ACQUIRED IMMUNODEFICIENCY SYNDROME presented by : Deepti Awasthi. CONTENTS. Introduction History Epidemiology HIV Virus Routes of transmission Pathogenesis. Clinical signs and manifestations Oral manifestations Lab diagnosis Prophylaxis Treatment Universal precautions References.
ACQUIRED IMMUNODEFICIENCY SYNDROMEpresented by :DeeptiAwasthi
40 million - infected worldwide
5 million – newly infected
3 million – died
2.2 million children - <15 yr
2nd largest after south africa
In 2003, 5 million infected
Status of HIV epidemic in India
Manipur Andhra Pradesh Nagaland Tamil Nadu Karnataka
High Prevalent states
1st case reported in chennai
HIV-1 : US & central africa
HIV-2 : west africa & india
The genome – 3 str. Genes : gag, pol, env.
- 75% of all cases
- male to male & male to female is more potent route than female to male.
1) I.V. Drug abusers
3) blood recipients
- pre term delivery
- low maternal antenatal CD4 count
- illicit drugs during pregnancy.
- elective cesarean delivery – by 87% +
ZVT in the mother & infant.
semen, vaginal secretions , cervical secretions, breast milk, CSF, synovial, pleural, peritoneal, pericardial & amniotic fluid.
anti –HIV activity
Ethanol – 70%
Formaldehyde – 5%
Glutaraldehyde – 2%
H2O2 – 0.3%
Interaction of gp120 of HIV to CD4+T cell
internalisation of virion
uncoating of virion
Activated CD4+T cell inactivated CD4+T cell
budding,syncytia LATENT PHASE
Quantitative depletion qualitative failure to respond
acute aseptic meningitis
1) ACUTE HIV INFECTION
2) ASYMPTOMATIC OR LATENT INFECTION
< 200 = clinical AIDS sets in
3) PERSISTENT GENERALIZED
4) AIDS RELATED COMPLEX (ARC)
CMV HERPES SIMPLEX
PAROTID SWELLINGS ORAL CANDIDIASIS
HAIRY LEUKOPLAKIA HERPETIC LESIONS
DELAYED TOOTH ERUPTION
ADVANCED HIV/AIDS DISEASE DEFINITIONS FOR SURVEILLANCE FOR ADULTS
Any clinical stage 3 or stage 4 disease
where CD4 is available, any clinical stage and CD4 <350/mm3
Testing Options for HIV
2. Virus isolation & culture
3. POLYMERASE CHAIN REACTION
4. ANTIBODY DETECTION
not highly specific
false + ve results
The most widely used screening test is ELISA.
In this HIV proteins are seperated acc. to their electrophoretic mobility by poly- acramide gel electrophoresis are blotted onto strips of nitrocellulose paper.
Identification of sources
Elimination of high risk activities
c)Target cell protection by anti-CD4 antibody
2. General management
3. Immunorestorative measures-
Administration of IL-2, thymic factors ,leucocyte transfusion & bone marrow transplantation.
4. Specific anti – HIV agents
ZVT 200 mg TID to the women & continued during delivery
decreases rate to < 8 %.
- Symptomatic - NSAIDS
- severe: prednisolone - life threatening: stop ART
Less severe - 2 drug PEP
more severe - 3 drug PEP
2% NaOCl 60 ml