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Human Immunodeficiency Virus Eva L. Dizon,M.D. Pediatric Infectious Disease Microbiology Our Lady of Fatima University
OBJECTIVES ,[object Object],[object Object]
Specific Objectives: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology: ,[object Object],[object Object],[object Object],[object Object]
 
Epidemiology: HIV-1 (distributed worldwide) and HIV-2 (mainly endemic in west Africa) were first isolated and associated with the disease in 1982 and 1983. AIDS was first recognized in 1981, although retrospective studies suggest that cases occurred in Africa in the 1950's and in the U.S. by the 1970's.
 
 
 
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
The latest statistics of the global  HIV  and  AIDS  were published by UNAIDS in November 2009, and refer to the end of 2008. More than 25 million people have died of AIDS since 1981. Africa has over 14 million AIDS orphans. At the end of 2008, women accounted for 50% of all adults living with HIV worldwide In developing and transitional countries, 9.5 million people are in immediate need of life-saving AIDS drugs; of these, only 4 million (42%) are receiving the drugs. Estimate Range People living with HIV/AIDS in 2008 33.4 million 31.1-35.8 million Adults living with HIV/AIDS in 2008 31.3 million 29.2-33.7 million Women living with HIV/AIDS in 2008 15.7 million 14.2-17.2 million Children living with HIV/AIDS in 2008 2.1 million 1.2-2.9 million People newly infected with HIV in 2008 2.7 million 2.4-3.0 million Children newly infected with HIV in 2008 0.43 million 0.24-0.61 million AIDS deaths in 2008 2.0 million 1.7-2.4 million Child AIDS deaths in 2008 0.28 million 0.15-0.41 million
Remedios aids foundation
 
 
Transmission: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DOH Reported Modes of Transmission HIV/AIDS Registry, January 1984-July 2007 (N=2,916) Reported Modes of Transmission Jan. 1984- July 2007 July 2007 Heterosexual Contact 1,781 10 Homosexual Contact 567 9 Bisexual Contact 200 9 Blood/blood product 19 0 Injecting drug use 7 0 Needle prick injuries 3 0 Perinatal 44 0 No exposure reported 295 3 TOTAL 2,916 31
 
 
 
 
 
Pathogenesis: ,[object Object],[object Object],[object Object],3.Establishes a fulminant local infection within a few days, and then spreads quickly throughout the body.
 
 
 
 
 
Symptoms of acute retroviremia in HIV-infected patients Myalgia  lymphadenopathy  fever fatigue pharyngitis rash (often on trunk) nausia diarrhea loss of weight night sweats mucocutaneous ulcers headache In blood: lymphopenia
 
 
Disease associated with various levels of CD4 cells during HIV infection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
Stages of Disease ,[object Object],[object Object],[object Object],no symptoms, or any or all of the following "mononucleosis-like symptoms":  fever , headache ,  malaise , myalgia,  arthralgia  lymphadenopathy  hepatosplenomegaly  meningitis,  encephalitis rash -  small  pink papules or  macules over much of  the body
Stage II- Completely assymptomatic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stage III- Overt Disease ,[object Object]
 
Diagnosis Test ELISA Agglutination test Purpose Initial Screening test Western blot Immunofluorescence test Confirmatory test p24 antigen Virion RNA- RT PCR CD4 CD8 ratio Early marker of Infection Detection of a recent infection To confirm treatment efficacy Detection of recent infection  Staging the disease and to confirm treatment efficacy Viral Isolation
Opportunistic Infections ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Opportunistic infections ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Opportunistic infections ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment ,[object Object],[object Object],[object Object],[object Object]
Classes of Antiretroviral drugs ,[object Object],[object Object]
Classes of antiretroviral drugs ,[object Object],[object Object],[object Object],[object Object]
Classes of antiretroviral drugs ,[object Object]
 
 
PREVENTION ,[object Object],[object Object]
 
Manifestations: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
  In resource-poor countries and communities, sometimes medical facilities and testing is unavailable, and it isn’t possible to decide the appropriate time to begin treatment on the basis of test results. The World Health Organization has developed a disease staging system for HIV infection which is not dependent on testing. WHO disease staging system for HIV Infection and Disease in Adults and Adolescents Clinical Stage I:   Asymptomatic  Generalized lymphadenopathy  Performance scale 1: asymptomatic, normal activity Clinical Stage II: Weight loss, < 10% of body weight  Minor mucocutaneous manifestations (seborrheic dermatitis, prurigo, fungal nail infections, recurrent oral ulcerations, angular cheilitis)  Herpes zoster within the last five years
 
 

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Human immunodeficiency virus

  • 1. Human Immunodeficiency Virus Eva L. Dizon,M.D. Pediatric Infectious Disease Microbiology Our Lady of Fatima University
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  • 6. Epidemiology: HIV-1 (distributed worldwide) and HIV-2 (mainly endemic in west Africa) were first isolated and associated with the disease in 1982 and 1983. AIDS was first recognized in 1981, although retrospective studies suggest that cases occurred in Africa in the 1950's and in the U.S. by the 1970's.
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  • 12. The latest statistics of the global HIV and AIDS were published by UNAIDS in November 2009, and refer to the end of 2008. More than 25 million people have died of AIDS since 1981. Africa has over 14 million AIDS orphans. At the end of 2008, women accounted for 50% of all adults living with HIV worldwide In developing and transitional countries, 9.5 million people are in immediate need of life-saving AIDS drugs; of these, only 4 million (42%) are receiving the drugs. Estimate Range People living with HIV/AIDS in 2008 33.4 million 31.1-35.8 million Adults living with HIV/AIDS in 2008 31.3 million 29.2-33.7 million Women living with HIV/AIDS in 2008 15.7 million 14.2-17.2 million Children living with HIV/AIDS in 2008 2.1 million 1.2-2.9 million People newly infected with HIV in 2008 2.7 million 2.4-3.0 million Children newly infected with HIV in 2008 0.43 million 0.24-0.61 million AIDS deaths in 2008 2.0 million 1.7-2.4 million Child AIDS deaths in 2008 0.28 million 0.15-0.41 million
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  • 17. DOH Reported Modes of Transmission HIV/AIDS Registry, January 1984-July 2007 (N=2,916) Reported Modes of Transmission Jan. 1984- July 2007 July 2007 Heterosexual Contact 1,781 10 Homosexual Contact 567 9 Bisexual Contact 200 9 Blood/blood product 19 0 Injecting drug use 7 0 Needle prick injuries 3 0 Perinatal 44 0 No exposure reported 295 3 TOTAL 2,916 31
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  • 29. Symptoms of acute retroviremia in HIV-infected patients Myalgia lymphadenopathy fever fatigue pharyngitis rash (often on trunk) nausia diarrhea loss of weight night sweats mucocutaneous ulcers headache In blood: lymphopenia
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  • 40. Diagnosis Test ELISA Agglutination test Purpose Initial Screening test Western blot Immunofluorescence test Confirmatory test p24 antigen Virion RNA- RT PCR CD4 CD8 ratio Early marker of Infection Detection of a recent infection To confirm treatment efficacy Detection of recent infection Staging the disease and to confirm treatment efficacy Viral Isolation
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  • 55.   In resource-poor countries and communities, sometimes medical facilities and testing is unavailable, and it isn’t possible to decide the appropriate time to begin treatment on the basis of test results. The World Health Organization has developed a disease staging system for HIV infection which is not dependent on testing. WHO disease staging system for HIV Infection and Disease in Adults and Adolescents Clinical Stage I:   Asymptomatic Generalized lymphadenopathy Performance scale 1: asymptomatic, normal activity Clinical Stage II: Weight loss, < 10% of body weight Minor mucocutaneous manifestations (seborrheic dermatitis, prurigo, fungal nail infections, recurrent oral ulcerations, angular cheilitis) Herpes zoster within the last five years
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