HIV, AIDS, and Immunodeficiency Overview

HIV, AIDS, and Immunodeficiency

• Immunodeficiency weakens the immune system, increasing susceptibility to infections, cancers, and other diseases.
• HIV (Human Immunodeficiency Virus) is a virus that can lead to AIDS.
• AIDS (Acquired Immunodeficiency Syndrome) occurs when HIV severely damages the immune system, resulting in life-threatening infections and illnesses.
• HIV stages include seroconversion illness (often asymptomatic or influenza-like), the asymptomatic stage (long-lasting), symptomatic HIV (development of infections), and late-stage HIV (AIDS-defining conditions).
• HIV is found in various bodily fluids, primarily semen, vaginal fluids, blood, and breast milk.
• The most frequent mode of HIV transmission in the UK involves unprotected anal or vaginal sex.
• HIV transmission via oral sex is relatively rare.
• HIV is not spread through sweat, urine or saliva.
• Risk factors include other STIs, sharing needles, unsafe injections, and blood transfusions.
• Diagnosis involves an HIV test.
• PEP (Post-Exposure Prophylaxis) is emergency HIV medicine taken within 72 hours of exposure and can prevent contracting HIV.
• Treatment involves antiretroviral medicines (ART) to stop the virus's replication and aims for an undetectable viral load.

Learning Outcomes

• Knowledge of HIV, AIDS, & Immunodeficiency is essential
• Understanding of the stages and symptoms of HIV
• Knowledge of HIV transmission and risk factors is necessary.
• Awareness of current testing and treatment options is crucial.

Intended Learning Outcomes

• Develop extensive knowledge about HIV.
• Define terms like HIV, AIDS, and Immunodeficiency.
• Identify the different stages of HIV infection.
• Understanding of the signs and symptoms associated with HIV.

Immunodeficiency

• Immunodeficiency results in increased risk of infection, cancer, and other illnesses.
• This is due to the immune systems inability to fight off infections.

Examples of Immunodeficiency Diseases

• Ataxia-telangiectasia
• Chediak-Higashi syndrome
• Hypogammaglobulinemia
• Leukocyte adhesion defects
• Combined immunodeficiency disease
• AIDS
• HIV

History of HIV/AIDS

• In 1983, Luc Montagnier suspected a virus as the cause of HIV, and teamed up with Françoise Barré-Sinoussi to find the retrovirus.
• The cut hunter hypothesis suggests HIV originated in chimpanzees and spread to humans through hunting and contact with infected blood.

What is AIDS?

• AIDS is a set of conditions arising from immune system damage from HIV.
• HIV damage leads to life-threatening illnesses and infection.

HIV Stages

• Stage 1 (Seroconversion): Short illness after HIV contraction.
• Stage 2 (Asymptomatic): No visible symptoms, but virus is active and damages the immune system.
• Stage 3 (Symptomatic): Infections and illnesses arise due to a very weakened immune system.
• Stage 4 (Late-stage/AIDS-defining illness): Severe immune deficiency leads to opportunistic infections and cancers.

Common AIDS-Defining Illnesses

• Candidiasis
• Cervical cancer
• Coccidioidomycosis
• Cryptococcosis
• Cryptosporidiosis
• Cytomegalovirus disease/CMV
• Encephalopathy (HIV related)
• Herpes simplex
• Histoplasmosis
• Isosporiasis
• Kaposi's sarcoma
• Lymphoma (Burkitt's, immunoblastic)
• Mycobacterium avium complex (MAC)
• Mycobacterium tuberculosis (TB).
• Mycobacterium/other species
• Pneumocystis pneumonia (PCP)
• Pneumonia (recurrent)
• Progressive multifocal leukoencephalopathy (PML)
• Salmonella septicemia (recurrent)
• Toxoplasmosis of brain
• Wasting syndrome

Common AIDS-Defining Illnesses (Specific examples)

• Non-Hodgkin Lymphoma: Cancer of the lymphatic system, often painless lymph node swelling.
• Tuberculosis (TB): Bacterial infection increasing risk with HIV, resulting in HIV/TB coinfection.
• Cryptococcal Meningitis: Fungal infection, causing brain infection (not contagious.)
• Cachexia (Wasting Syndrome): Complex process of sudden weight loss/mass loss.
• Kaposi's sarcoma (KS): Cancer caused by Herpesvirus type 8(HHV-8). Most don't develop this cancer but can also affect lymphatic systems and organs.
• Hairy leukoplakia: Oral condition triggered by Epstein-Barr Virus. Warning sign for a weak immune system and potentially HIV.

Viral load

• Viral load measures the amount of HIV in the blood.
• A low viral load indicates effective treatment and reduced risk of transmission.

HIV Treatment

• Antiretroviral therapy (ART) is a combination of drugs taken daily.
• The goal is to achieve an undetectable viral load, to help protect other people.

Risk Factors for HIV

• Recent exposure to infected fluids.
• Other STIs
• Injecting drug use
• Unsafe injections
• High-risk sexual behaviours without using prophylactic measures
• Blood transfusions and tissue transplantation.

Prevention

• Condoms for sex
• PrEP
• PEP

Gender and Ethnicity Distribution

• Focus on men and women living with HIV infection and ethnicity within the UK

UK Statistics

• Number of people living with HIV in 2019.
• Percentage of people diagnosed and not diagnosed.

In the Surgery

• Correct Patient Management Practices: Proper infection control (universal precautions), respectful treatment, and avoiding assumptions are key.

Avoiding Stigma

• The presence of stigma and discrimination is noted.

General Health and Wellbeing

• Promote overall health strategies like regular exercise, balanced diet, avoiding smoking, and optimal oral hygiene to support people with HIV.

Additional Information-

• List of learning outcomes and possible learning methods was included.
• Explanations of important medical terminology.
• Specific types of HIV diagnosis and transmission was covered.
• Treatment pathways and prevention strategies were explored.