Professional Documents
Culture Documents
Aids Kul
Aids Kul
TENTANG
HIV/AIDS
1
Top HIV/AIDS-Infected
Countries
SubSaharan
Africa
1.
South Africa
9.
United States
2.
Nigeria
10.
Russian Federation
3.
Zimbabwe
11.
China
4.
Tanzania
12.
Brazil
5.
The Congo
13.
Thailand
6.
Ethiopia
7.
Kenya
8.
Mozambique
Figure 1
40,000
42 59%
24 27%
TERINFEKSI
2-3 mgg
Acute Retroviral
Syndrome
2-3 mgg
Sembuh
Seroconvesion
1,3 TH
AIDS
8 THN
ASIMTOMATIK
IS THERE A CURE?
There is
NO
cure for
HIV/AIDS
Figure 20
Centers
HIV Prevention
Most prevention
funding
Funds go to states;
some cities;
community based
organizations; other
entities/programs
$589.8
$616.8
Medicare
Ryan
White
All Other
51% ($6.0B)
$656.6
$749.7
$793.6
$731.7
SEJARAH AIDS
Pertama Kali Timbul di Afrika, Haiti dan USA
1978
1979
Sarkoma Kaposi pada orang Afrika yang
mukim di Eropa
1981
USA . Sarkoma Kaposi di kalangan
Homo Seks
1982
Luc Montagnier ,Paris.
LAV (Limphadenonathy Associated Virus)
1984
Transmisi Heteroseks, Galo dkk. HTLV
IIII
1986
Penyebab AIDS adalah HIV
Indonesia :
Kasus pertama ( BALI ) :April 1987.
Wisatawan Belanda
Kasus kedua ( Jakarta ) :Nopember 1987.
Warga Kanada tinggal di JKT.
Kasus ketiga ( Jakarta ) : 1989. Warga
Perancis tinggal di JKT
Orang Indonesia Pertama di Bali: Juni
1988
HIV
13
14
Life Cycle
Viral Replication
helper T cells
macrophages
monocytes
B cells
microglial brain cells
intestinal cells
http://www.cat.cc.md.us/courses/bio141/lecguide/unit2/viruses/hivad.
html
HIV
T-cell
Immature
Dendritic cell
Skin or
mucosa
HIV co-receptors,
CD4 + chemokine
receptor CC5
Burst of HIV
replication
Via lymphatics or
circulation
24 hours
1.
PEP
2.
48 hours
Selective of
macrophagetropic HIV
3.
Mature Dendritic
cell in regional LN
undergoes a single
replication, which
transfers HIV to T19
cell
HIV
Human
Immunodeficiency
Virus
AIDS
Acquired
Immune
Deficiency
Syndrome
Normal counts range from 500 to 1500 cells per cubic millimeter
of blood
Initially in HIV infection there is a sharp drop in the CD4 count and
then the count levels off to around 500-600 cells/mm3.
CD4 counts can also be used to predict the risks for particular
conditions such as Pneumocystis carinii pneumonia, CMV disease
or MAI disease.
Treatment decisions are often based on Viral Load and CD4 count.
Perjalanan Infeksi
HIV
Tertular
HIV
Periode
HIV
Jendela*
2 minggu - 6 bulan
Tahun
AIDS
Positif
3 - 10
1 - 2
Tahun
Tampak sehat
infeksi
vitas biasa.
Timbul
symptoms
window
period
2
weeks
10
years
Stage 1 - Primary
Short, flu-like illness - occurs one to six weeks
after infection
no symptoms at all
Infected person can infect other people
Stage 2 - Asymptomatic
Lasts for an average of ten years
This stage is free from symptoms
There may be swollen glands
The level of HIV in the blood drops to very low
levels
HIV antibodies are detectable in the blood
Stage 3 - Symptomatic
The symptoms are mild
The immune system deteriorates
emergence of opportunistic infections and
cancers
system weakens
The illnesses
become more
severe leading to
an AIDS diagnosis
Opportunistic Infections
associated with AIDS
Bacterial
Tuberculosis
(TB)
Strep
pneumonia
Viral
Kaposi Sarcoma
Herpes
Opportunistic Infections
associated with AIDS
Parasitic
Pneumocystis
carinii
Fungal
Candida
Cryptococcus
AIDS
CD4 count drops below 200 person is considered
pasangan
Dari ibu ke bayi melalui :
Hamil
Melahirkan
menyusui
Modes of HIV/AIDS
Transmission
Transmission
AIDS
PTS )
2. Homoseksual.
3. Mereka yg suka/ pernah melakukan
Through Sex
Intercourse (penile penetration into the
vagina)
Oral
Anal
Digital Sex
Mother-to-Baby
Before Birth
During Birth
Postpartum
After the birth
(shown) is a rare
cancer of the blood
vessels that is
associated with HIV. It
manifests as bluish-red
oval-shaped patches
that may eventually
become thickened.
Lesions may appear
singly or in clusters.
ciuman
Terpapar batuk atau bersin
Berbagi makanan atau
menggunakan alat makan bersama
Air kotor, Udara
Bagaimana mengetahui
status HIV ?
Status HIV hanya dapat diketahui melalui
N
A
R
A
L
U
N
E
P
H
A
G
E
C
N
E
M
A
R
CA
HIV :
ADMINISTRATION
Blood
Urine
Oral
Immunosorbent
Assay/Enzyme Immunoassay (ELISA/EIA)
Radio Immunoprecipitation Assay/Indirect
Fluorescent Antibody Assay (RIP/IFA)
Polymerase Chain Reaction (PCR)
Western Blot Confirmatory test
URINE TESTING
ORAL TESTING
Orasure
The
TREATMENT OPTIONS
ANTIRETROVIRAL DRUGS
(Zidovudine)
(Nevirapine)
Protease inhibitors
Norvir
(Ritonavir)
WESTERN BLOT
Expensive $ 80 - 100
technically more difficult
visual interpretation
lack standardisation
- performance
- interpretation
- indeterminate reactions
resolution of ??
POLYMERASE CHAIN
REACTION (PCR)
Looks for HIV DNA in the WBCs of a person.
PCR amplifies tiny quantities of the HIV DNA
present, each cycle of PCR results in doubling of
the DNA sequences present.
The DNA is detected by using radioactive or
biotinylated probes.
Once DNA is amplified it is placed on
nitrocellulose paper and allowed to react with a
radiolabeled probe, a single stranded DNA
fragment unique to HIV, which will hybridize
with the patients HIV DNA if present.
Radioactivity is determined.
VIRUS ISOLATION
Virus
OPPORTUNISTIC INFECTION
TREATMENT
MONOGAMOUS RELATIONSHIP
A
PROTECTED SEX
STERILE NEEDLES
Dosing
1996
Zerit/Epivir/Crixivan
10 pills, Q8H
1998
Retrovir/Epivir/Sustiva
5 pills, BID
2002
Combivir (AZT/3TC)/EFV
3 pills, BID
2003
Viread/ Emtriva/Sustiva
3 pills, QD
2004
Truvada/Sustiva
2 pills, QD
TRUVADA
Truvada is made up of HIV drugs from a class
called nucleoside/nucleotide reverse transcriptase
inhibitors (NRTIs), also known as nukes.
The NRTIs block reverse transcriptase, a protein
that HIV needs to make more copies of itself.
This may slow down HIV disease
Vaccines?
Whole virus vaccines
Attenuated viruses: Essentially intact, living HIV virions that have
been chemically or genetically damaged.
Whole killed virus: Intact virions that have been damaged so badly
that they are completely nonfunctional (dead).
Subunit vaccines
Clone one gene from HIV, express the protein and use it to vaccinate
patients. The disadvantage is that the person only raises antibodies
against one target. With free virus, the targets are mainly the
envelope proteins; however, these are extremely variable proteins.
Six amino acids of the V3 loop of gp120 appear to be relatively
constant (some variability exists but most antibodies cross react with
the variants). Antibodies against cocktails of different V3's are being
tried.
Nucleic Acid Vaccines
Gene gun, muscle expression.
PENUTUP
Sesuai dgn sifat AIDS itu sendiri, maka
pencegahan AIDS relatif mudah, yaitu
menghindari pemakaian jarum suntik berganti
ganti dan menghindari hubungan seksual dgn
pasangan ganda.
Agama dan Pancasila melarang hubungan
seksual ekstra marital. Akan tetapi penggunaan
jargon jargon Agama atau Pancasila dalam
batasan ucapan verbal saja jelas tidak ada
gunanya, bahkan bisa membuat orang tertutup
terhadap informasi yang benar
ANY
QUestions?
Thank you!