HIV AIDS

HUMAN IMMUNODEFICIENCY VIRUS

WHAT IS HIV
HIV STANDS FOR HUMAN IMMUNODEFICIENCY VIRUS IT IS A MEMBER OF A GROUP OF VIRUSES CALLED AS RETROVIRUSES. HIV INFECTS THE HUMAN CELLS AND USES THE ENERGY AND NUTRIENTS FROM THESE CELLS TO GROW AND REPRODUCE.

STRUCTURE OF HIV

WHAT IS AIDS
AIDS (ACQUIRED IMMUNODEFICIENCY SYNDROME). IT IS A DISEASE IN WHICH THE BODYS IMMUNE SYSTEM BREAKS DOWN AND IS UNABLE TO FIGHT OFF CERTAIN INFECTIONS, KNOWN AS OPPORTUNISTIC INFECTIONS. SO AIDS IS A DISEASE WHERE AS HIV IS THE CAUSATIVE ORGANISM.

GLOBAL SCENARIO

ESTIMATED NUMBER OF ADULTS AND CHILDREN NEWLY INFECTED IN 2009

SCENARIO IN INDIA

REPORTED AIDS CASES IN DIFFERENT STATES

AGE AND SEXWISE DISTRIBUTION

SOME LITERATURE
FIRST CASE- OFFICIALLY RECORDED IN 1981 BY CDC ( CENTRE FOR DISEASE CONTROL), ATLANTA IN A GAY MAN. FIRST CASE IN INDIA- IN 1986, MADRAS MEDICAL COLLEGE.

MECHANISM OF ACTION OF HIV

HIV-------- HUMAN BODY LIVES IN WHITE BLOOD CELLS MULTIPLIES PRIMARILY HERE. DURING THIS PROCESS DAMAGES OR KILLS THESE CELLS ( SPECIALLY THE CD4 CELLS OR THELPER CELLS) THUS WEAKENING THE IMMUNE SYSTEM OF THE BODY. AS A RESULT INDIVIDUALS ARE SUSCEPTIBLE TO VARIOUS INFECTIONS OR ILLNESSES. NORMAL CD4 COUNT= 450 TO 1200 <200 AIDS

HOW QUICKLY DO PEOPLE INFECTED WITH HIV DEVELOP AIDS

BASICALLY DEPENDS UPON INDIVIDUALS IMMUNE SYSTEM. LOW IMMUNE POWER-> 3 TO 6 MONTHS HIGH IMMUNE POWER-> REMAIN ASYMPTOMATIC FOR 10 TO 12 YEARS. EARLY DETECTION CAN HELP PROLONG A PERSONS LIFE.

MODES OF TRANSMISSION
HIV PRESENT IN CERTAIN BODY FLUIDS.
1) BLOOD 2) SEMEN 3) VAGINAL SECRETIONS 4) BREAST MILK

MODES OF TRANSMISSION

o UNPROTECTED SEXUAL INTERCOURSE (EITHER VAGINAL OR ANAL) WITH SOMEONE WHO IS HIV INFECTED.
VAGINAL SEX----- WOMEN > RISK THAN MEN ANAL SEX------ (MALE- MALE) OR (MALE- FEMALE) HIGHER RISK IN BOTH THE CASES COS LINING OF THE ANUS AND THE RECTUM ARE VERY THIN AND FILLED WITH SMALL BLOOD VESSELS THAT CAN BE EASILY INJURED DURING THE INTERCOURSE.

MODES OF TRANSMISSION

o UNPROTECTED ORAL SEX

SOMEONE WHO IS HIV INFECTED.

WITH

LESS RISK OF TRANSMISSION THAN VAGINAL OR ANAL SEX. RISK IS INCREASED WHEN ----- CUTS OR SORES IN THE MOUTH AS IT ALLOWS THE VIRUS TO ENTER THE BLOOD STREAM

o SHARING NEEDLES OR SYRINGES WITH SOMONE WHO IS HIV

INFECTED. RESEARCHES SHOW -> HIV CAN SURVIVE IN USED NEEDLES FOR A MONTH OR MORE. DRUG USERS , BODY PIERCING AND TATTOOS.

MODES OF TRANSMISSION o MOTHER TO CHILD TRANSMISSION

PREGNANCY--25% RISK OF TRANSMISSION TO THE NEW BORNS. - CAN OCCUR AT ANY STAGE OF GESTATION. - MOST TRANSMISSION DURING LABOR AND DELIVERY THROUGH DIRECT CONTACT OF THE INFANT WITH MATERNAL BLOOD AND CERVICAL SECRETIONS.

BREAST FEEDING---

20 TO 40% RISK OF

TRANSMISSION. OPTIMALLY------ CONTRA INDICATED IN HIV INFECTED WOMEN > RISK IF MASTITIS OR CRACKED NIPPLES.

HOW HIV IS NOT TRANSMITTED

FOOD AIR ( COUGHING & SNEEZING) EVERYDAY CONTACT ( SHARING
UTENSILS, BATHROOM FACILITIES AND HUGGING) KISSING ( POSSIBLE ONLY IN DEEP KISSING IF ULCERS OR CUTS PRESENT IN THE MUCOSA OF THE MOUTH)

SWEAT, TEARS, FAECES, URINE(

CONTAINS HIV BUT CANNOT TRANSMIT THE DISEASE)

MOSQUITOES, FLEAS.

PREVENTION OF HIV

MODES OF PREVENTION OF HIV

PRACTICE SAFER SEX


o
o

CONDOMS:
USE ONLY LATEX CONDOMS USE ONLY WATER BASED LUBRICANTS. FEMALE CONDOMS PROPER USE OF LATEX BARRIERS

o o

MODES OF PREVENTION CONTAMINATED NEEDLES:



DO NOT SHARE NEEDLES OR SYRINGES . USE DISPOSABLE NEEDLES OR SYRINGES. TATTOOING OR PIERCING FROM A QUALIFIED PROFESSIONAL WHO USES STERILE EQUIPMENTS.

MODES OF PREVENTION BLOOD TRANSFUSIONS:



ENSURE THAT THE BLOOD TO BE TRANSFUSED IS PROPERLY SCREENED FOR HIV. BLOOD TO BE TRANSFUSED SHOULD ALWAYS BE ARRANGED FROM A RECOGNISED AND FDA APPROVED BLOOD BANKS.

LINK BETWEEN HIV & OTHER STIs (SEXUALLY TRANSMITTED INFECTIONS) 3 TO 5 TIMES MORE RISK OF CONTRACTING OR TRANSMITTING THE VIRUS. DUE TO OPEN SORES OR BREAKS IN THE SKIN ( AS WITH SYPHILIS, HERPES , CHANCROID) WHERE NO BREAKS IN THE SKIN ( CHLAMYDIA & GONORRHEA).

SYMPTOMS OF THE DISEASE

NOT POSSIBLE TO TELL JUST BY LOOKING AT SOMEONE IF HE OR SHE IS INFECTED WITH HIV OR HAS AIDS. DEPENDS UPON THE IMMUNE SYSTEM OF INDIVIDUALS. INITIALLY MAY DEVELOP WITH TEMPORARY FLU LIKE SYMPTOMS OR SWOLLEN GLANDS. LOSS OF APPETITE, WEIGHT LOSS, PERSISTENT COUGH, HAIR LOSS, ABDOMINAL PAIN ON AND OFF. BUT EVEN PRESENCE OF THESE SYMPTOMS DOES NOT MEAN THAT THE PERSON HAS AIDS. THE ONLY WAY TP KNOW HIV STATUS IS TO BE TESTED FOR HIV.

TESTS FOR HIV- AIDS

DIAGNOSED ONLY WITH BLOOD TESTS


ELISA ( ENZYME LINKED IMMUNO ABSORBENT ASSAY) WESTERN BLOT PCR ( POLYMERASE CHAIN REACTION)

 

WINDOW PERIOD(BLOOD TEST)

+ve test -ve test

13th june11

13th Dec11

TESTS FOR HIV- AIDS

SURROGATE MARKERS--- CD4 COUNT NORMAL- 450 TO 1200 < 200 --------- AIDS DEPENDING UPON THIS COUNT ANTI RETROVIRAL THERAPY IS STARTED.

 VIRAL LOAD
ALSO USED TO DETERMINE WHEN TO BEGIN ART AND TO ASSESS ITS EFFECTIVENESS.

IS THERE A CURE FOR AIDS?

ANTI RETROVIRAL THERAPY

INCREASES ONLY THE LIFE SPAN OF INDIVIDUALS BUT NOT CURE THE DISEASE.  HIGHLY TOXIC AND CAUSES A LOT OF SIDE EFFECTS. (HEART DAMAGE, KIDNEY FAILURE, & OSTEOPOROSIS).  HIV MUTATAES QUICKLY INTO NEW VIRAL STRAINS AND HENCE HAVE BECOME HIGHLY RESISTANT TO CURRENT DRUGS.  ALSO VERY EXPENSIVE.


EFFECT OF HIV- AIDS ON NUTRITION

REDUCED FOOD INTAKE



ANOREXIA, NAUSEA, VOMITING,DYSPHAGIA (ORAL OR OESOPHAGEAL LESIONS), DRUG INDUCED, PSYCHOSOCIAL & ECONOMIC FACTORS.

REDUCED ABSORPTION


ACUTE & CHRONIC DIARRHOEA AND MALABSORPTION.

INCREASED UTILISATION


INFECTION ASSOCIATED HYPER METABOLISM

NUTRITIONAL MANAGEMENT OF HIVAIDS

NUTRITIONAL ASSESSMENT --- WHEN? FOLLOWING DIAGNOSIS REPEATED AT REGULAR INTERVALS DURING THERAPY NUTRITIONAL INTERVENTION--- WHY? HAS BENEFICIAL EFFECTS ON: THE CLINICAL COURSE OF THE DISEASE IMMUNOLOGICAL STATUS. MARKERS  ANTHROPOMETRY HEIGHT, WEIGHT, SKIN FOLD THICKNESS  DIETARY INTAKE FOOD FREQUENCY, QUALITATIVE & QUANTITATIVE ASPECTS.

OBJECTIVES OF NUTRITIONAL SUPPORT

DEVELOP BETTER EATING HABITS & DIET BUILD/ REPLENISH BODY STORES OF NUTRIENTS. PREVENT & STABILISE WEIGHT LOSSTHUS IMPROVING SURVIVAL PRESERVE AND GAIN BODY & MUSCLE MASS PREVENT FOOD & WATER BORNE ILLNESSES PROVIDE LOW COST AND NUTRITIOUS FOOD.

COUNSELLING
PRE TEST COUNSELLING
    

EXPLAIN FALLIBILITY OF TESTS HELP EXPRESS FEELINGS AND REGAIN CONTROL EXPLAIN RELEVANT FACTS ABOUT HIV INFECTION AND CONTROL ADVANTAGES AND DISADVANTAGES OF ANTIBODY TESTING ESTABLISH SHORT TERM & LONG TERM GOALS

POST TEST COUNSELLING

    

RAPPORT & TRUST BUILDING. PROVIDE EMOTIONAL SUPPORT REVIEW INFORMATION ON AVAILABLE SUPPORT PROVIDE RISK REDUCTION INFORMATION EDUCATE ON STRESS MANAGEMENT

HELP FIGHT HIV - AIDS

VOLUNTEER WITH YOUR LOCAL AIDS SERVICE ORGANISATION TALK WITH THE YOUNG PEOPLE YOU KNOW ABOUT HIV AIDS SPONSOR AN HIV- AIDS EDUCATION EVENT OR FUNDRAISER WITH UR LOCAL SCHOOL, COMMUNITY GROUP OR RELIGIOUS ORGANIZATION URGE GOVERNMENT OFFICIALS TO PROVIDE ADEQUATE FUNDING FOR AIDS RESEARCH , PREVENTION EDUCATION, MEDICAL CARE & SUPPORT SERVICES SPEAK OUT AGAINST AIDS RELATED DISCRIMINATION.

DR. PRAFULLA L. THORAT M.B.B.S, DHA , AFIH.