1 BASIC FACTS ABOUT HIV/AIDS a presentation by CHUKUDUM WATCHERS.

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BASIC FACTS ABOUT HIV/AIDS

a presentation by

CHUKUDUM WATCHERS

Definitions HIV – Human Immunodeficiency Virus The virus which causes AIDS

SIV – Simian Immunodeficiency Virus Retrovirus found in numerous strains in primates; the

specific strains infecting humans are HIV-1 & HIV-2

AIDS – Acquired Immune Deficiency Syndrome

A collection of symptoms & signs of illnesses due to immune depletion

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Relationship of HIV & AIDS

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Types of HIV

HIV Type 1 HIV Type 2- Most predominant world wide- More virulent- Has subtypes M, N, O and P (M is most predominant)- Subtype M has strains A, B, C, D, F, G, H, J and K

- Mainly in West Africa

- Less easily transmitted

- Longer period from initial infection and onset of illness

HIV origin: the theories Hunter theory:

Most accepted theory. That SIV was transferred to humans after chimps being killed & eaten or their blood getting into hunters’ cuts/wounds

Oral Polio vaccine theory: Congo, Ruanda & Burundi in the late 1950s.

That the vaccine was cultivated using kidney cells of local chimps infected with SIV

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HIV origin: the theories Conspiracy theory: -HIV manufactured as a biological warfare

programme, to wipe out black & homosexual people.

-HIV was developed by the US as a weapon of germ warfare

-Right wing American groups blamed the Soviets for the AIDS epidemic.

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HIV origin: the theories Colonialism theory: Locals were forced into

labour camps where SIV could have infected them. They were inoculated with unsterile needles against diseases e.g. smallpox. Many camps employed prostitutes to keep workers happy

Heavenly theory: HIV came from an angry God who was unhappy with gays, IVDUs & promiscuity. Others believed that HIV came as a cosmic debris as part of the tail of a comet

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Origin of HIV/AIDS HIV is a zoonotic infection-resembles SIV Genetic analysis indicates HIV introduced into humans ~

1931 1959 serum sample from Congo HIV+ Here chimpanzees are kept as pets and butchered for food HIV 1st discovered in 1980s by Luc Montagnier (Paris);

Later in 1980s by Robert Gallo (US)

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Origin of HIV/AIDS No. of people who developed AIDS before

the 1980s are unknown First cases of AIDS recognized in early

1980s In 1984, 1st AIDS (‘slim disease’) case in

Uganda was reported

Modes of HIV transmission Sexual intercourse (heterosexual & same

sex; commonest mode of transmission) Mother to Child transmission (pregnancy,

labour, birth, breast feeding) Occupational exposure Blood products infusion Donor organ and tissue transplantation (Intravenous) Injection drug use

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Phase 1 Rapid spread through urban sexual

networks along major highways from its origin in the Lake Victoria region

The fight against HIV began only after the civil war in 1986. ACP set up in 1987

By this time Urban areas had prevalence rates of up to 29% .

HIV/AIDS trend in Uganda

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Phase 1 cont’d CBOs came up targeting education, HIV

prevention(ABC) & stigma reduction TASO was one of the first

Philly Bongoley Lutaaya (19 October 1951 – 15 December 1989), a Ugandan musician spent his life writing songs about his battle with AIDS; toured many places spreading messages of prevention & hope.


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Phase 2: 1992 to 2000 HIV prevalence fell dramatically, from about

15% in 1991 in adults to about 5% in 2001 Reason: Gov’t. ABC prevention campaign & the

high numbers of AIDS-related deaths Prevention initiatives continued through the

nineties with high levels of funding from both the gov’t & international donors e.g. World Bank

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Phase 3: 2000 to 2005 The third phase saw the stabilization of

HIV prevalence at 6.4%

Free ARV drugs were introduced in 2004

Funders included World Bank, Global Health, PEPFAR, CDC

HIV Prevalence & Incidence by Region

RegionTotal No. (% Living with HIV), 2011

Newly Infected, 2011

Adult Prevalence Rate, 2011

Global Total34.0 million (100%)

2.5 million 0.8%

Sub-Saharan Africa

23.5 million (69%)

1.8 million 4.9%

South/South-East Asia

4.0 million (12%)

280,000 0.3%

Eastern Europe/Central Asia

1.4 million (4%) 140,000 1.0%

Latin America 1.4 million (4%) 86,000 0.4%

North America 1.4 million (4%) 51,000 0.6%

Western/Central Europe

900,000 (3%) 30,000 0.2%

East Asia 830,000 (2%) 89,000 0.1%

Middle East/North Africa

300,000 (1%) 37,000 0.2%

Caribbean 230,000 (0.7%) 13,000 1.0%

Oceania 53,000 (0.2%) 2,900 0.3%

So, What happens when HIV enters the Human body?

1. Window Period Time from initial infection with HIV to time antibodies

are detectable (usually 3-8 weeks) Period varies between individuals & depends on the

test used 95% of people develop antibodies within 3-4 months HIV antibody tests may give negative results in an

infected person during this period Very high Viral Load Victim highly infectious

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2. Seroconversion The change from non-detectable antibody test

(Negative test) to detectable antibody levels (Positive test) is referred to as seroconversion

Seroconversion marks end of the window period Presents with unspecific symptoms e.g. fever, flu,

headache, general weakness, poor appetite, etc Symptoms short lived; patient improves in 2-4

weeks

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3. Development of Symptoms & Signs i.e.

Stage I Asymptomatic stage of HIV infection There may only be enlarged lymph nodes


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….when HIV enters the Human body

Stage IIMultiple symptoms and conditions e.g. Skin rash Herpes zoster Oral ulcers Fungal nail infections Recurrent Respiratory Tract Infections

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Stage IIIMultiple symptoms & conditions e.g. TB of the lungs Diarrhoea > a month Oral thrush >10% unintended weight loss Persistent fevers (unexplained) for > a month

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Stage IVMultiple symptoms and conditions e.g. Cancers like Kaposi’s sarcoma Oesophageal candidiasis Pneumocystis jiroveci pneumonia Cryptococcal meningitis TB outside the lungs

AND HOW WILL A PERSON WITHHIV/AIDS PRESENT CLINICALLY?

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MANIFESTATIONS OF HIV/AIDS

1. Manifestations due to Opportunistic Infections

2. Manifestations due to HIV/AIDS Associated Cancers

3. Manifestations due to Drugs used in treatment of HIV/AIDS

4. Other HIV/AIDS related conditions

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Fungal skin infections

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Oral thrush

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Oral Hairy Leukoplakia

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Angular Cheilitis (Candidiasis)

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Mixed Infections

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Herpes simplex virus

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Extensive H.S. infection of lips & nose

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Molluscum contagiosum


Molluscum contagiosum

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Herpes zooster39


Generalised itchySkin rash

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TB of the skin41


Herpes simplex genitalia

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HPV43

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HPV44

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Vaginal Candidiasis45


2. HIV/AIDS Associated Cancers

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Kaposi’s sarcoma: gum & legs affected

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Kaposi’s sarcoma: palate involvement

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Lymphoma


Squamous cell carcinoma of the eye

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Kaposi’s sarcoma

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3. Manifestations due to Drugs used in HIV/AIDS Treatment

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3. Manifestations due to drugs

Nevirapine rash

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Steven Johnson’sSyndrome

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Nevirapine side effects

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SevereAnaemia

of AZT

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Fat maldistribution (Stavudine induced)

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Loss of body fat(as with Protease

Inhibitors)

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4. Other HIV/AIDS Associated Conditions

4. Other HIV/AIDS Associated conditions

Psoriasis

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Eczema

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HIV wasting syndrome

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May God have mercy upon

mankind

1 BASIC FACTS ABOUT HIV/AIDS a presentation by CHUKUDUM WATCHERS.

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