Download AIDS - University of Rajshahi

HIV and Medications
By
Dr. Ananda Kumar Saha
Department of Zoology
University of Rajshahi, Rajshahi-6205
World AIDS Day – 2004
Five people worldwide die of AIDS every
minute of every day
Incidence / Prevalence of HIV / AIDS (Dec, 2004)
Living with AIDS
Newly infected
Death
39.4 million
4.9 million
3.1 million
Source: WHO & UNAIDS
Total population living with HIV/AIDS (Dec, 2004) : 39.4 million
HIV infected children
An AIDS patient
WHAT IS THE DIFFERENCE BETWEEN HIV AND AIDS?
HIV is the virus that causes AIDS.
H - Human
: Virus can only infect human beings.
I - Immuno-deficiency : Body’s immune system failure to work
properly.
V - Virus
: It reproduces by taking over the
machinery of the human cell.
A
I
D
S
- Acquired :
- Immune :
- Deficiency :
- Syndrom :
One must acquire or get infected with.
Affect’s the body’s immune system.
It makes the immune system deficient.
Someone with AIDS may experience a wide range
of different diseases and opportunistic infections.
HOW DO YOU GET AIDS?
 Blood
Vaginal fluid
Semen
Breast milk of people infected with HIV
Anatomy of the HIV
The Different Stages of HIV Infection
Primary HIV Infection
This stage of infection lasts for a few weeks and is often
accompanied by a short flu like illness which occurs just
after infection.
Clinically Asymptomatic Stage
This stage lasts for an average of ten years and as its name
suggests, is free from any symptoms, although there may be
swollen glands.
Symptomatic HIV Infection
Over time the immune system loses the
struggle to contain HIV. This is for three main
reasons;
The lymph nodes and tissues become damaged or
"burnt out" because of the years of activity;
HIV mutates and becomes more pathogenic, in other
words stronger and more varied, lending to more T
helper cell destruction;
The body fails to keep up with replacing the T helper
cells that are lost.
Progression from HIV to AIDS
As the immune system becomes more and
more damaged the illnesses that present
become more and more severe leading
eventually to and AIDS diagnosis.
Most people get the HIV virus by:
Having sex with an infected person.
Sharing a needle (shooting drugs) with
someone who's infected
Being born when the mother is infected,
or drinking the breast milk of an infected
woman.
WHAT HAPPENS IF I'M HIV POSITIVE?
 Fever
 Headache
 Sore muscles and joints
 Stomach ache
 Swollen lymph glands or
 A skin rash
HIV Life Cycle
HIV Life cycle
IS THERE A CURE FOR AIDS?
 There is no cure for AIDS.
 There are drugs that can slow down the HIV virus,
and slow down the damage the immune system.
 But there is no way to get all the HIV out of your
body.
 There are other drugs that you can take to prevent or
to treat opportunistic infections.
HIV Positive Couple of Kenya
Bottle-Feeding
HOW DOES HIV SPREAD DURING SEX?
 To spread HIV during sex, HIV infection in blood or
sexual fluids must be transmitted to someone.
 Sexual fluids come from a man's penis or from a
woman's vagina.
 HIV can be transmitted when infected fluid gets into
someone's body.
 If there is no contact with blood or sexual fluids, there
is no risk.
HIV in the Environment
Scientists and medical authorities agree that
HIV does not survive well in the
environment.
No one has been identified as infected with
HIV due to contact with an environmental
surface.
HIV is unable to reproduce outside its living
host
Businesses and Other Settings
 There is no known risk of HIV transmission to co-workers,
clients, or consumers from contact in industries such as foodservice establishments.
 Instruments that are intended to penetrate the skin (such as
tattooing and acupuncture needles, ear piercing devices) should
be used once and disposed of or thoroughly cleaned and
sterilized.
 Instruments not intended to penetrate the skin but which may
become contaminated with blood (for example, razors) should
be used for only one client and disposed of or thoroughly
cleaned and disinfected after each use.
Kissing
Casual contact through closed-mouth or
"social" kissing is not a risk for transmission
of HIV.
The risk of acquiring HIV during openmouth kissing is believed to be very low.
Biting
 Biting is not a common way of transmitting HIV.
 HIV has been found in saliva and tears in very low
quantities from some AIDS patients.
 HIV has not been recovered from the sweat of HIV-infected
persons.
 Contact with saliva, tears, or sweat has never been shown
to result in transmission of HIV.
Insects
No evidence of HIV transmission through
insects--even in areas where there are many
cases of AIDS and large populations of insects
such as mosquitoes.
HIV lives for only a short time inside an insect
and, unlike organisms that are transmitted via
insect bites.
HIV does not reproduce (and does not survive)
in insects.
Precautions:
 Gloves should be worn during contact with blood or other body
fluids that could possibly contain visible blood, such as urine,
feces, or vomit.
 Cuts, sores, or breaks on both the care giver's and patient's
exposed skin should be covered with bandages.
 Hands and other parts of the body should be washed immediately
after contact with blood or other body fluids.
 Practices that increase the likelihood of blood contact, such as
sharing of razors and toothbrushes, should be avoided.
 Needles and other sharp instruments should be used only when
medically necessary. (Do not put caps back on needles by hand or
remove needles from syringes. Dispose of needles in punctureproof containers.
MEDICATIONS
Reverse Transcriptase Inhibitors (NUKES).
 Block Reverse transcription (Viral DNA from RNA)
Protease Inhibitors
 Block the action of protease to assemble a new
copy of the virus.
Integrase Inhibitors
 Block the action of integrase that inserts the viral
DNA into the infected cell’s DNA strands.
INTERUPTING TREATMENT
 Side effects are intolerable
 There’s a drug interaction
 Women might choose to stop treatment during the
first three months of pregnancy.
WHEN TO START TREATMENT
 Patients with symptoms of HIV diseases or with
less than 200 T- Cells.
 Patients with no symptoms who have less than 350
T- Cells, Viral load over 100,000 should be offered
treatment.
GOALS OF THERAPY
 Reduce viral load as much as possible for
long as possible.
 Preserve the Immune system
 Improve the patient’s quality of life
 Reduce sickness and death due to HIV
SIDE EFFECT OF ANTIVIRAL MEDICATIONS
Blood Sugar
 High blood sugar can be a side effect of the HIV
protease inhibitors.
 HIV Protease inhibitor medications develop insulin
resistance.
Blood Fats
 Too much fat in the blood increases the risk of heart
diseases or pancreatitis.
CAN THESE DRUGS CURE AIDS?
 The drugs do not cure AIDS.
 They make it possible for people with AIDS to
live a long time.
HIV/AIDS situation in Bangladesh:
Govt. of
Bangladesh 2004
UNAIDS Global
HIV/AIDS Report 2002
The World Fact
book 2005
HIV positive
person
465
13,000
13,000
Deaths due to
HIV/AIDS
30
650
650
Bangladesh: Low prevalence but high vulnerability
• Less then 0.1% of the Bangladeshi population is HIV
positive
• A lack of HIV / AIDS awareness
• High rate of injection drug use
• Unsafe blood transfusion practice
• Close proximity to Thailand, Myanmar and India
To decrease the risk of spreading HIV:
Use condoms during sexual activity
Do not share drug injection equipment
If you are HIV-infected and pregnant, talk with your
doctor about taking anti-HIV drugs
If you are an HIV-infected woman, don't breast feed
any baby
If you think you've been exposed to HIV, get tested and
ask your doctor about taking anti-HIV medications.