Download Acquired Immunodeficiency Syndrome (AIDS/HIV)

Back to REPORTABLE DISEASES
Acquired Immunodeficiency
Syndrome (AIDS/HIV)
Reporting Obligations
Laboratory confirmed cases of HIV infection shall be reported
to the local Health Unit.
Epidemiology
Aetiologic Agent:
The human immunodeficiency virus (HIV) is a retrovirus of
which two types have been identified: type 1 (HIV-1) and type
2 (HIV-2). They are serologically and geographically distinct but
have similar epidemiological characteristics. The pathogenicity
of HIV-2 may be lower than that of HIV-1; they have genotypic
and phenotypic differences. HIV-2 has lower disease
progression and lower rates of mother-to-child transmission.
Clinical Presentation:
AIDS is a severe, life threatening clinical condition and is an
advanced HIV related disease. This syndrome represents the
late clinical stage of HIV infection resulting from progressive
damage to the immune system, leading to one or more of
many opportunistic infections and cancers of which bacterial
pneumonia is one of the common presentations. Symptoms
of acute HIV infection may include fever, arthralgia or myalgia,
rash, lymphadenopathy, sore throat, fatigue, headache, oral
ulcers and or genital ulcers, weight loss, nausea, vomiting or
diarrhea. Acute symptoms, if present, occur two to four weeks
after the initial infection and last from one to two weeks or as
long as several months. In Canada, AIDS is diagnosed when
a person with HIV develops one or more “AIDS- defining”
symptoms.
Modes of transmission:
• Person- to- person through unprotected sexual intercourse
• Contact with infected body fluids: sexual fluids, blood, and
breast milk
• The use of HIV infected-contaminated needles and syringes
and some drug paraphernalia, including sharing by
injection drug users
• Transfusion of infected blood or its components, organ and
tissue transplants
• Contact of abraded skin or mucosa with body secretions
such as blood, semen and CSF
• The presence of another STI in either the source or the
exposed person, particularly ulcerative lesions such as
syphilis or genital herpes, increases the potential for sexual
transmission of HIV.
• Occupational exposure to HIV infection: percutaneous
injury with a sharp object potentially contaminated with
blood or other bodily fluid: mucous membrane exposure to
blood or other bodily fluid
• Vertical transmission from mother to infant during
pregnancy, delivery or breast feeding
• While virus has occasionally been found in saliva, tears,
urine and bronchial secretions, transmission after contact
with these secretions in the absence of blood has not been
reported
REPORTABLE
DISEASES
TOOLKIT
Information for
Health Care
Professionals
Incubation Period:
Variable: time from initial infection to detectable antibodies
(window period) is usually 1-3 months. The time from HIV
infection to diagnosis of AIDS has an observed range of less than
one year to 15 years or longer.
Period of Communicability:
Not known precisely; begins early after onset of HIV infection
presumably extending throughout life. Infectivity during the first
months is considered to be high; it increases with viral load, with
worsening clinical status and with the presence of other STIs.
Risk Factors/Susceptibility
The Ontario Advisory Committee on HIV/AIDS has identified
four populations at greatest risk of acquiring HIV/AIDS
in Ontario, including gay and bisexual men, African and
Caribbean Ontarians, Aboriginal Ontarians and people who
use injection drugs. See Modes of Transmission for specific
risk factors.
Diagnosis & Laboratory Testing
The diagnosis of HIV infection is based primarily on a
positive serologic test. Persons with HIV infection may
be totally asymptomatic. Therefore, serologic testing is
recommended when there is a high index of suspicion (e.g.,
high-risk behaviour and/or suspicious clinical symptoms and
signs). Persons may also present with specific opportunistic
infections or other conditions indicative of underlying
immunosuppression. See ‘PHO Labstract May 2016, HIV
patient information sheet: If You’ve Just Found Out You Are
HIV Positive’.
TESTING INFORMATION & REQUISITION
Treatment & Case Management
The Public Health Agency of Canada provides information related
to: screening, testing, post-test procedures, post-diagnosis clinical
management and disclosure of HIV.
Patient Information
PATIENT FACT SHEET
Additional Resources
1. Public Health Agency of Canada, “Human Immunodeficiency Virus – HIV
Screening & Testing Guide.”
2. CATIE. “Canada’s source for HIV and hepatitis C information.”
3. Canadian AIDS Society publication. “HIV Transmission: Factors that Affect
Biological Risk”, 2013.
4. AMMI Canada, The Use of Early Antiretroviral Therapy in HIV-infected Persons.
References
1. Ministry of Health and Long Term Care, Infectious Diseases Protocol, 2014.
2. Heymann, D.L., Control of Communicable Disease Manual (19th Ed.),
Washington, American Public Health Association, 2008.
Leeds, Grenville & Lanark District Health Unit, Oct 2016