AIDS (PDF)

AIDS 1 AIDS Acquired immune deficiency syndrome (AIDS) or acquired immunodeficiency syndrome (AIDS) is a collection of symptoms and infections resulting from the specific damage to the immune system caused by the human immunodeficiency virus (HIV) in humans. The human immunodeficiency virus, or...

AIDS 1 AIDS Acquired immune deficiency syndrome (AIDS) or acquired immunodeficiency syndrome (AIDS) is a collection of symptoms and infections resulting from the specific damage to the immune system caused by the human immunodeficiency virus (HIV) in humans. The human immunodeficiency virus, or HIV, attacks the body's immune system by weakening the body's defense against disease; HIV makes the body vulnerable to a number of potentially life-threatening infections and cancers. Clinical manifestations The clinical manifestations of AIDS are widespread and may affect virtually any organ system. Diseases associated with HIV infection and AIDS results infections, malignancies or direct affect of HIV on the body tissues. The followings are the common clinical manifestations and effects of severe HIV infection. 1. Respiratory manifestations Pneumocystis carinii Pneumonia (PCP): PCP is the initial manifestation of AIDS in 60% of patient. Clinical feature include fever, chills, non productive cough, shortness of breath, chest pain. Untreated PCP eventually progress and cause significant pulmonary impairment and ultimately respiratory failure, tachycardia, cyanosis, and hypoxemia. 1  AIDS 2 Tuberculosis: Tuberculosis infection is more common in injecting drug users. Tuberculosis responds well to antituberculosis therapy. 2. Gastrointestinal manifestations. Wasting syndrome: Diagnostic criteria include profound involuntary weight loss, weakness, intermittent or constant fever. Anorexia, diarrhea, GI malabsorption and lack of nutrition in chronic disease all contribute to wasting syndrome. Oral Candidiasis: A fungal infections occur in nearly all patients with AIDS. It is characterized by creamy white patches in oral cavity. If untreated then oral candidiasis will progress to involve the esophagus and stomach. 3. Oncologic manifestations Kaposi’s sarcoma (KS): KS is the most common HIV-related malignancy, is involving the endothelial layer of blood vessels and lymphatic system. KS was first noticed in 1872 by Dr. Moritiz Kaposi. KS is most often seen in homosexuals and bisexuals. Cutaneous lesions (Usually brownish pink to deep purple) appears on whole body. Diagnosis of KS is conformed by biopsy of suspected lesions. 4. Neurological Manifestation HIV encephalopathy: It is also referred as the AIDS dementia complex (ADC). This condition occurs in two thirds of patients with AIDS. It is clinical syndrome characterized by a progressive decline in cognitive, behavioral and motor functions. HIV has been found in the brain and cerebrospinal fluid (CSF) of the patient s with ADC. HIV release 2  AIDS 3 the toxins or lymphokinnes that cause the cellular dysfunction or interference the functions of neurotransmitters rather than cell damage. Depressive manifestations  Irratational guilt and shame  Loss of self esteem  Helplessness feelings  Suicidal idiatation. 5. Intergumentry manifestations  Herpes simplex and herpes zoster associated with painful vesicles  Plaque formations  Seborheic dermatitis  Scaly rashes on scalp and face  Generalized folliculitis  Flaking skin or atrophic dermatitis  Disturbed skin integrity 6. Specific manifestations in women  Vaginal candidiasis 3  AIDS 4 HIV Transmission HIV-1 is transmitted in body fluids containing HIV, these fluids include Blood, Seminal fluid, Vaginal secretions, Amniotic fluid, Breast milk. 1- sexual route 2- Perinatal route 3- Parenteral Route Investigation: ELISA TEST (enzyme-linked immuno sorbent assay) Polymerase Chain Reaction (PCR) Viral load Western blot CD4 ratio T lymphocytes Treatment of HIV Infection: Treatment decisions for an individual patient are based on three factors: 1. Nucleoside analog reverse transcriptase inhibitors (NRTIs) Zidovudine Lamivudin 2. Non-nucleoside reverse transcriptase inhibitors (NNRTIs) Nevirapine (Viramune) Delavirdine (Rescriptor) 4  AIDS 5 Efavirenz (Sustiva) Tenofovir (Viread) 3. Protease inhibitors Nelfinavir (Viracept) Ritonavir (Norvir) Saquinavir (Invirase,fortovase) Indinavir (Crixivan) Amprenavir (Agenerase) Health Education’s Prevention Reduce the number of sexual partners to one. Always use latex condoms; if allergic to latex, use female condoms (nonlatex). Do not reuse condoms. Do not use cervical caps or diaphragms without using a condom as well.. Avoid anal intercourse because this practice may injure tissues. Do not ingest urine or semen. If you are HIV seropositive, do not have unprotected sex with another HIV-seropositive person, because cross-infection with another HIV strain can increase the severity of the disease. Do not share needles, razors, toothbrushes, sex toys, or other blood-contaminated articles. If HIV seropositive, do not donate blood, plasma, body organs, or sperm. 5 AIDS 6 6