Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)
Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)
Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)
LECTURE
MODULE
Since HIV was first identified almost 30 years ago, remarkable progress has been
made in improving the quality and duration of life for people living with HIV disease.
● HIV or human immunodeficiency virus and acquired immunodeficiency syndrome
is a chronic condition that requires daily medication.
● HIV- 1 is a retrovirus isolated and recognized as the etiologic agent of AIDS.
● HIV-2 is a retrovirus identified in 1986 in AIDS patients in West.
Classification
The stages of HIV disease are based on clinical history, physical examination,
laboratory evidence of immune dysfunction, signs and symptoms, and infections and
malignancies.
● Primary infection (Acute/Recent HIV Infection). The period from infection with
HIV to the development of HIV-specific antibodies is known as primary infection.
● HIV asymptomatic (CDC Category A). After the viral set point is reached,
HIV-positive people enter into a chronic stage in which the immune system cannot
eliminate the virus despite its best efforts.
● HIV symptomatic (CDC Category B). Category B consists of symptomatic
conditions in HIV-infected patients that are not included in the conditions listed in
category C.
● AIDS (CDC Category C). When the CD4+ T-cell level drops below 200
cells/mm3 of blood, the person is said to have AIDS.
Pathophysiology
Check out this awesome pathophysiology and easy to understand video by Osmosis.
https://www.youtube.com/watch?v=5g1ijpBI6Dk&feature=emb_title
In the fall of 1982, after the first 100 cases were reported, the Centers for Disease
Control and Prevention (CDC) issued a case definition for AIDS.
● In 2008, the CDC reported that approximately 56, 300 new HIV infections
occurred in the United States in 2006.
● The figure was roughly 40% higher than their former estimate of 40, 000 HIV
infections per year.
● Almost 7000 people still contract HIV infection every day.
● An estimated 33 million people are living with HIV/AIDS; however, the number of
new infections declined from 3 million in 2001 to 2.7 million in 2007.
● The global percentage of women among people with HIV/AIDS remains at 50%.
● Sub-Saharan Africa continues to be most heavily affected by HIV/AIDS, with
67% of all people living with the disease.
● In 2007, 72% of deaths from HIV/AIDS occurred in the same region.
Causes
HIV is transmitted through body fluids that contain free virions and infected CD4+
T cells.
● Sharing infected drug use equipment such as needles.
● Having sexual relations with infected individuals (both male and female).
● Blood transmission. Receiving HIV-infected blood or blood products especially
before blood screening.
● Maternal HIV. Infants born to mothers with HIV infection.
Clinical Manifestations
HIV has four categories with specific manifestations for each stage.
● This is experienced during the early infection stages.
● People who are acutely infected with HIV experience this symptom.
● This symptom is mostly present in category B wherein the patient has already
entered the chronic stage.
● Constitutional symptoms. Fever more than 38.5⁰C or diarrhea exceeding 1 month
in duration may also indicate presence of HIV infection.
● Patients with HIV category C experience wasting syndrome or severe wasting of
the muscles.
Complications
The patient should be monitored for presence of complications and should be managed
appropriately.
● Opportunistic infections. Patients who are immunosuppressed are at risk for
opportunistic infections such as pneumocystis pneumonia which can affect 80% of
all people infected with HIV.
● Respiratory failure. Impaired breathing is a major complication that increases
the patient’s discomfort and anxiety and may lead to respiratory and cardiac failure.
● Cachexia and wasting. Wasting syndrome occurs when there is profound
involuntary weight loss exceeding 10% of the baseline body weight and it is a
common complication of HIV infection and AIDS.
Medical Management