-There are around 40 million HIV/AIDS infected people in the
world.
-Around one third of the new cases are resulting from
heterosexual transmission. And in them two-thirds are women.
-Incidence of HIV/AIDS in pregnancy varies from 0.3% to 2%.
Causative organisms:
-Acquired immunodeficiency syndrome(AIDS) is caused by DNA
retroviruses termed as human immunodeficiency virus, HIV-1 and HIV-2.
-Worldwide most of the cases are caused by HIV-1.
-Whereas HIV-2 infection is endemic in West
Africa.
-These retroviruses contain genome that encodes reverse
transcription of DNA from RNA.
-So the virus can make its own DNA copies in host cells.
Transmission:
-By infected blood and blood products.
-Sexual transmission by saliva, vaginal secretions and semen.
-It is the major mode of transmission.
-Vertical transmission possibly by placenta and membranes
can occur.
-The baby can acquire the infection mainly during labor or
after delivery through breast milk.
Clinical features:
Acute illness or acute retroviral syndrome:
-It usually starts within days o weeks after exposure.
-Generally it is similar o other viral syndromes.
-It usually lasts less than 10 days.
-Presenting symptoms:
Fever
Nigh sweats
Fatigue
Rash
Headache
Lymphadenopathy
Pharyngitis
Myalgias
Arthralgias
Nausea,
Vomitings &
diarrhea etc.
Chronic viremia begins after symptoms abated.
The stimulating factors which lead to further progression of
asymptomatic viremia to the immunodeficiency syndrome are not well defined.
Usually the median time is about 10 years.
AIDS:
-HIV positivity in association with any number of clinical
findings can be considered as AIDS.
-Generalized lymphadenopathy, oral hairy leukoplakia,
opthous ulcers and thrombocytopenia are commonly seen clinical features.
-The opportunistic infections that may herald AIDS are:
Ø
Esophageal or pulmonary candidiasis
Ø
Persistent herpes simplex or zoster
Ø
Condylomata accuminata
Ø
Tuberculosis
Ø
Cytomegalovirus infection
Ø
Molluscum contagiosum
Ø
Pneumocysis infections
Ø
Toxoplasmosis etc.
-Neurological disease is common. About half of patients will
have central nervous system symptoms.
-CD4+ count of less than 200/micro lit is also considered
diagnostic for AIDS.
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