AIDS

What are HIV and AIDS? Human immunodeficiency virus. HIV is the virus that causes AIDS (acquired

immunodeficiency syndrome), a life-threatening disease.

Attacks the body's immune system. Destroys infection-fighting cells. When these cells are destroyed, the immune

system can no longer defend the body against infections and cancers.

HIV infection becomes AIDS when patient lose the ability to fight off serious infections or tumors.

These infections, called opportunistic infections, might not normally cause severe or fatal health problems.

If pregnant woman infected with HIV, baby may be infected by the virus before or during birth.

The baby can also get the virus from breast milk.

Babies who are infected may become very sick and die.

Without treatment, about one third of babies born to HIV-infected mothers become infected with the virus.

HIV should be tested at first prenatal visit. If infected with HIV, treatment can help

prevent spread of the infection to the baby.

Modes of transmission

How does HIV infection occur?

Unprotected sex with an infected partner Shared needles Contact with infected body fluids (for example,

blood, semen, or breast milk) Transfusion with infected blood. HIV can be passed to an unborn baby through

the placenta, by exposure to blood and body fluids during labor and at delivery, or through breast-feeding.

What are the symptoms?

Fever that lasts from a few days to longer than a month

Unexplained weight loss Loss of appetite Nausea and vomiting Tiredness Prolonged swelling of the lymph nodes Sore throat Long-lasting or multiple viral skin problems,

such as herpes sores or plantar warts

Swollen parts of the body

Deterioration of the body tissues

Repeated, severe yeast infections in mouth or vagina despite treatment

Chronic muscle and joint pain Diarrhea, especially if it lasts longer than a

month Headache Enlarged spleen and liver.

Life Cycle

HIV particles enter the body in a fluid as it can HIV particles enter the body in a fluid as it can not survive without a support medium.not survive without a support medium.

The virus targets any cell expressing CD4, The virus targets any cell expressing CD4, including T helper cells, macrophages, including T helper cells, macrophages, dendritic cells and monocytes.dendritic cells and monocytes.

HIV Life Cycle: Attachment HIV Life Cycle: Attachment Requires CD4 Receptor plus a Requires CD4 Receptor plus a

Co- receptorCo- receptor

HIV Replication– Attachment– Penetration– Uncoating– Reverse Transcription– Integration– Replication– Assembly– Release

Dr.T.V.Rao MD 13

How is HIV infection diagnosed?

The screening test for HIV is usually a blood test called the ELISA test.

When this test is positive, another more specific blood test, usually the Western blot test, is done to confirm the diagnosis.

If both tests are positive, AIDS is confirmed. Tests can usually detect HIV infection within

several weeks of exposure to the virus. HIV tests are always strictly confidential

whether the results are positive or negative

Tests for other sexually transmitted diseases Test for tuberculosis (TB) Ultrasound scans to check for normal growth of

the baby Nonstress tests during the latter part of the

pregnancy to check the baby's heartbeat for signs of stress

Tests for immune system every 2 to 3 months.

How is it treated?

If pregnant and have tested positively for HIV, antiviral drug zidovudine (also called ZDV or AZT) is necessary.

Having a cesarean section (C-section) instead of a vaginal delivery also reduces the risk of infecting the baby.

For opportunistic infections such as pneumonia, TB, yeast infection, or toxoplasmosis medicine is necessary.

During labor and delivery no need to be isolated.

All hospital personnel use special precautions when they handle blood or other body fluids to prevent the spread of AIDS.

Baby to be treated with ZDV for at least the first 6 weeks of life to help prevent infection.

Should not breast-feed the baby. Give formula to the baby instead of breast milk to help prevent spread of the virus to the baby.

If a baby is born infected with HIV infection, the baby will be treated with antiviral drugs.

Baby will be tested for HIV after birth.

Lab tests to see how well the immune system is working, to measure the amount of HIV in the blood, and to screen for infections or other medical problems

Antiviral medicines, such as non-nucleoside reverse transcriptase inhibitors (NNRTI's), nucleoside analogues (NRTI's), and protease inhibitors

Regular dental exams because people who are HIV positive often have mouth problems, including gum disease

Preventive treatment for such diseases as: Pneumocystis carinii pneumonia (PCP) Tuberculosis Toxoplasmosis (be sure to avoid raw meat

and cat litter boxes) Tetanus Hepatitis B Pneumococcal infections Influenza (by getting flu shots)

Treatments for other opportunistic infections and tumors as they develop.

CD4+ T-cell count is below 350 cells per cubic millimeter, or

Viral load is over 30,000 copies per milliliter (mL) when using the branched DNA test, or more than 55,000 copies/mL when using the RT-PCR test.

How long do the effects last?

The full effects of AIDS may not appear until 5 to 10 years after first infected with HIV.

AIDS is a fatal disease, life expectancy has increased greatly as new treatments are developed.

How to prevent spreading the HIV virus?