Download Click to edit Master title style

Click to edit Master title style
HIV and AIDS
Click to edit Master title style
What are HIV and AIDS?
 HIV is the human immunodeficiency virus. It is the virus that
can lead to acquired immune deficiency syndrome, or AIDS.
There are two types of HIV, HIV-1 and HIV-2. In the United
States, unless otherwise noted, the term “HIV” primarily refers
to HIV-1.
 Both types of HIV damage a person’s body by destroying
specific blood cells, called CD4+ T cells, which are crucial to
Source CDC, 2011
helping the body fight diseases.
Click to edit Master title style
Source CDC, 2011
HIV-1
Click to edit Master title style
Source: © 2011 WebMD, LLC. All rights reserved.
Click to edit Master title style
Symptoms and Pathogenesis
Source : Source
Click to edit Master title style
 Within a few weeks of being infected (initial or acute
HIV infection )with HIV, some people develop flu-like
symptoms that last for a week or two, but others have
no symptoms at all.
 Symptoms of acute HIV may or may not manifest
after an initial exposure. These symptoms usually
dissipate spontaneously in a few weeks
Source CDC
Click to edit Master title style
Source Wikimedia
Click to edit Master title style
 People living with HIV may appear and feel healthy for several
years. However, even if they feel healthy, HIV is still affecting
their bodies.
 After initial symptoms, the disease often goes into a period
of remission. This window period, known as asymptomatic HIV,
can last for months or up to ten years.
 It is important to note that a person with an asymptomatic
HIV infection can still pass the disease to other people.
Source CDC
Click to edit Master title style
 When the HIV infection manifests again, a person's T4 cells
and CD4 cells, which are the body's main fighters of infection,
have been compromised, weakening the individual.
 Symptoms of early symptomatic HIV infection include:
 Loss of weight
 Lethargy, malaise, fatigue
 Fevers and sweats
 Memory loss
 Frequent yeast infections
 Skin rashes
 Herpes infections causing sores in the anus, genitalia and mouth
Click to edit Master title style
 The mean time from sero-conversion to onset of disease is
approximately 9 years. The time is similar whether the virus was acquired
by sexual behavior or the use of clotting agents.
Source: University of South Carolina
Click to edit Master title style
Data Source: Minnesota HIV/AIDS Surveillance System
Untreated HIV Infection: Average Time Course for
Stages and Evolution of CD4 Count and VL
1000
106
HIV RNA
105
800
104
600
103
400
HIV Antibodies
102
200
CD4 + T cells
6 months
Primary infection
10 years
Asymptomatic Chronic Infection
10
? 2 years
AIDS
Click to edit Master title style
 AIDS is the late stage of HIV infection, when a person’s immune system
is severely damaged (less than 200 CD4 cells/ml of blood) and has
difficulty fighting diseases.
 Patients with AIDS manifest with:
Weight loss
Seizures
 Extreme fatigue
 Loss of coordination
 Fever
 Dysphagia (difficulty in swallowing)
 Confusion and loss of memory
 Shortness of breath, chronic cough
 Severe headaches
 Coma
 Neck stiffness
 Tuberculosis
Source :Vitals.com
Click to edit Master title style
Data Source: Minnesota HIV/AIDS Surveillance System
Click to edit Master title style
Click to edit Master title style
Leukoplakia
CDC
atopic eczema
Click to edit Master title style
DermNet.com.
Click to edit Master title style
Psoriasis - Exfoliative Erythroderma
Click to edit Master title style
Data Source: Minnesota HIV/AIDS Surveillance System
Click to edit Master title style
Oral Thrush
Weight loss
Click to edit Master title style
Epidemiology
Click to edit Master title style
 Three (3) million people around the world die of AIDS each
year and, so far, more than 25 million people have died of the
disease.
 At least 33 million people are infected
 More than 14,000 new infections every day.
 In sub-Saharan Africa, more than 22 million people are living
with HIV infection.
Source CDC
Click to edit Master title style
 In 2009, the estimated number of diagnoses of HIV
infection in the 40 states and 5 U.S. dependent areas was
42,959.
 In the 40 states, diagnoses of HIV infection among adults
and adolescents totaled 41,845 with 31,872 diagnoses in
males and 9,973 diagnoses in females.
 Among children under age 13 years, there were an
estimated 166 diagnoses of HIV infection in 2009.
Source CDC
Click to edit Master title style
Data Source: Minnesota HIV/AIDS Surveillance System
Click to edit Master title style
Click to edit Master title style
Overview of HIV/AIDS in Minnesota
Source MDH 2011 HIV/AIDS in M Minnesota : Annual Review
Minnesota HIV/AIDS Surveillance:
Cumulative Cases

As of December 31, 2011, a cumulative total of 9,785*
persons have been diagnosed and reported with HIV
infection in Minnesota. Of these:
3,788 persons have been diagnosed with HIV infection
(non-AIDS)
 5,997 have progressed to AIDS


Of these 9,785 persons, 3,347 are known to be
deceased
* This number includes only persons who reported Minnesota as their state of residence at the time of their HIV and/or AIDS diagnosis.
Data Source: Minnesota HIV/AIDS Surveillance System
HIV/AIDS in Minnesota:
New HIV Infection, HIV (non-AIDS) and AIDS Cases by Year, 1996-2011
*Includes all new cases of HIV infection (both HIV (non-AIDS) and AIDS at first diagnosis) diagnosed within a given calendar year.
^Includes all new cases of AIDS diagnosed within a given calendar year, including AIDS at first diagnosis. This includes refugees in the HIV+ Resettlement Program, as well as, other
refugee/immigrants diagnosed with AIDS subsequent to their arrival in the United States.
Data Source: Minnesota HIV/AIDS Surveillance System
HIV/AIDS in Minnesota:
Number of Prevalent Cases, and Deaths by Year, 1996-2011
*Deaths among MN AIDS cases, regardless of location of death and cause.
^Deaths in Minnesota among people with HIV/AIDS, regardless of location of diagnosis and cause.
Data Source: Minnesota HIV/AIDS Surveillance System
Click to edit Master title style
Diagnosis of HIV Infection
 Detection and quantization of HIV : p24 antigen, viral
culture and PCR
 HIV Antibody Tests
 Rapid tests : can diagnose HIV infection within 20-30
minutes
Click to edit Master title style
Risk factors
Click to edit Master title style
Potentially infectious body fluids
 Blood
 Bloody body fluids
 Semen
 Vaginal secretions
 Breast milk
Low risk: not considered potentially infectious unless bloody;
 Saliva, sputum
 Feces, urine
 Sweat, tears
Click to
edit Master titleRoutes
style
Major
Transmission
 Sexual intercourse with infected person: includes anal, vaginal
and oral
 Blood/blood products:
previously transfusion of blood and blood products
currently injection drug use (needles and syringes)
transmission in health care setting (unusual)
 Mother to infant: during pregnancy, labor and delivery and breast
feeding
 Not casual contact : mosquitoes bites
Click to edit Master title style
Sexual transmission of HIV
 Risk varies for different practices
 Factors facilitating transmission include:
Trauma
STDs
Viral load
Sexual transmission of HIV : Risk varies for different practices
Exposure Route
Risk per 10,000 exposures
Receptive anal intercourse
50
Receptive penile-vaginal
intercourse
10
Insertive penile-vaginal
intercourse
10
Insertive anal intercourse
6.5
Receptive oral intercourse
Estimates of per-act risk of acquisition of HIV are approximate and
vary widely depending on the viral load of the source contact, the
presence of sexually transmitted diseases, and other factors (CDC)
1
Click to edit Master title style
HIV and Sexually Transmitted Diseases
 Individuals with STDs are at least 2-5 times more
likely to acquire HIV if exposed to HIV through sexual
contact.
 If an HIV-infected individual is also infected with
another STD, they are more likely to transmit HIV
through sexual contact.
Click to edit Master title style
HIV and Sexually Transmitted Diseases
Genital ulcers (syphilis, herpes…) result in breaks in
genital tract lining or skin, creating portal of entry for
HIV
 Non-ulcerative STDs (Chlamydia and gonorrhea)
increase concentration of cells in genital secretions that
can serve as targets for HIV (e.g., CD4+ cells).
Click to edit Master title style
Prevention
Click to edit Master title style
Prevention
 Know your HIV status by getting tested. Everyone between
the ages of 13 and 64 should be tested for HIV at least once.
 Abstain from sexual activity or Be faithful (be in a longterm mutually monogamous relationship with an uninfected
partner).
 Limit your number of sex partners. The fewer partners you
have, the less likely you are to encounter someone who is
infected with HIV or another STD.
Click to edit Master title style
Prevention
 Correct and consistent condom use. Latex condoms are
highly effective at preventing transmission of HIV and some
other sexually transmitted diseases.
Get tested and treated for STDs and insist that your partners
do too.
 Male circumcision has also been shown to reduce the risk of
HIV transmission from women to men during vaginal sex.
Click to edit Master title style
Prevention
 Do not inject drugs. If you inject drugs, you should
get counseling and treatment to stop or reduce your
drug use. If you cannot stop injecting drugs, use clean
needles and works when injecting.
 Obtain medical treatment immediately if you think
you were exposed to HIV. Sometimes, HIV medications
can prevent infection if they are started quickly.
Click
to edit Master title style
Prevention
 Participate in risk reduction programs: programs exist to help
people make healthy decisions, such as negotiating condom
use or discussing HIV status. Health department can refer you
to programs.
 Female condom: protects vagina, cervix and external
genitalia, offering extensive barrier protection.
 Microbicide: gel, cream, suppository, film lubricant, sponge
or vaginal ring that reduces sexually transmitted disease
Click to edit Master title style
Source:
Coates T.
Intl AIDS
Conf 2008;
Mexico
City
Abs
TUSS020
Click to edit Master title style
Treatment
Click to edit Master title style
 All people with HIV should be seen on a regular basis by a
health care provider experienced with treating HIV infection.
 Many people with HIV, including those who feel healthy, can
benefit greatly from current medications used to treat HIV
infection.
 These medications can limit or slow down the destruction of
the immune system, improve the health of people living with
HIV, and may reduce their ability to transmit HIV.
Source CDC
Click to edit Master title style
 Untreated early HIV infection is also associated with
many diseases including cardiovascular disease, kidney
disease, liver disease, and cancer.
 Support services are also available to many people
with HIV. These services can help people cope with their
diagnosis, reduce risk behavior, and find needed
services.
Source CDC
Click to edit Master title style
 While current medications can dramatically improve
the health of people living with HIV and slow
progression from HIV infection to AIDS, existing
treatments need to be taken daily for the rest of a
person’s life, need to be carefully monitored, and come
with costs and potential side effects.
 At this time, there is no cure for HIV infection.
Source CDC
Click to edit Master title style
 Untreated early HIV infection is also associated with
many diseases including cardiovascular disease, kidney
disease, liver disease, and cancer.
 Support services are also available to many people
with HIV. These services can help people cope with their
diagnosis, reduce risk behavior, and find needed
services.
Source CDC
Click to edit Master title style
Data Source: Minnesota HIV/AIDS Surveillance System
HIV
HBV
Transmission
Sex, bloody fluid
Sex, blood ,body fluids
Pathogen
Virus
Risks factors
Unprotected sex,
multiple partners,
other STDs, injectingdrug use, MSM
Treatment
No treatment but
medications slow
down destruction of
the immune system
Vaccine
No vaccine
Click to edit Master title style
Virus
Unprotected sex,
multiple partners,
other STDs, injectingdrug use, MSM
No treatment
Very efficient vaccine
TRANSMISSION
HIV
HBV
Cuts or breaks in the skin
Yes
Yes
Breast milk
Injections or needle stick
No style
ClickYesto edit Master title
Yes
Yes
Deep kissing
No
No
Sex
Yes
Yes
Breathing in droplets
No
No
Blood transfusion
Yes
Yes
Saliva
No
No
Dry blood (1week old)
No
Yes
Birth to an infected mother
Yes
Yes
Sharing items such as razors
or toothbrushes with infected
Yes
Yes