Hiv Aids

Presented by:Dr.Anita Chaudhari Roll No : 2

INTRODUCTION

 AIDS---Acquired immuno deficiency syndrome(slim desease).  Fatal illness---caused by retro virus known as HIV.  It breaks down immune system of body.  Person once infected remains infected for lifetime.  AIDS refer to last stage of HIV infection.  It is a pendemic desease.

WHAT IS AIDS

 It is thusA  (acquired)     : got from others I   (immuno)      : body's defense system D (deficiency)   : not working properly S (syndrome)    : a group of symptoms

WHAT IS HIV HIV is:

 Human –

isolated to the human species

 Immuno -- Lacking ability to fight infectious agents Deficiency  Virus –

a disease causing agent

EPIDEMIOLOGICAL FEATURES Agent factors a.Agent—HIV is 1/10,000th of mm in dia.It has unique ability to destroy humanT4 helper cells,spreads throughout body & passes through blood brain barrier & can destroy brain cells. b.Reservoir of infection--- They are cases & carriers.Once infected virus remains in body lifelong. Symptomless HIV infected carrier can infect others. a.Source of infection---The virus is in greatest concentration in blood ,semen,and CSF.Lower conc. Detected in tears, saliva, breast milk, urine, cervical and vaginal secretions. Only blood and semen have been shown to transmit the virus

EPIDEMIOLOGICAL FEATURES Host factors a.Age—In sexually active persons of age group 20-49 years. b.Sex---Sexual practices like multiple partners, anal intercourse , male homosexuality,prostitution, increases risk. c. High risk group —male homosexuals & bisexuals, prostitutes , iv drug abusers, blood & blood product transfusion of HIV infected. d.Immunology —The virus reproduces and destroys WBC’s(T helper cells),thus reducing the immunity of the body.

MODE OF TRANSMISSION SEXUAL TRANSMISSION  Infected person’s blood, semen, are rich in HIV.  However tears, saliva, sweat, urine do not pose danger  Most easily by unprotected sexual intercourse.

MODE OF TRANSMISSION BLOOD CONTACT  Transfusion of infected blood or blood products . 

Use of infected needles & instruments without sterilization .

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Sharing of needles & syringes by HIV drug addicts .

MODE OF TRANSMISSION MATERNAL –FOETAL TRANSMISSION

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Infected mother to baby during pregnancy& through breast-feeding.

INCUBATION PERIOD 

Incubation period is uncertain.

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May range from few months to 6 years or more.

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Virus can lie silent in body for many years.

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It is estimated that 75% of infected with HIV develop AIDS by end of 10 years.

CLINICAL MANIFESTATION 1.

Initial infection — HIV infected have no symptom for first 5 years.Look healthy,feel well but can transmit the virus. 2. Asymptomatic carrier state--Infected people have antibodies but no signs of desease. 3. AIDS related complex--illness caused by damage to immune system show one or more clinical signs( diarrhoea,fever,loss of weight,cough,enlarge spleen,fatigue,G.weakness,etc.) 4. AIDS--End stage of HIV infection.No. of infections occur at this stage.Due to uncontrol infection.

CLINICAL DIAGNOSIS  Person is considered to have AIDS if 2 major signs are present with atleast 1minor signs. Major Signs-- Long standing, unexplained fever (more than1 month) .  Unexplained diarrhoea (more than 1 month)  Persistent unexplained fatigue & weight loss more than 5 kg within short period .

CLINICAL DIAGNOSIS Minor signs-- Persistent cough (more than1 month)  Generalised pruritic dermatitis  Oral candidiasis  History of herpes zosters  chronic herpes simplex infection

LABORATORY DIAGNOSIS SPOT TEST  This is simple rapid test for finding out HIV status.  Rarely chances of false positive report & hence positive report should be confirmed by doing ELISA test.

ELISA TEST  The infection can only be detected by doing blood test i.e. ELISA HIV antibody test.

WESTERN BLOT(WB) TEST  Specialized and costly confirmatory test for HIV.  Done to confirm positive ELISA or SPOT test report.

LABORATORY DIAGNOSIS

CD4 & VIRAL LOAD TESTING  Very costly tests & done only in affording patients who are willing to start anti-HIV (antiretroviral) drugs.  It is mandatory to do pre-test & post-test counseling of all patients before & after test respectively.

PREVENTION & CONTROL OF HIV HIV can be prevented by adopting simple measures:

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SAFE SEX –using condoms

SAFE BLOOD -uncontaminated

SAFE NEEDLES -sterilised

PREVENTION & CONTROL OF HIV  EDUCATION--- only means available for mass awareness  SAFE MOTHERHOOD HIV may pass from infected mother to foetus through placenta ,during delivery or by breast feeding.  SAFE RAZOR AND BLADE (not previously used)

EDUCATION TO PATIENTS

GENERAL CARE

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Sympathetic attitude, family and public support . Patient should be advised to take adequate rest & diet rich in proteins ,vitamins & avoid outside food. Patient should be advised not to donate blood or organ. Patient should be advised to use condom. Patient be encouraged to give up smoking, alcohol. Patient should drink boiled water ,do exercise or yoga

HOW HIV-- NOT TRANSMITTED

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No risk of contracting HIV infection in daily routine & by casual contact with HIV positive person. AIDS virus is not transmitted through:

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Embarrassing Touching hand shaking or hugging

HOW HIV-- NOT TRANSMITTED 

Sharing bathroom or toilet

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Coughing or sneezing

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Eating together or sharing utensils

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Swimming pools

HOW HIV--NOT TRANSMITTED

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Sharing clothes

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Mosquito bite, Insect bite or houseflies .

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Patient caring

ANTI RETROVIRAL TREATMENT SYMPTOMATIC TREATMENT Early treatment of common problems like fever, cough, diarrhoea etc. from family doctor .  Early treatment of opportunistic infections like TB etc.  SPECIFIC ANTI-RETROVIRAL TREATMENT HIV suppressants drugs should be used as there is no vaccine or cure available.(The drug should be as per Doctors  advice). For eg.  4 weeks  For accidental pricks - AZ3 200 mg tds + Lamivudin 150 mg bd for  ADVANCED AIDS — Nelfinavil 750 mg tds

+AZT