HIV & AIDs.pptx

H: Infects only Human beings
I: Immunodeficiency Virus weakness the Immune system and increases the risk of infections
V: Virus that attacks the body and finally kills the body’s immune system

1. HIV/ AIDS Amjad Khan Afridi Lecturer, Department of Health & Biological Sciences Chapter # 09 World AIDs Day, 1 st December

2. INTRODUCTION

3. What is HIV? Human immunodeficiency virus (HIV)   H: Infects only Human beings I: Immunodeficiency Virus weakness the Immune system and increases the risk of infections V: Virus that attacks the body and finally kills the body’s immune system

4. What is HIV? Group: Lentivirus Subgroup: Retroviruses All viruses except Retroviruses contain DNA Other Lentiviruses include SIV, FIV, Visna and CAEV, which cause diseases in monkeys, cats, sheep and goats. Human immunodeficiency virus (HIV)  is a type of virus that specially targets white blood cells called Helper-T cells ( CD4 cells ) .  By killing more and more of these cells, the body's immune defenses are weakened and eventually  compromised . There is ongoing damage to immune defense cells. As this happens, the body becomes increasingly less able to fight off infections. When this happens, a person is said to have  acquired immunodeficiency syndrome (AIDS) .

5. What is HIV…? Human immunodeficiency virus (HIV)  is a type of virus that specially targets white blood cells called Helper-T cells ( CD4 cells ) .  By killing more and more of these cells, the body's immune defenses are weakened and eventually  compromised . There is ongoing damage to immune defense cells. As this happens, the body becomes increasingly less able to fight off infections.  When this happens, a person is said to have  acquired immunodeficiency syndrome (AIDS) . Human immunodeficiency virus (HIV)   is a virus that can be transmitted from someone with HIV to someone without through body fluids like semen, blood, vaginal secretions, and breast milk.

6. HIV enclosed with coat called viral envelope. This envelop possess little spikes around 72 in numbers . These spikes are made of proteins gp120 and gp41 . Bellow the envelop a layer is present called matrix , made of protein p17 (Matrix proteins) Bellow the matrix another layer of protein p24 forming viral core (capsid) and usually bullet-shaped . Inside the core, three types of enzymes are present which are required for HIV replication called (Reverse transcriptase, Integrase and protease) . Inside the core, HIV genomes are present, which consists of two identical copies of ssRNA . HIV Structure

7. Where it came from? In 199: Was found that, Chimpanzees Virus, SIV (Simian Immunodeficiency Virus) almost identical to HIV. Chimpanzees were the source of HIV-1 Virus from chimps to human. More research: How SIV could have developed in the chimps?

8. How did virus cross from chimps to Humans? Simple and plausible theory: “ Hunter Theory” or “ Bush Meat Theory” Blood of chimps getting into cuts or wounds on the human hunter.

9. 5 Epi d emiolo g y Since the first cases of AIDS were identified in 1981, close to 30 million people have died as a res u lt of HIV i nf e ctio n . This mak e s AIDS one of the most destructive epidemics in recorded history. In 2009, HIV infected approximately 33 million p e o p le wo r ldwide. Ap p roximately 68% of these cases are in sub-Saharan

10. 6 Epi d emiolo g y In 2009 alone, approximately 1.8 million people died from AIDS and 2.6 million people were newly infected with HIV. Most of these infections were acquired through heterosexual transmission. As of December 2009, women accounted for 52% of all people living with HIV worldwide. Persons aged 15 to 24 years accounted for approximately 40% of new HIV infections worldwide.

11. 8 HIV virus infection The HIV Virus: Invades the helper - T cells (CD4 cells) in the body of the host (defense mechanism of a person). Is threatening a global epidemic. Is preventable & manageable but is NOT curable.

12. 10 HIV and AIDS When the immune system becomes weakened by HIV, the illness progresses to AIDS Some blood tests, symptoms or certain infections indicate progression of HIV to AIDS

13. 11 HIV and AIDS AIDS Predisposes our body to other opportunistic infections. Opportunistic infections and malignancies that rarely occur in the absence of severe immunodeficiency (e.g. Pneumocystis pneumonia, central nervous system lymphoma). Persons with positive HIV serology who have ever had a CD4 lymphocyte count below 200 cells/mcL or a CD4 lymphocyte percentage below 14% are considered to have AIDS. 24 th May, 2022

14. 15 T yp e s of HIV HIV –1 Group M- 9 subtypes, 90% of all cases world wide Group O (Now able to be detected with most routine HIV antibody tests) HIV – 2 1% of cases world wide Slower progression W est Africa 79 cases in US, but most were African born

15. 16 HIV-1 and HIV-2 Transmitted through the same routes Associated with similar opportunistic infections HIV-1 is more common worldwide HI V - 2 is fou n d in W est Africa, Mozambique, and Angola HIV-2 is less easily transmitted HIV-2 is less pathogenic Duration of HIV-2 infection is shorter

16. HIV Pathogenicity

17. RIS K F A C T OR S

18. 19 Risk Factors I. Sexual Practices that promote Disease Transmission Under the influence of drugs Multiple partners Sores in genital area

19. 20 Risk Factors II. Exposure to blood/body fluids Administration of blood or blood products Transplantation of tissue or organs Implantation of infected semen Use of injected drugs (drug abuse) Occupational exposure o Accidental needle stick V. HIV-infected mothers to infants during pregnancy, delivery, or breastfeeding

20. 21 Other Risk Factors Ulcerative STD’s Syphilis ( Treponema pallidum ) Chancroid ( Haemophilus ducreyi ) Herpes simplex Non-ulcerative STD’s Gonorrhea ( Neisseria gonorrhoeae ) Chlamydia (chlamydia trachomatis) Trichomoniasis ( Trichomonas vaginalis)

21. 22

22. 24 Primary infection (Acute HIV) Most develop a flu-like illness within a month or two after the virus enters the body. M ay last for a few weeks. Fever , Headache ,Muscle aches and joint pain Rash Sore throat and painful mouth sores Swollen lymph glands, mainly on the neck These symptoms can be so mild that you might not even notice them.

23. 26 Clinical latent infection (Chronic HIV) Person is HIV+ but asymptomatic lasts for several years (subclinical) o Vi ral replication occurring up to 10 - billion virons per day Chronic lymphadenopathy

24. 27 Early Symptomatic Disease CD4 counts drop to 500-600 cells/ml Symptoms: R ecurrent fever, night sweats, malaise, headache , d iarrhea & f atigue etc. Physical findings: L ymphadenopathy, spleen enlarged, rash & weight loss

25. 30 Some symptoms of AIDS Soaking night sweats Recurring fever Chronic diarrhea Permeant white spots or unusual lesions on your tongue or in your mouth Permeant , unexplained fatigue Weight loss Skin rashes or bumps

26. D I A GNOSI S

27. 37 Laboratory diagnosis Evidence of HIV infection : Evidence of clinical or immunologic deterioration Virus isolation : HIV can be cultured from lymphocytes in peripheral blood . Measurement of viral nucleic acid : By RT-PCR Detection of viral antigen : P24 antigen tests Detection of viral antibody : ELISA & Western Blot assay Recognition of immunodeficiency CD4+ T cell count Recognition of AIDS related disease

28. TREATMENT

29. There's no cure for HIV/AIDS, but many different drugs are available to control the virus called Antiretroviral therapy, or ART. Each class of drug blocks the virus in different ways. ART is now recommended for everyone, regardless of CD4 T cell counts. It's recommended to combine three drugs from two classes to avoid creating drug- resistant strains of HIV. Antiretroviral therapy

30. 50 Antiretroviral Agents Entry inhibitors : (Enfuvirtide ( Fuzeon ) Reverse Transcriptase inhibitors (A b a c a v ir, Nevirapine) Protease inhibitors (Ritonavir – Saquinavir) Integrase inhibitors ( R altegravir ) https://www.youtube.com/watch?v=604tb9pehxE&feature=emb_imp_woyt

31. 49 When to start treatment Everyone with HIV infection, regardless of CD4 T cell count, should be offered antiviral medication. HIV therapy is particularly important for the following situations: severe symptoms. Presence of an opportunistic infection. CD4 T cell count is under 350. Pregnant. HIV-related kidney disease. P resence of hepatitis B or C.

32. P R E V E NTIO N

33. 64 Prevention of HIV Infections I. Vaccines Education, Counseling & Behavior mod. Free needles for IV drug users Improved blood supply V. Screening and treating pregnant women Remunehttps://www.cdc.gov/hiv/basics/hiv-prevention/resources.html https://www.cdc.gov/hiv/basics/hiv-prevention/resources.html

34. END 25 th May, 2022