An Introduction to HIV and AIDS Aims and Objectives AIM: To gain an understanding of HIV/AIDS OBJECTIVES: Know the difference between HIV and AIDS Be able to describe the basics of HIV infection and methods of transmission Know about some of the illnesses associated with HIV/AIDS Have an insight into the prevention and treatment of the disease What is HIV / AIDS HIV Human Immuno-deficiency Virus AIDS Acquired Immune-deficiency Syndrome History of HIV There are two species HIV-1 and HIV-2 Both viruses are of primate origin Unknown how SIV (simian immuno-deficiency virus) mutated into HIV Chimpanzee Sooty Mangabey HIV – 1 HIV -2 Pictures from www.americazoo.com Facts and figures The first cases were reported in Los Angeles, USA in 1981 Since then, 25 Million people have died There are now 40.3 Million people worldwide are living with HIV / AIDS (2.3 Million are children) AVERT, 2005 http://www.avert.org/worldstats.htm Facts and figures Sub Saharan Africa has the highest rates of infection 25.8 Million AVERT, 2005 http://www.avert.org/worldstats.htm How is HIV transmitted? There are 3 main routes of transmission: Sexual transmission Transfusion of infected blood or blood products Mother-to-child transmission during pregnancy, birth and breastfeeding How is HIV transmitted? However, for HIV transmission to occur 2 things are important: The virus must be alive and in a contaminated body fluid or tissue There must be a sufficient quantity of the virus * Low risk of transmission from tears, saliva and urine of infected individuals HIV infecting a cell HIV Particle White blood cell (CD4) Cell Doc Kaiser's Microbiology Home Page http://www.cat.cc.md.us/courses/bio141/lecguide/unit2/viruses/hivad.html HIV infecting a cell Virus particle Doc Kaiser's Microbiology Home Page http://www.cat.cc.md.us/courses/bio141/lecguide/unit2/viruses/hivad.html HIV infecting a cell Virus particles inserts itself into the cell DNA The cell changes function and creates thousands of copies of the virus particle The new virus particle are coated with protein The cell bursts and the new virus particles are released to go and infect other CD4 cells Protection against infection? White blood cells (lymphocytes) defend the body from infection HIV stops some of these cells (CD4) from working properly The body can not defend itself Infections occur Signs - Infections not normally seen in healthy individuals Caused by: Bacteria Viruses Fungi Parasites All usually controlled by the white blood cells Symptoms Very long list of symptoms Not the same in every HIV +ve person - Three main body systems affected: Respiratory Gastrointestinal Neurological - Cancers - Respiratory Conditions Pneumonia – PCP Pneumocystis Carinii bacteria Rare in immunocompetant people One of the first indication of AIDS Treated with Septrin antibiotics Tuberculosis – TB Bacteria Usually affects the lungs (immunocompetant people too) Can affect every other organ of the body Very long course of treatment Gastrointestinal Conditions Oral Candida (Thrush) Oesophagitis Fungal Coats the tongue and alters tastes Fungal (Candida), Viral (Herpes), bacterial Makes swallowing difficult and is painful Unexplained diarrhoea Bacterial (salmonella,shigella,listeria,E.coli) Parasitic (cryptosporidim, CMV) Contributes to severe weight loss Neurological Conditions Toxoplasmosis Parasitic (Toxoplasma gondii) Causes encephalitis and eye damage Person loses brain function Progressive Multifocal Leukoencephalopathy – PML Viral (JC virus) Destroys the myelin sheath round nerve cells impairing nerve impulse conduction Rapid progression, causes death within months of diagnosis Neurological Conditions Cryptococcal meningitis Fungal (Cryptococcus neoformans) Can cause seizures, confusion and ultimately death if untreated HIV-related Dementia Not infectious but auto-immune response to HIV Causes loss of brain function, specifically memory Cancers All HIV +ve people are at increased risk of developing cancer Common malignancies are: • Karposi’s sarcoma – purple nodules on skin, can affect other organs too • Lymphomas – cancers of lymph nodes • Cervical and Breast Cancer • Colon Cancer Treatment HIV can not be cured (at the moment) Anti-retroviral therapy aims to slow viral replication and help the body fight infection Illnesses common in HIV There are 4 groups of infection which are - Bacterial, Fungal, Viral, Protozal B= Pneumonia (chest infections), TB F= Candida (thrush) V= Shingles (herpes), PML P= Toxoplasmosis, PCP Psychological aspects of HIV diagnosis New diagnosis Life long Illness - ? 15/20 years Stigma Therapy Life decisions/changes – work? Chronic aspects of disease ie feeling sick, tiredness, pain Nursing care for HIV +ve patients They shouldn’t be treated any differently… but be aware of the following: Infection control procedures Their low immune status Nutritional needs Psychological support Any questions?
