HIV and AIDS

THE ZAMBIAN EXPERIENCE

Dr Soka Nyirenda, Physician-UTH-Zambia
Introduction
 We have lost key people in our society
 The most productive
 The reproductive group (The youth)
 Everyone is involved; Either you are
infected or affected
 Economies, workplaces, schools, sport
 “Our sisters in the neighborhood are in trouble!... This
Fellow has been given his allowances. He doesn’t
even choose which skirt ……”
 “Ever since his second girlfriend died, he hasn’t been
well. He has missed almost all matches this season.
The coach is even…..”
 “Too bad. The team is relegated. No one can score
now. Ever since John…….
 “Please Doctor, treat my young brother. We don’t
want him to die. He has brought pride and comfort to
our family. Now he is dying. He is shy to come on his
own”
How common is the disease of HIV/AIDS in our
society?

• The whole world is affected in one way or

another
• Majority of HIV infections are in Africa,
especially Southern Africa
• About 19-25% in Zambian society
• Among pregnant mothers (Antenatal) 30%
• Most affected age 16-49 years
• Females; 16-28yrs
• Males; 22-49 yrs
 1.1 million Zambians infected with HIV
 Every part of society is affected
 140,000 require ARV
 12,000 are taking ARV
 Most who started ARV
• Have reduced frequency of admissions to hospital
• Are back on their feet
• Have gone back to their normal duties
How is this disease transmitted?
 Sex –majority
• Man-woman (Heterosexuality)
• Man-man (x10 more dangerous)
(homosexuality)
 Mother-to-child transmission (during
giving birth) (1 out of 3 infected)
 Other methods (very rare)
• Needle prick
• Blood transfusion
Why are the sportsmen, women affected
more?

 Entertainers---fans (men, women, girls

etc)
 Improved income; Money is power,
higher living standards
 “Sudden civilisation”

 Unable to handle fame

HIV; What does it look like?
What does the virus (HIV) do when the
enters the body ?
 The immune system –Collection of organs and cells
(White blood cells) which protect us against millions of
germs.

• Organs (Liver, spleen, lungs etc)

• They FILTER off the germs

• White blood cells

• Directly attack (like soldiers) the germs with the aim of killing
them (rarely fail )
The way our immune (defense) system works

COUNTRY OUR BODY

Military (Defense) Immune (Defense) System

Soldiers White blood cells

Commanders CD4 lymphocytes

Attacking soldiers CD8 lymphocytes

 The commanders (CD4) give instructions
to the attacking cells (CD8)
 Without CD4 , the CD8 cells are useless
on their own
 The HIV attacks the CD4, hence the
weakening the whole immune system
 Then germs (even the weakest of germs)
take advantage of this and cause disease
(Opportunistic infections)
What the virus (HIV) does once it enters
our body

1. It dodges the immune system

2. Attacks the CD4 (Commanders)
3. Enters the CD4
4. Lives happily inside the CD4 cells
5. Takes charge of all activities and use
the machinery inside to multiply itself
into millions every 24 hours!
 Millions of these viruses cause the cell
burst, then these new virus attack many
more CD4 cells until all cells finish
 Thus, number of CD4 cell continuously
reduce
 The body also produces many more CD4
to attack the virus but the virus is faster
in attacking
 As this war goes on (months –years)
• The virus defeats the defense system
• Then the virus goes on to attack your organs
(brain, heart, kidneys, liver etc) and cause
damage.
WHEN YOU DELAY, THE DAMAGE DONE ON
THE BODY BY THE VIRUS CANNOT BE
REVERSED ( PERMANENT)
Why do some people with HIV progress to AIDS
faster than others?

1. The amount of virus in the body

2. Those whose CD4 count is dropping fast
 Influencing factors
• Sex
• Sexually Transmitted Diseases
• Tuberculosis, malaria and other infection, fever
• Alcohol, smoking, drug use
• Poverty (poor diet, unclean water, overcrowded)
• Depression, Stress
Consequences of the infection

 Continued damage to your immunity whether it

shows or not (“window period”)
• Leading to permanent damage
• Many germs take advantage and cause severe
disease (Tuberculosis, pneumonia, diarhoea, brain
damage, blindness, cancers, anaemia, oral thrush)
WHEN IT REACHES A CERTAIN STAGE, THERE IS
VERY LITTLE THE HEALTH PROVIDER OR ARVs
CAN DO FOR YOU---TOO LATE!
 The body needs 500-1200cell/ul CD4 to
function properly
 As virus damages these cells
• 450----Tuberculosis
• 350---running nose, Herpes Zoster, chest infection
• 200 (AIDS), severe pneumonia, diarrhoea, weight
loss, cancers (cervix, brain, blood system, KS)
• 100—brain infection (Advanced disease)
Thus
 There is need to have an HIV test early
because;
•Everyday the virus multiplies in millions
•Everyday it continues to attack more defense cells
•Everyday it continues to damage your organs and
body
NOT KNOWING YOUR HIV STATUS IS SUICIDAL
IT’S A QUESTION OF TIME
Access to ARV
 Almost 40% of the country's health staff
have been trained to take care of
HIV/AIDS patients. Doctors start the
process
 HIV patients can access HIV drugs
NEED
 Players need to be helped
SUMMARY
 Prevention is better than cure
• If you don’t have it, don’t get it from someone
 Knowing your HIV status is crucial for you
• If you have it, don’t give it to someone
 The earlier you know, the earlier you can plan your life
• The earlier the better
 When AIDS sets in, there is a risk of permanent damage,
in which case nothing can be done for you
 ARV work and are readily available
 There is need to COACH players how to TACKLE FAME