BASIC FACTS ABOUT HIV/AIDS

BASIC FACTS ABOUT HIV/AIDS Moro Workshop By Dr. J. Sewangi RACC - Mbeya Approach        Definitions Types of HIV Modes of transmission Mechanism of Immune destruction Clinical presentation Myths about HIV infection Discussion THE AIDS the short form for Acquired Immune Deficiency Syndrome. ►It is a collection of symptoms and signs which results from viral infection ►Is The history 1981 – 1st cases of AIDS reported ► In USA  Young people (20 – 45 years) died of  PCP (uncommon)  Homosexuals ► In Africa (central)  Young people died of  Diarrhoea  Severe wasting  Heterosexuals THE HIV  Is the short form for Human Immunodeficiency Virus  Sometimes called ‘‘AIDS VIRUS’’  Is the virus that destroys the human defense mechanism (immunity) that fights diseases  Discovered September 1983 Types of HIV 1 – subtypes A – J + RCF ► HIV 2 _ not as common ► HIV 3 _ newly discovered Subtypes distribution Subtypes A Kenya 55% Subtypes C 3% Subtype D 3% Recombinant 39% ► HIV Uganda Tanzania 15% 10% 0% 55% 6% 30% 29% 55% Brain storming Which body fluids do you think could be infectious?  Why do people get infected with HIV and what are the predisposing factors?  How can the individual with HIV/AIDS be identified?  HIV TRANSMISSION ► In order to understand transmission we need to be clear about the body fluids that could be infectious. HIGH CONCENTRATION Contains sufficient amount of virus to infect LOW CONCENTRATION HIV is present in negligible quantities (no possibility of infection) CONTAINS NO VIRUS AT ALL 1.Blood and blood products 2.Semen 3.Vaginal and cervical secretions 4.Breast milk 5.Amniotic fluid 6.Synovial fluid around bone joints 1.Saliva ( only found in minute amounts in a very small number of people) 2.Tears 3.Blister fluids 1.Urine 2.Faeces 3.Vomitus 4.Sweat HIV is generally spread in 3 ways intercourse ► Blood to blood contact ► MTCT - Pregnancy, childbirth, breast feeding Most infectious phases for HIV infected people ► Soon after infection ( the first 4 - 8 weeks) ► When there is a high viral load ► During full blown AIDS This is because there are larger quantities of virus in the blood stream at those times ► Sexual Risk situation and risk behaviour Poverty & risky behavior… ► Poverty decrease awareness of people about HIV. ► Poverty weakens the power of defense against HIV. ► Poverty leads to enrollment of women in the commercial sex. ► poverty constrains people to react appropriately with HIV/AIDS. MECHANISM OF IMMUNE DESTRUCTION MECHANISM OF BODY DEFENCE MECHANISM OF IMMUNE DEFICIENCY ► Mainly HIV attacks Lymphocytes known as helper cells or T4 or CD4 Cells ► Attack and slowly destroy the immune system RESPONSE TO HIV ►There are 3 general types:  Rapid progressors  Slow progressors  5% there may be no development of immune deficiency at all. RAPID PROGRESSORS immune deficiency within 5 -7 years and others 3 - 4 years. ► These are said to have a very active and aggressive viral strain ► Their bodies can’t suppress the virus sufficiently to delay or stop the disease progress. ► Develop SLOW PROGRESSORS May remain well for 10 - 15 years The difference can be explained by ► Different viral strains ► Dosage of infection ► The body's response to the virus ► The general health status of the individual Production of HIV Antibodies (Abs) in response to HIV infection ► Abs produced in response to HIV are not able to overcome or destroy the virus. ► Usually detected in the blood stream 4 - 6 weeks after infection CLINICAL PRESENTATION 1. Window period   Is the 1st 3 -6 months after acquiring HIV infection or shorter at 1 -2 weeks. There may be sero-conversion illness with the following features ( 1 -2 weeks).  Fever tiredness, rash, sore throat, muscle and joint pains, some swelling of lymph nodes.   HIV Abs test converts from NEGATIVE to POSITIVE - also called SERO- CONVERSION ILLNESS. HIV Abs test becomes positive 4 -6 weeks after infection and 1 -5 years after infection, this is the only indication for HIV in a person 2. Dormant period ► May last between 3 and 7 years (or up to 10 years/life) ► The person is able to spread the virus. ► The virus is progressively causing damage to the immune system or may remain dormant for life. 3. AIDS – Related Complex (ARC) ► Is the stage of onset of clinical illness with non specific symptoms or signs ► Presents with  Chronic swelling of lymph nodes  Herpes zoster  Occasional fevers  Skin rashes  Fungal nail infection  Recurrent oral ulceration  Recurrent upper respiratory infections (URTI)  Weight loss  Fatigue 4. Severe AIDS related disease patient presents obvious symptoms and signs of AIDS ►There is severe opportunistic infections (OI), some cancers and HIV related organ damage. These conditions are referred to as AIDS defining illnesses  E.g. ►Bacteria ►The ►Viruses ►Protozoa ►Fungi ►Cancer - Tuberculosis (kifua kikuu) Herpes zoster (mkanda wa jeshi) Pneumonia white patches - mouth, vagina Kaposis sarcoma - skin HIV is a very variable disease  There are very few rules: ► Serious and severe OI can appear at a variety of different clinical and immune levels. ► Some progress rapidly and others more slowly. ► Some may have a slow and gentle decline ► Some may remain very well for many years and then suddenly deteriorates ► Some may never get ill. ► Some may get repeated OI with many different conditions. ► Some may only suffer from a few of the common OI ► Some can get reasonably well after being very sick. ► Others may get very sick after being reasonably well. Myths about HIV infection ► Kissing ► Sneezing,  No transmission risk from mouth - to - mouth unless both partners have large open sores in their mouths or severely bleeding gums.  No transmission risk through spitting, sneezing, sharing glasses or musical instruments, swimming pools, showers or by sharing washing machine or toilet seats.  HIV is unable to reproduce outside its living host i.e. does not survive well in the open air.  HIV is not transmitted by insects  Insects do not inject their own or a previously bitten person’s or animal’s blood into the next person bitten but inject saliva through which diseases like malaria and yellow fever are transmitted. coughing, sharing glasses/cups ► Insects ► Protected sex  If unbroken condom is used properly, there is no risk of transmission. No virus can pass through the condom. ► Casual ► Air contact  No risk of transmission  No transmission. However such stories, which may frighten the public, are circulated on the internet Thank you