HIV AIDS IN ENGLISH

                                                       

                                                  HIV  AIDS IN ENGLISH

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 HIV /  AIDS-

           Acquired Immunodeficiency syndrome (AIDS) is a term first used in 1981 for a cluster of diseases associated with loss of cellular immunity in adults who had no obvious reason for presenting such immune deficiencies. AIDS is considered to be the late clinical stage of infection with the human immunodeficiency virus (HIV).

           In 1993, a revised surveillance definition of AIDS included additional diseases indicator. Addition is that all HIV-infected persons with a CD4 cell count of under 200/mm3 or a CD4 T-lymphocyte percentage of total lymphocytes under 14%, regardless of clinical status, are regarded as AIDS cases

CAUSATIVE AGENT-

           When the virus was first identified it was called "lymphadenopathy-associated virus (LAV) by the French scientists. Researchers in USA called it "human T-cell lympho-tropic virus III (HTLV-III)". In May 1986, the International Committee on the Taxonomy gave it a new name : human immunodeficiency virus (HIV).

           Two serologically distinct types of  this  virus HIV-1 and HIV-2, have been identified. The virus has been found in greatest concentration in blood, semen and CSE Lower concentrations have been detected in tears, saliva, breast milk, urine, and cervical and vaginal secretions. HIV has also been isolated in brain tissue, lymph nodes, bone marrow cells and skin of the patient.

HOW IT SPREADS-

           Mode of transmission—

           1. Person to person transmission through unprotected (heterosexual or homosexual) intercourse.

           2. Contact of abraded skin or mucosa with body secretions such as blood, CSF or semen.

           3. the use of HIV-contaminated needles and syringes, including sharing by intravenous drug users.

           4.Transfusion of infected blood or its components and transplantation of organs of infected person.

           5. HIV can also be transmitted from mother to child (MTCT or vertical transmission). From 15% to 35% of infants born to HIV-positive mothers are infected through placental processes at birth.

           6. HIV-infected women can transmit infection to their infants through breastfeeding and this can account for up to half of mother-to-child HIV transmission.

INCUBATION PERIOD

           It is Variable. Although the time from infection to the development of detectable antibodies(window period) is generally 1–3 months, the time from HIV infection to diagnosis of AIDS has an observed range of less than 1 year to 15 years or longer. The median incubation period in infected infants is shorter than in adults.

CLINICAL MANIFESTATIONS-

           The clinical features of HIV infection have been classified into four phases:

           I.          Initial infection with the virus –

           In this phase most HIV infected people have no symptoms for the first five years or so. They look healthy and feel well although right from the  start they can transmit the virus to others. Some HIV infected persons may have mild symptoms initially such as fever sore throat and rashes.

            

           II.         Asymptomatic carrier state-

 

           In this state HIV infected people stay asymptomatic but they may spread infections. They have antibodies, but no overt signs of disease, except persistent generalized lymphadenopathy. It is not clear how long the asymptomatic carrier state lasts.

           III.        AIDS-related complex (ARC)-

           A person with ARC has illnesses caused by damage to the immune system, they may exhibit one or more of the following clinical signs; unexplained diarrhoea lasting longer than a month, fatigue, malaise, loss of more than 10 per cent body weight, fever, night sweats, or other milder opportunistic infections such as oral thrush, generalized lymphadenopathy or enlarged spleen.

           IV.       AIDS. –

           AIDS is the end-stage of HIV infection. A number of opportunist infections commonly occur at this stage. Tuberculosis and Kaposi sarcoma are usually seen relatively early. Serious fungal infections such as Candida oesophagitis, Cryptococcus meningitis and penicillosis, and parasitic infections such as Pneumocystis carinni pneumonia or Toxoplasma gondii encephalitis etc.

DIAGNOSTIC INVESTIGATIONS-

Ø  History  - present health history, personal history and sexual history.

Ø  Presence of antibodies to HIV is the basis for the most widely used test of HIV infection. ELISA and Western Blot is a highly specific test for detecting HIV antibody in the blood.

Ø  Several laboratory markers are available to provide prognostic information and guide therapy decisions. The most widely used marker is  CD4 lymphocyte count. People with healthy immune system usually have more than 950 CD4 cells/μL of blood. The number falls over the course of HIV infection. People with AIDS usually have CD4 cell count below 200.

TREATMENT-

Ø  At present there is no cure for HIV infection. A person infected with HIV will remain HIV positive for rest of his life.

Ø  But antiviral chemotherapy have proved to be useful in controlling viral load and in prolonging the life of severely ill patients. This therapy is known as ART (ante retroviral treatment)

 

PREVENTION-

Ø  Providing health education regarding prevention of HIV infection is the best policy to preventing HIV and AIDS because aware people are always safe.

Ø  People should be educated to make life-saving choices such as avoiding indiscriminate sex, using condoms. There is, however, no guarantee that the use of condoms will give full protection, but chance are reduced.

Ø  People should also avoid the use of shared razors  and toothbrushes.

Ø  Intravenous drug users should be informed that the sharing of needles and syringes involves special risk.

Ø  Educational material and guidelines for prevention should be made widely available

Ø  Women suffering from AIDS or who are at high risk of infection should attend special counselling sessions and make proper informed decision before becoming pregnant because there are chances of vertical transmission.

Ø  People in high-risk groups should be urged to refrain from donating blood, body organs, sperm or other tissues.

Ø  All blood should be screened for HIV before transfusion and voluntary blood donation should be encouraged.

Ø  Strict sterilization practices should be ensured in hospitals and clinics.

Ø  Pre-sterilized disposable syringes and needles should be used as far as possible.

Ø  All bio medical waste in hospitals, clinics and labs should be discarded as per BMW management guidelines.

Ø  Every needle prick injury in hospitals specially to health workers should  be handled as emergency and post exposure prophylaxis should be provided.

Ø  All pregnant women should be tested for HIV during anti natal examination.

Ø  Reporting of HIV positive cases to local health authority is very important to control spread of infection. Official reporting of AIDS cases is obligatory in most countries.

Ø  Concurrent & terminal disinfection Of equipment contaminated with blood or body fluids and with excretions and secretions visibly contaminated with blood and body fluids by using bleach solution