HIV AIDS

Dr Laxmikant Chavan MD
Prevalence
People living with HIV/AIDS
• 36.9 million people living (all ages) with HIV/AIDS
worldwide in 2017
Mortality
• 940 000people died of HIV-related illnesses worldwide in
2017
Reaching the 90 90 90 targets

• While there has been progress towards UNAIDS’ 90-90-90

targets for prevention and treatment, this appears to be
stalling and at current rates the targets will not be achieved
by the 2020 deadline
PATHOGENESIS
Pathogenesis
Pathogenesis
Pathogenesis
Pathogenesis
Pathogenesis
Pathogenesis
Pathogenesis
Pathogenesis
Pathogenesis
 Natural History of HIV Infection

• Immune suppression
• HIV attacks white blood cells, called CD4 cells, that protect
body from illness
• Over time, the body’s ability to fight common infections is
lost
• Opportunistic infections occur
 HIV Disease
• Severity of illness is determined
by amount of virus in the body
(increasing viral load) and the
degree of immune suppression
(decreasing CD4+ counts)
• Higher the viral load, the sooner
immune suppression occurs
Natural Course of HIV Infection
Prevention of HIV Transmission

• Public health strategies to prevent HIV

transmission
• Screen all blood and blood products
• Follow universal precautions
• Educate in safer sex practices
• Identify and treat STIs/other infections
• Provide referral for treatment of drug dependence
• Apply the comprehensive PPTCT approach to prevent
vertical transmission of HIV
 HIV Disease
•Progression of HIV disease is measured by:
• CD4+ count
• Degree of immune suppression
• Lower CD4+ count means decreasing immunity
• Viral load
• Amount of virus in the blood
• Higher viral load means more immune suppression
OI’s in HIV
CXR
Toxoplasmosis
Primary CNC Lymphoma
OI and Primary Prophylaxis
Vaccines which Can be Given
Quiz
Quiz
Progression of HIV Infection

• HIGH viral load (number of copies of HIV in the blood)

• LOW CD4 count (type of white blood cell)

• Increasing clinical symptoms (such as opportunistic

infections)
Prevention of HIV Transmission

• Strategies to prevent HIV transmission

• Personal strategies

• Public health strategies

• Safe practices: no risk of HIV transmission

• Risk reduction: reduces but does not eliminate risk

 HIV Disease: Summary
• HIV multiplies inside the CD4+ cells, destroying them
• As CD4+ cell count decreases and viral load increases,
the immune defences are weakened
• HIV-infected people become vulnerable to opportunistic
infections
• HIV is a chronic viral infection with no known cure
• Without ARV treatment, HIV progresses to symptomatic
disease and AIDS
Natural History of HIV Infection
•Virus can be transmitted during each stage

• Seroconversion
• Infection with HIV, antibodies develop
• Asymptomatic
• No signs of HIV, immune system controls virus production
• Symptomatic
• Physical signs of HIV infection, some immune suppression
• AIDS
• Opportunistic infections, end-stage disease