acquired Immunodeficiency Syndrome (AIDS). It defines AIDS as a condition caused by the human immunodeficiency virus (HIV) that weakens the immune system. HIV is transmitted through sexual contact, exposure to infected body fluids, or from mother to child. A person may not notice symptoms initially or may experience brief flu-like symptoms before entering a prolonged asymptomatic phase. Late stage symptoms occur as the virus interferes more with the immune system, increasing risk of infections. Diagnosis involves HIV testing to detect antibodies or genetic material from the virus. There is currently no cure for AIDS but treatment involves antiretroviral therapy to slow disease progression.
This document provides an overview of Acquired Immunodeficiency Syndrome (AIDS) caused by the Human Immunodeficiency Virus (HIV). It discusses the identification and emergence of AIDS in 1981, the global impact and transmission of HIV, clinical manifestations of AIDS, and methods for controlling and managing the epidemic.
AIDS was first recognized in 1981 when previously healthy homosexual men in Los Angeles and New York developed rare pneumonias and cancers. In 1983, HIV was isolated as the causative agent of AIDS. HIV attacks CD4+ T cells of the immune system, ultimately weakening the body's ability to fight infections and certain cancers. The virus continues to spread globally in an ongoing pandemic.
Hiv infection progresses from asymptomatic infection to AIDS, the most severe stage. It is caused by the HIV virus which depletes CD4+ T cells, weakening the immune system. Left untreated, opportunistic infections develop. HIV is transmitted via blood, sex, or perinatally. Treatment involves antiretroviral therapy to suppress the virus indefinitely and treat any infections, with the goals of prolonging life, improving quality of life, and restoring immune function. Nursing care focuses on medication adherence, nutrition, symptom management, and psychological support.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
HIV.pptx
1. HIV : AETIOLOGY AND
CLINICAL FEATURES
PRESENTOR :- Dr. Rajesh sai , 1st year Resident
MODERATOR :- Dr. Pratima , Professor
DEPARTMENT OF PEDIATRICS
2. INTRODUCTION
There has been an estimated 70% decline in new infections in children aged
0-14 yr, largely the result of antiretroviral treatment (ART) of HIV-infected
pregnant women for the prevention of mother-to-child transmission.
Seventy percent of adults and children with HIV infection live in sub-Saharan
Africa, where the disease continues to have a devastating impact.
Children experience more rapid disease progression than adults, with up to
half of untreated children dying within the first 2 yr of life.
This rapid progression is correlated with a higher viral burden and faster
depletion of infected CD4 lymphocytes in infants and children than in adults.
Accurate diagnostic tests and the early initiation of potent drugs to inhibit
HIV replication have dramatically increased the ability to prevent and control
this disease.
3. ETIOLOGY
VIRAL CHARACTERISTICS:-
HIV-1 and HIV-2 are members of the Retroviridae family and belong to
the Lentivirus genus
The HIV-1 genome contains two copies of single-stranded RNA that is
9.2 kb in size
RNA is enclosed in a capsid. Matrix is outside of the capsid
HIV has a bilayer phospholipid membrane
with two proteins
gp120 – involved in attachment to CD4
receptor
gp41- involved in fusion of cellular proteins
Each RNA copy has a reverse transcriptase enzyme
4. HIV GENOME
At both ends of the genome there are identical regions, called LTR
(long terminal repeats), which contain the regulation and expression
genes of HIV.
The remainder of the genome includes three major sections:
GAG region, which encodes the viral core proteins
p24 - capsid protein: CA
p17- matrix protein: MA
p9 and p6- which are derived from the precursor p55
POL region, which encodes the viral enzymes
reverse transcriptase [p51],
protease [p10]
integrase [p32])
5. HIV GENOME (CONTD….)
ENV region, which encodes the viral envelope proteins
gp120 and gp41, which are derived from the precursor gp160.
Gp120 carries highly variable V3 loop proteins an is involved in
forming neutralizing antibodies
Antibodies against gp41 are used in diagnosis of HIV
6. Viral entry receptors
The most important receptor is CD4
HIV is also known as CD4 positive tropism
CD4+ cells are found on CD4+ T cells, CD4+ macrophages and
CD4+ microglial cells
Other receptors include
Co receptors
CXCR4 – coreceptor in lymphocytes
CCR5 – beta chemokine receptor involved in HIV entry in
macrophages
Other receptors include Antibodies, Complement receptors and
direct cell to cell transmission of HIV
7. How does HIV infect the cells?
Gp120 binds to the CD4 receptor when HIV approaches the host cell
After viral attachment, the gp120 and CD4 molecule undergo
conformational changes
Gp41 will then interact with the peptide receptor . It is then involved in the
initial entry of a cell(attachment of HIV is started
gp120 binds to CD4 receptor
Induces conformational changes in gp120
Also binds to coreceptors
Gp 41 interacts with peptide receptors
Initial entry of cell (Attachment)
8. After attachment of the cell endocytosis of the cell in clathrin
coated compounds will happen
Removal of protein envelope by use of proteases will happen
Free viral RNA will be released
Reverse transcriptase enzyme will then form a single stranded copy
of DNA and the ds DNA
This ds DNA will enter the cell and get
integrated into the host cell.
This structure is called a provirus
This provirus become active and starts
producing viral RNA copies
These RNA copies will be released from
the cell by budding,leading to infection,
,transmission and further spread
9.
10. HIV 2 vs HIV 1
HIV 2 does not have Vpu gene . Instead the Vpx gene is present.
The vpu gene in HIV 1 is involved in viral particle release and
immune regulation
HIV 2 has a long asymptomatic period
Lower CD4+ T cell cont
HIV 2 is less prevalent in pediatric population
Less mother to child transmission rates are seen in HIV 2
11. Transmission
There are 3 modes of transmission in pediatric HIV
1. Sexual contact transmission – in adolescenece
2. Blood product related – 2 to 6 % transmission
3. Vertical transmission
It is also called mother to child transmission (MTCT) or parent to
child transmission(PTCT)
It is the most important mechanism of transmission
It can happen during intrauterine life seen in about 20 – 30% of all
vertical transmission , and is most commo in late pregnancy
12. It can happen during intrapartum period, 70% of vertical
transmission
It can happen via postpartum transmission which can occur via
breast feeding
This route is negligible in western countries
In developing countries , the postpartum route accounts for about
20 – 40% of all transmissions
The overall transmission rate via vertical transmission of HIV is
In western countries it is 12 – 30 %
In developing countries like asia and Africa it is upto 50%
13. RISK FACTORS FOR VERTICAL TRANSMISSION
High maternal viral load (most important)
In the case of preterm delivery , the risk of vertical transmission is more
The babies of low birth weight
Prolonged rupture of membranes lasting for >4 hours
Low CD4+ cell count in the mother
Elective LSCS decreases transmission by 87% if used with zidovudine
therapy in the mother and infant
However , the additional benefit of LSCS appears negligible if the
mothers viral load is <1000 copies/ml
14. Clinical patterns of HIV
Three clinical patterns of HIV disease have been described in children
1. Rapid progressors or rapid disease course (15–25%):
In these, the onset of AIDS occurs within the first few months of life
with a median survival time of 6–9 months (if left untreated).
OIs and neurological manifestations are common.
In resource-poor countries, most of HIVinfected newborns will have this
rapidly progressing disease.
2. Short-term progressors or slower progression (60–80%):
Majority of those infected perinatally (intra partum) have a
median survival time of 6 years with slower progression
HIV related illnesses develop by 3–4 years progressing to AIDS by 6–7 years
They present clinically with recurrent bacterial infections, failure to thrive and
lymphoid interstitial pneumonitis (LIP)
15. 3. Long-term progressors or long-term survivors (<5%):
Few of those perinatally infected have minimal or no progression
of disease with relatively normal CD4 counts and very low viral
loads for longer than 8 years.
Possible mechanisms for this delay in disease manifestations
include effective humoral immunity and/or cytotoxic T lymphocytic
responses, host genetic factors, and infection with attenuated or
defective virus.
16. CLINICAL MANIFESTATIONS
In most infants, physical examination at birth is normal.
Initial symptoms may be subtle, such as lymphadenopathy and
hepatosplenomegaly, or nonspecific, such as failure to thrive, chronic
or recurrent diarrhea, respiratory symptoms, or oral thrush and may be
distinguishable only by their persistence.
Whereas systemic and pulmonary findings are common in the United
States and Europe, chronic diarrhea, pneumonia, wasting, and severe
malnutrition predominate in Africa.
Clinical manifestations found more commonly in children than adults
with HIV infection include recurrent bacterial infections, chronic
parotid swelling, lymphocytic interstitial pneumonitis (LIP), and early
onset of progressive neurologic deterioration
Chronic parotid swelling and LIP are associated with a slower
progression of disease.
17. The CDC Surveillance Case Definition for HIV infection is based on
the age-specific CD4+ T-lymphocyte count or the CD4+ T-
lymphocyte percentage of total lymphocytes except when a stage 3–
defining opportunistic illness supersedes the CD4 data.
Age adjustment of the absolute CD4 count is necessary because
counts that are relatively high in normal infants decline steadily until
age 6 yr, when they reach adult norms.
The CD4 count takes precedence over the CD4 T-lymphocyte
percentage, and the percentage is considered only if the count is
unavailable.
18.
19. INFECTIONS
Approximately 20% of AIDS-defining illnesses in children are recurrent bacterial
infections caused primarily by encapsulated organisms such as Streptococcus
pneumoniae and Salmonella as a result of disturbances in humoral immunity.
Other pathogens, including Staphylococcus, Enterococcus, Pseudomonas
aeruginosa, and Haemophilus influenzae, and other Gram-positive and Gram-
negative organisms may also be seen.
The most common serious infections in HIV-infected children are bacteremia,
sepsis, and bacterial pneumonia, accounting for more than 50% of infections in
these patients.
Meningitis, urinary tract infections, deep-seated abscesses, and bone/joint
infections occur less frequently.
Milder recurrent infections, such as otitis media, sinusitis, and skin and soft
tissue infections, are very common and may be chronic with atypical
presentations.
20. OPPORTUNISTIC INFECTIONS
Opportunistic infections are generally seen in children with severe depression
of the CD4 count.
Young children generally have primary infection and often have a more
fulminant course of disease reflecting the lack of prior immunity
In addition, infants < 1 yr of age have a higher incidence of developing stage
3–defining opportunistic infections and mortality rates compared with older
children and adults even at higher CD4 counts, reflecting that the CD4 count
may overpredict the immune competence in young infants.
The peak incidence of Pneumocystis pneumonia occurs at age 3-6 mo in the
setting of undiagnosed perinatally acquired disease, with the highest
mortality rate in children younger than 1 yr of age.
Aggressive approaches to treatment have improved the outcome
substantially. Although the overall incidence of opportunistic infections has
markedly declined since the era of combination antiretroviral therapy
21.
22.
23.
24.
25. ORGAN SPECIFIC MANIFESTATIONS
RESPIRATORY TRACT
Recurrent upper and lower respiratory tract infections (pneumonia)
are common, and complications like invasive sinusitis and mastoiditis
may also occur.
Bronchiectasis with recurrent secondary infections may be seen
Besides PCP, pathogens like viruses (CMV) and fungi (Aspergillus,
Histoplasma, or Cryptococcus), can be the causes
Pulmonary and extra-pulmonary tuberculosis is an important
association.
Lymphoid interstitial pneumonitis (LIP) can occur in up to 25% of HIV-
infected children.
LIP is a chronic process with progressive alveolar capillary block
26. Clinically, LIP manifests with insidious onset of cough, tachypnea,
clubbing and hypoxia with minimal rales or normal auscultatory
findings.
Hepatosplenomegaly, lymphadenopathy and parotid enlargement
may occur.
Chest radiograph shows chronic diffuse reticulonodular pattern
with hilar lymphadenopathy.
Presumptive diagnosis is based on clinical and radiological
manifestations and lung biopsy is diagnostic.
The hypoxia resolves with oral corticosteroids
27. CENTRAL NERVOUS SYSTEM
HIV is a neurotropic virus leading to primary CNS involvement.
Neurological manifestations can be caused by the HIV itself, OIs,
tumors or drugs.
The manifestations vary and range from developmental delay to
progressive encephalopathy with loss or arrest of developmental
milestones, impaired brain growth (acquired microcephaly),
symmetric motor dysfunction, marked apathy, spasticity, hyper-
reflexia, abnormal plantar reflex, gait disturbance, loss of language
or motor skills, neuropsychiatric manifestations, etc.
Older patients can have scholastic backwardness, cognitive
deterioration, behavioral problems and learning disabilities
28. Neuroimaging reveals cerebral atrophy, increased ventricular size,
basal ganglia calcifications, leukomalacia, etc.
HIV encephalopathy needs early initiation of treatment with highly
active anti-retroviral therapy (HAART) with drugs penetrating well in
the CNS (zidovudine, stavudine, and efavirenz).
Focal neurologic signs and seizures are may imply a co-morbid
pathologic process (CNS tumor, OI or stroke).
29. GASTROINTESTINAL AND HEPATIC MANIFESTATIONS
Candidiasis, periodontal disease, salivary gland disease, oral hairy
leukoplakia and oral ulcerations can occur.
Chronic or recurrent diarrhea with malabsorption, abdominal pain,
dysphagia, and failure to thrive are common symptoms of
gastrointestinal disease.
Gastrointestinal disease can be caused by bacteria (Salmonella,
Campylobacter, Mycobacterium Avium Intracellulare— MAC),
protozoa (Giardia, Cryptosporidium, Isospora, microsporidia), viruses
(CMV, HSV, rotavirus), or fungi (Candida).
Infections may be localized or disseminated.
HIV or AIDS enteropathy is the syndrome of malabsorption with
partial villous atrophy which is not associated with a specific
pathogen and has been postulated to be a result of direct HIV
infection of the gut
30. Disaccharide intolerance is common in those with chronic diarrhea.
Hepatomegaly is common(viral replication in reticuloendothelial
system).
Fluctuating serum levels of transaminases with or without
cholestasis is common.
Anti-retroviral drugs used for the treatment of OIs (like
antitubercular therapy) can also cause elevation of liver
transaminases.
Chronic hepatitis can be caused by CMV, hepatitis B or C, or MAC
and may lead to portal hypertension or hepatic failure.
Pancreatitis may occur due to drug therapy (pentamidine,
lamivudine) or OIs (MAC or CMV).
31. CARDIOVASCULAR SYSTEM
Usually the cardiac involvement is clinically silent.
Dilated cardiomyopathy, left ventricular hypertrophy, pulmonary
hypertension and congestive cardiac failure can occur.
Resting sinus tachycardia or sinus arrhythmia, pericardial effusion,
cardiac tamponade, conduction disturbances, nonbacterial thrombotic
endocarditis, and sudden death may be seen.
Electrocardiography and echocardiography are helpful in assessing
cardiac function.
Supportive treatment is required (diuretics, vasodilators and
inotropes).
32. RENAL DISEASE
Nephropathy is an unusual presenting symptom of HIV infection.
Renal disease can occur due to HIV infection of epithelial cells,
immune-complex mediated, OIs, hyperviscosity (hyperglobulinemia) or
use of nephrotoxic drugs.
Focal glomerulosclerosis (80%) progressing to renal failure in 6–9
months, mesangial hyperplasia (10–15%), segmental necrotizing
glomerulonephritis and minimal change disease may be seen.
Polyuria, oliguria, hematuria and acute renal failure have also been
seen.
Nephrotic syndrome is the most common manifestation of pediatric
renal HIV disease.
Cases resistant to steroid therapy can be candidates for cyclosporine
therapy.
33. DERMATOLOGICAL DISORDERS
Cutaneous manifestations seen in HIV-infected children are
inflammatory or infectious disorders which are not necessarily unique
to HIV infection.
The disorders tend to be more disseminated and respond less
consistently to conventional therapy.
Seborrheic dermatitis, severe eczema, recurrent or chronic episodes of
HSV, herpes zoster, molluscum contagiosum, anogenital warts,
candidial infections, tinea, onychomycosis, impetigo and scabies are
common.
34. HEMATOLOGICAL DISORDERS
Anemia is frequent (20– 70%) and can be due to chronic infection,
inadequate nutrition (folic acid, vitamin B12 or micronutrient
deficiency), autoimmune factors, virus-associated conditions
(hemophagocytic syndrome or parvovirus B19 red cell aplasia), and
bone marrow suppression or due to adverse effect of drugs
(zidovudine).
In those with low erythropoietin levels, subcutaneous recombinant
erythropoietin may be useful
Leukopenia occurs in almost one-third of untreated cases (and
neutropenia often occurs).
If anti-neutrophil antibodies are the cause, treatment with
intravenous immunoglobulin (IVIG) is useful.
Many drugs used for treatment or OI prophylaxis or anti-retroviral
drugs (zidovudine) may also cause leucopenia or neutropenia
35. Treatment with subcutaneous granulocyte colony-stimulating factor
can be used.
Thrombocytopenia may occur in up to 20% of patients. It may be
immunologic (i.e. circulating immune complexes or antiplatelet
antibodies), or due to drug toxicity or idiopathic. Treatment with IVIG
or anti-D offers some improvement.
If ineffective, a 2–3 days course of high-dose steroids is an
alternative.
ART can also reverse the thrombocytopenia
Patients are predisposed for thrombosis due to hyperviscosity (due
to hypergammaglobulinemia) as well as protein C and protein S
deficiency
Clinical disease due to venous or arterial thrombosis is rare.
36. MALIGNANCIES
As compared to adults, malignant diseases are uncommon in children.
Non-Hodgkin lymphoma and primary CNS lymphoma are known to
occur.
Epstein-Barr virus is associated with most lymphomas.
Kaposi sarcoma (caused by human herpesvirus 8) is very rare in HIV-
infected children.
OTHER ORGAN INVOLVEMENT
HIV-arthropathy, myopathy, rheumatologic, endocrine and metabolic
disorders may also be seen.