HIV - Aids

-what is HIV ?
-Etiology & Structure
-Difference between HIV1 & HIV2
-Transmission
-Risk Factors
-symptoms of HIV in children
-parthenogenesis of HIV
-stages of HIV with symptoms
-testing of HIV
-Diagnosis
-Epidemiology
-Treatment
-control and prevention

Transcript

3. WHAT IS HIV ?? WHAT IS HIV ??
4. WHAT IS HIV ?? WHAT IS HIV ?? HIV infection is condition caused by Human HIV infection is condition caused by Human Imuunodeficiency Viruse (HIV) Imuunodeficiency Viruse (HIV) A unique type of virus (Retrovirus ) A unique type of virus (Retrovirus ) This condition gradually destroys the immune system This condition gradually destroys the immune system which makes it hard for the body to fight infections. which makes it hard for the body to fight infections. It causes acquired immunodeficiency virus (ADIS) It causes acquired immunodeficiency virus (ADIS) Threatening a global epidemic Threatening a global epidemic Preventable , managable but Preventable , managable but NOT NOT curable . curable .
5. Other Names For HIV Other Names For HIV Former names of the virus include Former names of the virus include: : Human T cell lymphotrophic virus Human T cell lymphotrophic virus (HTLV-III) (HTLV-III) Lymphadenopathy associated virus (LAV) Lymphadenopathy associated virus (LAV) AIDS associated retrovirus (ARV) AIDS associated retrovirus (ARV)
6. History Of HIV History Of HIV It is now thought that HIV came from It is now thought that HIV came from similar virus found in chimpanzees - SIV. similar virus found in chimpanzees - SIV.
7. HIV probably entered the United States HIV probably entered the United States around 1970 around 1970 CDC in 1981 noticed unusual clusters of CDC in 1981 noticed unusual clusters of Kaposi’s sarcoma in gay men in NY and Kaposi’s sarcoma in gay men in NY and San Francisco, which led to the disease to San Francisco, which led to the disease to be called GRID (Gay Related Immune be called GRID (Gay Related Immune Deficiency). Deficiency).
8. By 1982 the disease was apparent in By 1982 the disease was apparent in heterosexuals and was renamed AIDS heterosexuals and was renamed AIDS (Acquired Immune Deficiency). (Acquired Immune Deficiency). 1984- Scientists identify HIV (initially called 1984- Scientists identify HIV (initially called HTLV-III or LAV) as the cause of AIDS HTLV-III or LAV) as the cause of AIDS 1987- AZT is the first drug approved for 1987- AZT is the first drug approved for treating AIDS treating AIDS
9. Etiology & Structure Etiology & Structure Causative agent : Human Immuno – Causative agent : Human Immuno – deficiency Virus. deficiency Virus.
10. Enveloped RNA retrovirus Enveloped RNA retrovirus Spherical 120 nm in diameter envelope proteins Spherical 120 nm in diameter envelope proteins make the spikes on the membrane make the spikes on the membrane Enveloped truncated conical capsid Enveloped truncated conical capsid Electron dense core Electron dense core Two copies of the single stranded (+) RNA Two copies of the single stranded (+) RNA Has enzymes: Reverse transcriptase, Integrase & Has enzymes: Reverse transcriptase, Integrase & Protease Protease Has LTR (long terminal repeats) and neg regulatory Has LTR (long terminal repeats) and neg regulatory genes genes HIV virus HIV virus Structure of Structure of
11. HIV-2 is lower transmissibility HIV-2 is lower transmissibility HIV-2 develops more slowly. HIV-2 develops more slowly. MTCT MTCT ( (Mother to child transmission Mother to child transmission) ) is relatively rare with HIV-2. is relatively rare with HIV-2. HIV-2 is found primarily in West Africa HIV-2 is found primarily in West Africa HIV-1 is more common worldwide. HIV-1 is more common worldwide. Difference between Difference between HIV1 & HIV2 HIV1 & HIV2
12. Is HIV and AIDS Is HIV and AIDS the same thing? the same thing?
13. “Human Immunodeficiency Syndrome” “Human Immunodeficiency Syndrome” A specific type of virus (a retrovirus) A specific type of virus (a retrovirus) HIV invades the helper T cells to replicate HIV invades the helper T cells to replicate itself. itself. No Cure No Cure HIV HIV
14. Acquired Immunodeficiency Syndrome Acquired Immunodeficiency Syndrome HIV is the virus that causes AIDS HIV is the virus that causes AIDS Disease limits the body’s ability to fight Disease limits the body’s ability to fight infection infection A person with AIDS has a very weak immune A person with AIDS has a very weak immune system system No Cure No Cure Aids Aids
15. Through Body Fluids : Through Body Fluids : Blood products Blood products Semen Semen Vaginal fluids Vaginal fluids Breast Milk Breast Milk Transmission Transmission
16. Sharing Needles Without sterilization Sharing Needles Without sterilization increases the chances of having HIV increases the chances of having HIV Unsterilized blades Unsterilized blades Through sex (oral ,anal ..) Through sex (oral ,anal ..)
17. Mother to baby: Mother to baby: Before birth Before birth During Birth During Birth Postpartum (after birth ) Postpartum (after birth ) If mother is HIV positive, 100% of children If mother is HIV positive, 100% of children will test positive at birth will test positive at birth Breast feeding increases transmission rate Breast feeding increases transmission rate
18. HIV cant be transmitted HIV cant be transmitted through : through : Toilet Toilet Sharing Utensils Sharing Utensils Mosquito Mosquito
20. Anyone of any age, race, sex or sexual orientation Anyone of any age, race, sex or sexual orientation can be infected with HIV, but you're at greatest can be infected with HIV, but you're at greatest risk of HIV/AIDS if you: risk of HIV/AIDS if you: Have unprotected sex with multiple partners. Have unprotected sex with multiple partners. You're at risk whether you're heterosexual, You're at risk whether you're heterosexual, homosexual or bisexual. homosexual or bisexual. (do not use (do not use condoms condoms). ). Risk Factors Risk Factors
21. a man who has sex with other men a man who has sex with other men Have unprotected sex with someone who is HIV- Have unprotected sex with someone who is HIV- positive positive Have another sexually transmitted disease, such Have another sexually transmitted disease, such as syphilis, herpes, chlamydia, gonorrhea or as syphilis, herpes, chlamydia, gonorrhea or bacterial vaginosis. bacterial vaginosis. People who People who inject drugs inject drugs or or steroids, especially if they steroids, especially if they share needles. share needles. Babies who are born to mothers who are Babies who are born to mothers who are infected with HIV. infected with HIV.
22. children children in in HIV HIV Symptoms of Symptoms of
23. Symptoms of HIV in children Symptoms of HIV in children Symptoms of HIV in children: Symptoms of HIV in children: Children who are HIV-positive may Children who are HIV-positive may experience experience Difficulty gaining weight Difficulty gaining weight Problems walking Problems walking Delayed mental development Delayed mental development Severe forms of common childhood illnesses Severe forms of common childhood illnesses such as ear infections (otitis media), such as ear infections (otitis media), pneumonia and tonsillitis pneumonia and tonsillitis
24. Pathogenesis of Pathogenesis of HIV HIV
26. HIV infects CD-4 positive cell HIV infects CD-4 positive cell Entry into cell by fusion requires gp41 and Entry into cell by fusion requires gp41 and coreceptors coreceptors Envelope lost and RNA uncoated Envelope lost and RNA uncoated DNA made from RNA using reverse Transcriptase DNA made from RNA using reverse Transcriptase DNA and Integrase migrate to nucleus forming DNA and Integrase migrate to nucleus forming a provirus by integrating viral DNA to host DNA a provirus by integrating viral DNA to host DNA
27. Rate of viral replication regulated by the activity of Rate of viral replication regulated by the activity of regulatory proteins (tat/rev, nef, etc) regulatory proteins (tat/rev, nef, etc) Co-infections (e.g., mycobacterial) stimulate the HIV- Co-infections (e.g., mycobacterial) stimulate the HIV- infected cells to produce more virus infected cells to produce more virus Transcription and translation produces necessary Transcription and translation produces necessary polyprotiens which are cleaved by the HIV protease polyprotiens which are cleaved by the HIV protease Assembly Assembly Maturation/release of virus Maturation/release of virus
28. Stages of HIV Stages of HIV With its symptoms With its symptoms
29. Stage 1: Stage 1: Primary HIV Infection Primary HIV Infection The first stage is called The first stage is called acute infection. acute infection. It is often accompanied by It is often accompanied by a short flu-like a short flu-like illness illness It typically happens within It typically happens within 2 2 to to 6 6 weeks weeks after exposure or becoming infected. after exposure or becoming infected. During this stage there is a large amount of During this stage there is a large amount of HIV in the peripheral blood and the immune HIV in the peripheral blood and the immune system begins to respond to the virus by system begins to respond to the virus by producing HIV antibodies. This process is producing HIV antibodies. This process is known as ( known as (seroconversion). seroconversion).
30. The symptoms of HIV The symptoms of HIV infection for stage 1 infection for stage 1 Fever Headache Sore throat Diarrhea that lasts for more than a week Fatigue vomiting
31. Stage 2: Stage 2: Clinically Asymptomatic Stage Clinically Asymptomatic Stage This stage lasts for an average of This stage lasts for an average of ten years ten years During this period During this period without symptoms without symptoms, HIV is slowly , HIV is slowly killing the CD4 T-cells and destroying the immune killing the CD4 T-cells and destroying the immune system. system. Blood tests during this time can reveal the number Blood tests during this time can reveal the number of these CD4 T-cells. For an HIV-infected person, of these CD4 T-cells. For an HIV-infected person, the number of CD4 T-cells steadily drops the number of CD4 T-cells steadily drops No clear symptoms appear * No clear symptoms appear *
32. Stage 3: Stage 3: Symptomatic HIV Infection Symptomatic HIV Infection AIDS (acquired immune deficiency AIDS (acquired immune deficiency syndrome) is the advanced stage of HIV syndrome) is the advanced stage of HIV infection. When the CD4 T-cell number infection. When the CD4 T-cell number drops below 200, people are diagnosed drops below 200, people are diagnosed with AIDS. with AIDS.
33. The symptoms of stage 3 The symptoms of stage 3 Being Being tired tired all of the time. all of the time. Swollen lymph nodes Swollen lymph nodes in the neck . in the neck . Fever Fever lasting for more than 10 days. lasting for more than 10 days. Night sweats. Night sweats. Unexplained Unexplained weight loss. weight loss. Purplish Purplish spots on the skin spots on the skin that don't go that don't go away. away. Shortness of breath. Shortness of breath. Severe, long-lasting Severe, long-lasting diarrhea. diarrhea.
34. Infections associated with AIDS Infections associated with AIDS HIV infected person at risk for HIV infected person at risk for infections infections. . The following diseases The following diseases are are predictive predictive of the of the progression to progression to AIDS AIDS: :
35. Oral Candidiasis (thrush) Oral Candidiasis (thrush)
36. Oral Hairy Leukoplakia Oral Hairy Leukoplakia Being that HIV reduces Being that HIV reduces immunologic activity, the immunologic activity, the intraoral environment is a intraoral environment is a prime target for chronic prime target for chronic secondary infections and secondary infections and inflammatory processes, inflammatory processes, including OHL, which is due including OHL, which is due to the Epstein-Barr virus to the Epstein-Barr virus under immunosuppressed under immunosuppressed conditions conditions
37. Kaposi’s sarcoma (KS) Kaposi’s sarcoma (KS) Kaposi’s sarcoma Kaposi’s sarcoma (shown) is a rare cancer (shown) is a rare cancer of the blood vessels that of the blood vessels that is associated with HIV. It is associated with HIV. It manifests as bluish-red manifests as bluish-red oval-shaped patches that oval-shaped patches that may eventually become may eventually become thickened. Lesions may thickened. Lesions may appear singly or in appear singly or in clusters. clusters.
38. Testing Options for HIV Testing Options for HIV
39. No name is used No name is used Unique identifying Unique identifying number number Results issued only Results issued only to test recipient to test recipient Anonymous Testing Anonymous Testing 23659874515 Anonymous
40. Confidential Testing Confidential Testing Person’s name is recorded along with HIV Person’s name is recorded along with HIV results. results. -Name and positive results are reported to the -Name and positive results are reported to the State Department and the Centers for State Department and the Centers for Disease Control and Prevention Disease Control and Prevention Results issued only to test recipient Results issued only to test recipient
41. Oral Testing Oral Testing Orasure: Orasure: The only FDA approved The only FDA approved HIV antibody. HIV antibody. As accurate as blood As accurate as blood testingDraws blood- testingDraws blood- derived derived fluids from the gum fluids from the gum tissue. tissue. NOT A SALIVA TEST! NOT A SALIVA TEST!
42. Diagnosis Diagnosis
43. The HIV Test The HIV Test Enzyme-linked Enzyme-linked immunosorbent assay immunosorbent assay (ELISA). (ELISA). This test is usually the first This test is usually the first one used to detect infection one used to detect infection with HIV. If antibodies to with HIV. If antibodies to HIV are present (positive), HIV are present (positive), the test is usually repeated the test is usually repeated to confirm the diagnosis. to confirm the diagnosis.
44. Expensive – $ 80 – 100 Expensive – $ 80 – 100 technically more difficult technically more difficult visual interpretation visual interpretation lack standardisation lack standardisation - performance - performance – – - interpretation - interpretation – – - indeterminate reactions – - indeterminate reactions – resolution of ?? resolution of ?? ‘Gold Standard’ for confirmation ‘Gold Standard’ for confirmation Western Blot Western Blot
45. Polymerase chain reaction (PCR). Polymerase chain reaction (PCR). This test finds either the RNA of the HIV virus This test finds either the RNA of the HIV virus or the HIV DNA in white blood cells infected or the HIV DNA in white blood cells infected with the virus. with the virus.
46. If you receive a diagnosis of HIV/AIDS, several types of tests can help your doctor determine what stage of the disease you : have. These tests include CD4 count. CD4 count. - - CD4 cells are a type of white blood cell that's specifically CD4 cells are a type of white blood cell that's specifically targeted and destroyed by HIV. targeted and destroyed by HIV. - - CD4 count vary from 500 to more than 1,000= healthy person CD4 count vary from 500 to more than 1,000= healthy person . . - - CD4 count becomes less than 200 =HIV infection progresses to CD4 count becomes less than 200 =HIV infection progresses to AIDS. AIDS. Viral load: Viral load: - - This test measures the amount of virus in your blood. This test measures the amount of virus in your blood.
47. Baby’s investigation of Baby’s investigation of HIV after birth HIV after birth Most HIV tests look for antibodies to HIV, not the Most HIV tests look for antibodies to HIV, not the virus itself. But these tests aren’t very useful for virus itself. But these tests aren’t very useful for babies born to HIV-positive mothers. babies born to HIV-positive mothers. WHY ? WHY ? That’s because the mother’s HIV antibodies That’s because the mother’s HIV antibodies get into the baby’s blood during pregnancy. get into the baby’s blood during pregnancy. If the mother is HIV-positive, the regular If the mother is HIV-positive, the regular HIV test will show that the baby is HIV- HIV test will show that the baby is HIV- positive, even when that isn’t true. positive, even when that isn’t true.
48. Epidem iology
49. Epidemiology Epidemiology Zimbabwe is Zimbabwe is one of the five one of the five countries hardest countries hardest hit by hit by HIV HIV and and AIDS AIDS globally. One in five globally. One in five Zimbabwean adults were living Zimbabwean adults were living with HIV and AIDS in 2009 while with HIV and AIDS in 2009 while approximately approximately 66,073 people died 66,073 people died of AIDS related causes of AIDS related causes. . It is estimated that It is estimated that 343,460 adults 343,460 adults are in need of are in need of Anti-Retroviral Anti-Retroviral Therapy Therapy (ART). (ART).
51. Treatment
52. Treatment Treatment Anti-retroviral medicines Anti-retroviral medicines work by stopping the HIV from work by stopping the HIV from making copies of itself . making copies of itself . - To strengthen the immune system. - To strengthen the immune system. - - The amount of virus in your body (viral load) is decreased. The amount of virus in your body (viral load) is decreased. - - Allows your body to make more CD4 T cells. Allows your body to make more CD4 T cells. Commonly three different types of medicines are taken Commonly three different types of medicines are taken together. This is called together. This is called combination therapy combination therapy. And that helps . And that helps to prevent the virus from becoming resistant to the to prevent the virus from becoming resistant to the medicines. These medicines are usually medicines. These medicines are usually taken for life taken for life. .
53. The classes of anti-HIV The classes of anti-HIV : drugs include drugs include Non-nucleoside reverse transcriptase inhibitors (NNRTIs). Non-nucleoside reverse transcriptase inhibitors (NNRTIs). It disables a protein needed by HIV to make copies of itself. It disables a protein needed by HIV to make copies of itself. Nucleoside reverse transcriptase inhibitors (NRTIs). Nucleoside reverse transcriptase inhibitors (NRTIs). They are faulty versions of building blocks that HIV needs to They are faulty versions of building blocks that HIV needs to make copies of itself. make copies of itself. Protease inhibitors (PIs). Protease inhibitors (PIs). It disables protease, another protein that HIV needs to make It disables protease, another protein that HIV needs to make copies of itself. copies of itself.
54. Entry or fusion inhibitors. Entry or fusion inhibitors. These drugs block HIV's entry into CD4 cells. These drugs block HIV's entry into CD4 cells. Integrase inhibitors Integrase inhibitors Raltegravir (Isentress) works by disabling Raltegravir (Isentress) works by disabling integrase, a protein that HIV uses to insert its integrase, a protein that HIV uses to insert its genetic material into CD4 cells. genetic material into CD4 cells.
55. Will Health Will Health Insurance Pay for Insurance Pay for HIV treatment ? HIV treatment ? HIV is a disease that requires a lot of management HIV is a disease that requires a lot of management including doctor visits and treatments. including doctor visits and treatments. Fortunately, Fortunately, most major health insurance will cover most major health insurance will cover HIV treatment under normal circumstances. HIV treatment under normal circumstances. Unfortunately, Unfortunately, there are some exceptions that can there are some exceptions that can occur and some concerns of which you should occur and some concerns of which you should make yourself aware. make yourself aware.
56. Because HIV is a relatively new disease, a lot Because HIV is a relatively new disease, a lot of treatments and medications for it are still of treatments and medications for it are still experimental. For the most part, insurance experimental. For the most part, insurance companies are not required to cover companies are not required to cover experimental medications and treatments experimental medications and treatments for HIV. for HIV.
57. Control & Control & Prevention Prevention
58. • • I recommend the same therapies I recommend the same therapies for all humans with HIV. There is for all humans with HIV. There is no reason to believe that no reason to believe that physiologic responses to therapy physiologic responses to therapy will vary across lines of class, will vary across lines of class, culture, race or nationality. culture, race or nationality.
59. There's no vaccine to prevent HIV There's no vaccine to prevent HIV infection and no cure for AIDS. infection and no cure for AIDS. But it's possible to protect yourself and But it's possible to protect yourself and others from infection. others from infection. That means educating yourself about That means educating yourself about HIV and avoiding any behavior that HIV and avoiding any behavior that allows HIV-infected into your body. allows HIV-infected into your body.
60. If you're HIV-negative If you're HIV-negative Educate yourself and others. Educate yourself and others. Know the HIV status of any sexual partner. Know the HIV status of any sexual partner. Use a new condom every time you have sex. Use a new condom every time you have sex. Consider male circumcision. Consider male circumcision. Use a clean needle. Use a clean needle. Be cautious about blood products in certain Be cautious about blood products in certain countries. countries. Get regular screening tests. Get regular screening tests. Don't become complacent. Don't become complacent.
61. If you're HIV-positive If you're HIV-positive Follow safe-sex practices. Follow safe-sex practices. Tell your sexual partners you have HIV. Tell your sexual partners you have HIV. If your partner is pregnant, tell her you If your partner is pregnant, tell her you have HIV. have HIV. Tell others who need to know. Tell others who need to know. Don't share needles or syringes. Don't share needles or syringes. Don't donate blood or organs. Don't donate blood or organs. Don't share toothbrushes. Don't share toothbrushes. If you're pregnant, get medical care right If you're pregnant, get medical care right away. away.
62. Prevention by Prevention by Common Sense Common Sense ABC rule : ABC rule : Abstinence Abstinence Be faithful (one partner) Be faithful (one partner) Condom Condom
63. How to protect your baby How to protect your baby : from getting HIV from getting HIV Mother-to-child transmission of HIV Mother-to-child transmission of HIV can be prevented by using can be prevented by using antiretroviral antiretroviral drugs drugs, which reduce the chances of a , which reduce the chances of a child becoming infected with HIV from child becoming infected with HIV from 20% to less than 5%. 20% to less than 5%.
64. focused education efforts in high risk focused education efforts in high risk populations. populations. Prevention of Mother to Child Transmission Prevention of Mother to Child Transmission behavior change:(faithfulness to one partner) behavior change:(faithfulness to one partner) condom promotion condom promotion vaccine development vaccine development Blood Safety Blood Safety Support to People Living with HIV Support to People Living with HIV Prevention strategies is Prevention strategies is based on: based on:
66. TH THAN ANK K YO YOU U