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Lesson objectives
Scope of the HIV/AIDS Pandemic Natural History and Transmission of HIV
HIV
Human Immunodeficiency Virus H = Infects only Human beings I = Immunodeficiency virus weakens the immune system and increases the risk of infection V = Virus that attacks the body
DR. S.K CHATURVEDI
AIDS
Acquired Immune Deficiency Syndrome A = Acquired, not inherited I = Weakens the Immune system D = Creates a Deficiency of CD4+ cells in the immune system S = Syndrome, or a group of illnesses taking place at the same time
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infections
HIV-1 is more common worldwide
Transmission of HIV
HIV is transmitted by Direct contact with infected blood Sexual contact: oral, anal, or vaginal Direct contact with semen or vaginal and cervical secretions HIV-infected mothers to infants during pregnancy, delivery, or breastfeeding
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Transmission of HIV
HIV is not transmitted by
Coughing, sneezing
Insect bites Touching, hugging
Public baths
Water, food
Kissing
Handshakes Work or school contact Using telephones Sharing cups, glasses, plates, or other utensils
Total 39.4 million (35.9 44.3 million) 37.2 million (33.841.7 million) Adults Women 17.6 million (16.3 19.5 million) Children under 15 years 2.2 million (2.0 2.6 million) Total 4.9 million (4.3 6.4 million) Adults 4.3 million (3.7 5.7 million) Children under 15 years 640 000 (570 000 750 000) Total 3.1 million (2.8 3.5 million) Adults 2.6 million (2.3 2.9 million) Children under 15 years 510 000 (460 000 600 000)
The ranges around the estimates in this table define the boundar within which the actual numbers lie, based on the best avail information. ies able
00003 -E-1 December 2004
More than 95% are in low and middle income countries Almost 2000 are in children under 15 years of age About 12 000 are in persons aged 15 to 49 years, of whom: almost 50% are women about 50% are 1524 year olds
* Source: UNAIDS,2004
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Reported cases
Reported AIDS cases (15,202) Estimated AIDS cases (219,400) People living with HIV/AIDS (2.2 million)
25/1000
933
Annual Pregnancies
ANC Coverage
27 M
65.4 %
Institutional Deliveries
[12.1% to 79.3%]
35.6 %
42.3 %
High Prevalence States: these are Tamil Nadu, Maharastra, Karnataka, Andhra Pradesh, Manipur and Nagaland
Sexual
IDUs
Perinatal
Unidentified
uninfected
63
uninfected
# infected during
BF for 2 yrs
# infected during
delivery
#infants infected
during pregnancy
Proportion of Respondents Stating That HIV can be Transmitted Through Sexual Contact, Selected States in India
2004 Report on the Global AIDS Epidemic
100 80 60 % 40 20 0 Urban Male Urban Female Rural Male Rural Female
Bihar
Gujarat
Uttar Pradesh
Personal strategies
Public health strategies
Safe practices: no risk of HIV transmission Risk reduction: reduces but does not eliminate risk
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Seroconversion Infection with HIV, antibodies develop Asymptomatic No signs of HIV, immune system controls virus production Symptomatic Physical signs of HIV infection, some immune suppression AIDS Opportunistic infections, end-stage disease DR. S.K CHATURVEDI
illness
Over time, the bodys ability to fight
HIV Disease
Progression of HIV disease is measured by: CD4+ count Degree of immune suppression Lower CD4+ count means decreasing immunity Viral load Amount of virus in the blood Higher viral load means more immune suppression
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HIV Disease
Severity of illness is determined by amount of virus in the body (increasing viral load) and the degree of immune suppression (decreasing CD4+ counts) Higher the viral load, the sooner immune suppression occurs
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HIV Disease
Direct infection of organ systems
HIV can directly infect the:
Brain (HIV dementia) Gut (wasting) Heart (cardiomyopathy)
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As CD4+ cell count decreases and viral load increases, the immune defences are weakened
HIV-infected people become vulnerable to opportunistic infections HIV is a chronic viral infection with no known cure Without ARV treatment, HIV progresses to symptomatic disease and AIDS
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Key Points
HIV is a global pandemic and the number of people living with HIV continues to increase worldwide. HIV epidemic is especially severe in resource-constrained settings
HIV is a virus that destroys the immune system, leading to opportunistic infections.
The progression from initial infection with HIV to end-stage AIDS varies from person to person and can take more than 10 years.
DR. S.K CHATURVEDI