Aaids-150808104852-lva1-app6892 (1).pptx

aids-150808104852-lva1-app6892 (1).pptx

1. HIV/AIDS

2. AIDS Acquired immuno deficiency syndrome Fatal illness Caused by a retrovirus HIV It breaks down the body's immune system, leaving the patient vulnerable to a host of life threatening opportunistic infections, neurological disorders or unusual malignancies.

3. INTRODUCTION

4. INTRODUCTION

5. Structure of HIV

6. MORPHOLOGY

7. MORPHOLOGY

8. MORPHOLOGY

9. MORPHOLOGY

10. MORPHOLOGY

11. MORPHOLOGY

12. Epidemiology

13. 19 AIDS Worldwide

14. HIV- Agent It is a RNA virus Which replicates in actively dividing T4 lymphocytes. Unique ability to destroy T4 Helper cells Reservoir- Once a person gets infected virus remains in his body lifelong. And the person is a symptomless carrier for years before the symptoms actually appear.

15. Source – The virus is found in great concentrations in blood, CSF and semen. Lower concentrations have been found in tears, saliva, breast milk, urine, cervical and vaginal secretions. Also isolated from brain tissue, lymph nodes, bone marrow cells and skin. However only blood and semen are known to transmit the virus.

16. 22 HIV in Body Fluids Semen 11,000 Vaginal Fluid 7,000 Blood 18,000 Amniotic Fluid 4,000 Saliva 1 Average number of HIV particles in 1 ml of these body fluids

17. Host Age- Most cases are among sexually active people aged between age 20- 49 years. High risk groups- Male homosexuals, hetero sexual partners, i.v . drug abusers, blood transfusion recipients, haemophiliacs and patients having STDs.

18. 24 HIV Transmission HIV enters the bloodstream through: Open Cuts Breaks in the skin Mucous membranes Direct injection

19. 25 Routes of Transmission of HIV Sexual Contact: Male-to-male Male-to-female or vice versa Female-to-female Blood Exposure: Injecting drug use/needle sharing Occupational exposure Transfusion of blood products Perinatal : Transmission from mother to baby Breastfeeding

20. 26 Routes of Transmission of HIV Occupational Transmission Health care worker/ hospital staff Laboratory workers Other routes Organ transplantation Artificial insemination Needle-prick

21. Incubation Period The incubation period is from HIV infection till development of AIDS. It is from a few months to 10 years or even more. However it is estimated that 75% of people infected with HIV will develop AIDS at the end of 10 years.

22. 28 HIV-Infected T-Cell HIV Virus T-Cell HIV Infected T-Cell New HIV Virus

23. Clinical Manifestations I] Initial Infection II] Asymptomatic Carrier State III] AIDS-related Complex(ARC) IV] AIDS

24. I] Initial Infection Except for a generally mild illness of fever, sore throat and rash, which about 70% of the people experience a few weeks after the initial infection; Most HIV –infected people have no symptoms for the first five years. However they can infect others. Antibody Response usually takes 2-12 weeks to appear in the blood stream. This period is called ‘the window period’. (Tests- Negative)

25. 34 HIV Infection And Antibody Response Infection Occurs AIDS Symptoms Initial Stage---------------- -------- Intermediate or Latent Stage- ------------- --- Illness Stage Flu-like Symptoms Or No Symptoms Symptom-free < ---- ----

26. 35 The Acute HIV Syndrome Follows 3-6 wks following primary infection

27. Asymptomatic Carrier State Infected people with antibodies but without any overt signs of the disease, except persistent generalized lymphadenopathy. It is however not firmly clear about how long does the asymptomatic stage lasts.

28. AIDS-Related Complex Has illnesses caused by damage to immune system, but without the opportunistic infections and cancers associated with AIDS. They may exhibit- Unexplained diarrhea(lasting more than a month), fatigue, malaise, loss of body weight(>10%), fever, night sweats. Signs of Mild infections like oral thrush, generalized lymphadenopathy, enlarged spleen.

29. 38 Common manifestation of AIDS Lung infection: P. Carinii pneumonia Gastrointestinal infection: candidiasis of mouth or oesophagus Skin infection: Kaposi’s sarcoma - red or violet macules or papules Central nervous System Infection: Toxoplasmosis Dementia Meningitis Primary CNS Lymphomas. Progressive Multifocal Leucoencephalopathy.

30. 39 Source: NACO Opportunistic Infections Among Reported AIDS Cases in India

31. 40

32. 41 Kaposi sarcoma Candidiasis Of Mouth

33. Swollen parts of the body

34. Deterioration of the body tissues

35. 44 Extreme Wt loss Lymphadenopathy

36. 45 P. Carinii pneumonia Primary CNS Lymphoma

37. PREVENTION

38. 47

39. Diagnosis of HIV HIV antibody test Viral antigen test - used for screening blood donors Detection of viral nucleic acid in blood. Determining the CD4 counts to assess the disease progression.

40. Testing- ICTC centre (Integrated Counseling & Testing Centre) District Hospitals Medical colleges Free HIV testing Confidential counseling Referral to nearest ART (Anti Retroviral Therapy) centre .

41. ANTIRETROVIRAL DRUGS NRTI NNRTI PI Zidovudine (AZT)* Nevirapine(NVP)* Indinavir(IDV)* Lamivudine (3TC)* Efavirenz (EFV)* Nelfinavir(NFV)* Stavudine (d4T)* Delavirdine(DLV) Saquinavir(SQV)* Didanosine ( ddl )* INTEGRASE INHIBITORS Ritonavir(RTV)* Zalcitabine(ddC)* Raltegravir Amprenavir(APV) Abacavir (ABC)* CCR5 antagonists Lopinavir (LPV)* Tenofovir (TFV )* Maraviroc Atazanavir (ATV )* Emtricitabine(FTC)   Foseamprenavir MAMC- Feb 2009 Fusion Inhibitor: Enfuvirtide (T-20) * Available in India , available under national programme

42. PREVENTION Avoid multiple partners – use Condoms. Use sterile needles each time for injection Never share needles Avoid unnecessary blood transfusions All pregnant women should be tested for HIV

43. Prevention Use standard work precautions – hand hygiene, personal protective gear. Proper disposal of biomedical waste Education

44. Occupational Exposure HCW comes in contact with potentially infectious body fluids due to – A percutaneous injury ( needle stick, cut with sharp object) Contact with mucous membrane Contact with non intact skin (abraded, chapped, dermatitis )

45. Management of Exposure site Do not panic Skin Wash wound & surrounding with soap/water Rinse well Do not scrub Do not use Antiseptic or Skin washes

46. Management of Exposure site Splash of Blood Eye Eye irrigation with water or Saline If using contact lens leave them in place while irrigating .Remove once eye is cleaned remove them & clean Mouth Spit fluid immediately Rinse mouth thoroughly with water / saline repeatedly Do not use soap or disinfectant

47. PEP Prescription Contact ART specialist Decision of starting PEP based on Exposure type & HIV status of source Decide PEP regimens

48. Post Exposure Prophylaxis In India recommended for occupational exposure It should be started as early as possible (within 72 hours) ARV is given for 4 weeks HIV testing should be done at baseline, 6wks, 3mths & 6mths

49. Thank you!