Acquired Immune Deficiency Syndrome (aids)

Acquired Immune Deficiency Syndrome (AIDS)

AIDS 

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Means Acquired Immune Deficiency Syndrome. It is acquired, which means it is neither hereditary nor inborn. It involves immune deficiency It is a syndrome, a combination of signs and symptoms that form a district clinical picture of disorder

HIV 

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Refers to the Human Immunodeficiency Virus which causes AIDS. It is retrovirus It belongs to lentivirus,which is sometimes called “slow virus” The period between infection and the appearance of AIDS can take from 7 to 12 years.

Pathophysiology 

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Human beings produce antibodies against specific infections. When HIV infection takes place,anti-HIV antibodies are produced but they do not appear immediately. This is called the “window effect” In some cases, antibodies to HIV become detectable 4 to 6 weeks after infection.

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When HIV is in circulation, it invades several types of cells – the lymphocytes, macrophages, the Langerhans cells and neurons within the CNS. HIV attacks the body’s immune system. The organism attaches to a protein molecule called CD4 which is found in the surface of T4 cells. Once the virus enters the T4,it inserts its genetic materials into the T4 cell’s nucleus taking over the cell to replicate itself. Eventually the T4 cell dies after having been used to replicate HIV.

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The virus mutates rapidly making it more difficult for the body’s immune system to recognize the invaders. HIV infection progresses through several stages.

The Clinical course of HIV infection begins when a person becomes infected with HIV through:  

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Sexual contact with infected person Injection of infected blood or blood products Perinatal or vertical transmission

SIGNS AND SYMPTOMS

Minor Signs      

Persistent cough for one month Generalized pruritic dermamatitis Recurrent herpes zoster Oropharyngeal candidiasis Chronic disseminated herpes simplex Generalized lymphadenopathy

Major Signs  

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Loss of weight – 10 % of body weight Chronic diarrhea for more than one month Prolonged fever for one month

Common Opportunistic Infections      f. g. h.

Pneumocystis carinii pneumonia Oral candidiasis Toxoplasmosis of the CNS Chronic diarrhea/wasting syndrome Cancers Kaposi's sarcoma Cervical dysplasia and Cancer Non-Hodgkin’s lyphoma

Mode of Transmission  

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Sexual intercourse Blood transfusion and sharing of infected syringes and needles among intravenous drug users Vertical or perinatal transmission

Several Ways of Receiving Infect  

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Blood transfusion Sharing of unsterilized syringes and needles used for intravenous injections Transmission during pregnancy Organ donation Accidental exposure in hospitals or clinics

Diagnostic Examination 

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EIA or ELISA-enzyme link immunosorbent assay Particle agglutination (PA) test Western blot analysis-confirmatory diagnostic test Immunoflourescent test Radio immuno-precipitation assay (RIPA)

Treatment Modalities 

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AIDS drugs are medicines usec to treat but not to cure HIV infection. These drugs are sometimes reffered to as “anteroviral drugs”

Two groups of Anteroviral Drugs 1.Reverse Transcriptase Inhibitors-they inhibit the enzyme called reverses transcriptase which is needed to “copy” information for the virus to replicate.  These drugs are: c. Zedovudine (ZDV) Retirvir d. Zalcitabline Havid e. Stavudine Zeprit f. Lamivudine Epivir g. Nevirapine Viramune h. Didanosine Videx

2. Protease Inhibitors-they work by inhibiting the enzyme protease which are needed for the assembly of viral particles. These Drugs are: c. Saquinavir Invarase d. Ritonavir Norvir e. Indinavir Crixivan

Nursing Management  

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Health Education Practice Universal/standard precaution prevention

Four C’s in the Management of HIV/AIDS    

Compliance Counseling/education Contact tracing Condoms

The End