HIV –

AIDS
Sri Vitayani
Acquired immunodeficiency
syndrome (AIDS)  sindrom
dgn gejala penyakit infeksi
oportunistik / kanker tertentu
akibat menurunnya sistem
kekebalan tubuh oleh oleh
infeksi human immuno-
deficiency virus (HIV).
 PENYEBAB

Disebabkan  HIV 

ditemukan ilmuwan Perancis,

Montagnier (1983).
Virus  darah, semen (duh

tubuh pria) & sekret vagina

(alat persetubuhan wanita) 

tubuh manusia.
 PENULARAN HIV

• Melalui hubungan seksual

dgn banyak orang.

• Melalui pemakaian ulang alat-
alat yg menembus kulit (jarum
suntik) tanpa disterilkan.
 How is HIV Transmitted?
• Unprotected sexual
contact with an infected
partner
• Exposure of broken skin
or wound to infected
blood or body fluids
• Transfusion with HIV-
infected blood
• Injection with
contaminated objects
• Mother to child during
pregnancy, birth or
breastfeeding

6
 What is HIV?

• Human: Infecting human beings

• Immunodeficiency: Decrease or
weakness in the body’s ability to fight off
infections and illnesses
• Virus: A pathogen having the ability to
replicate only inside a living cell

7
 Structure of HIV

Envelope

Reverse
Core p24 Transcriptase

RNA

8
 What is AIDS?
• Acquired: To come into possession of
something new
• Immune Deficiency: Decrease or weakness in
the body’s ability to fight off infections and
illnesses
• Syndrome: A group of signs and symptoms
that occur together and characterize a particular
abnormality
AIDS is the final stage of the disease caused by
infection with a type of virus called HIV.
9
 HIV vs. AIDS
• HIV is the virus that causes AIDS
• Not everyone who is infected with HIV has
AIDS
• Everyone with AIDS is infected with HIV
• AIDS is result of the progression of HIV
Infection
• Anyone infected with HIV, although
healthy, can still transmit the virus to
another person
10
FAKTOR-FAKTOR YANG
BERPENGARUH

1.Faktor dasar :

• Adanya penularan penyakit.

• Berganti-ganti pasangan

seksual.
2.Faktor medis :

• Gejala klinis  wanita &

Homoseksual  asimtomatis.

• Pengobatan modern, mudah,

murah, cepat & efektif 

risiko resistensi tinggi.

3.Faktor sosial :

• Mobilitas penduduk.

• Prostitusi.

• Waktu yang santai.

• Kebebasan individu.

• Ketidaktahuan.
KELOMPOK PERILAKU
RISIKO TINGGI
1.Usia :
• 20–34 thn  laki-laki.
• 16–24 thn  wanita.
• 20–24 thn  kedua jenis
kelamin.
2.Pelancong.

3.Pekerja seksual komersial

atau wanita tuna susila.

4.Pecandu narkotik.

5.Homoseksual.
 Testing for Viral Infection and
Immune Response
• Viral infection
–Viral Load
–p24 Antigen
• Immune response
–Antibody (IgG, IgM)
–Cellular response (CD4)
16
 Evolution of Antibodies

Window Period

17
 Window Period
• Time from initial infection with HIV until
antibodies are detected by a single test
• Usually 3-8 weeks before antibodies are
detected
• May test false-negative for HIV antibodies
during this time period
• Can still pass the virus to others during
this period
18
 Disease Progression
• Severity of illness is determined by
amount of virus in the body
(increasing viral load) and the degree
of immune suppression (decreasing
CD4+ counts)
• As the CD4 count declines, the
immune function decreases.

19
WHO HIV/AIDS Classification
System
Stage I Stage II Stage III Stage IV
Minor Symptoms Moderate
Asymptomatic Symptoms AIDS

20
 Can Disease Progression Be
Delayed?
• Prevention and
early treatment of
opportunistic
infections (OIs)
• Antiretroviral
therapy
• Positive living
21
 PERJALANAN PENYAKIT
1.Infeksi akut
• Pem. kadar CD4 : 1000 > CD4 > 750.
• Gejala timbul sesudah 1–3 bln.
• Sangat manular  virus  darah.
• Gejala :
Influenza : demam, nyeri tulang,
malaise, nafsu makan (-).
 Gejala Kulit : bercak merah/urtikaria.
Gejala saraf : sakit kepala, nyeri
mata, gangguan kognitif.
Gejala lain : mual, muntah, diare
yg lama, peny. jamur saluran
napas (kandidiasis orofarings).
2.Infeksi kronis asimtomatik; gejala (-)
• Kadar CD4 : > 500.

• Setelah infeksi akut  selama

bertahun penderita tampak baik 
lalu terjadi pembesaran kelenjar limfe
hampir diseluruh tubuh dan menetap.
3.Infeksi kronis simtomatik, bergejala
• Imunitas menurun berat : CD4 > 200.
• Terjadi infeksi oportunistik berat yg
mengancam jiwa.
• Terjadi penurunan kekebalan tubuh
 penyakit seperti kelainan darah,
penyakit saraf.
HIV + penicilliosis marneffeia
• Tubuh sudah kehilangan kekebalan.
• Kadar CD4 : 200 – 500  AIDS.
• Fase ini rata-rata > thn terinfeksi HIV.
• Reaktifitas herpes zoster / simpleks.
• Keganasan (+) : sarkoma kaposi,
limfoma non Hodgkin dll.
HIV + Herpes Simpleks
HIV + Kaposi’s Sarcoma
Natural History of HIV Infection

DR. S.K CHATURVEDI

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 DR. S.K CHATURVEDI
 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
DR. S.K CHATURVEDI
 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
DR. S.K CHATURVEDI
 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
DR. S.K CHATURVEDI
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)

DR. S.K CHATURVEDI

GEJALA-GEJALA HIV/AIDS
• Rasa lelah & sakit kepala yang
menetap, bukan bekerja berlebihan.
• Demam/ keringat malam menetap.
• Penurunan BB > 10% < 2 bulan, bukan
karena diet / olahraga.
• Pembesaran kelenjar getah bening.
• Batuk berat & lama pada orang yang
tidak merokok.
• Benjolan di kulit / jamur kulit, usus.
• Diare yang tidak sembuh.
• Sariawan yang menetap.
• Mudah berdarah  kulit, rongga
mulut, hidung, anus.
HIV + Candidiasis
HIV + Sifilis
HIV + tumor
 Mengapa Odha masih tampak sehat…….
Karena perjalanan penyakit HIV dalam tubuh seseorang tergolong unik, memiliki
masa inkubasi yang sangat panjang

STADIUM 1 STADIUM 2 STADIUM 3 STADIUM 4

AIDS
Window HIV+ dengan CD4 < 200
period gejala
HIV + penyakit 1 – 2 th.
1 – 3, bahkan Asimptomatik
6 bulan 5 – 10 tahun > 1 bulan
 PENCEGAHAN
• Pengetahuan : memberi
pengetahuan ttg penyakit AIDS,
cara penularan & pencegahannya.
• Keyakinan : menanamkan
keyakinan ttg bahaya AIDS.
• Kesadaran : ditumbuhkan
kesadaran serta motivasi untuk
berperilaku seksual yang sehat &
bertanggung jawab.
• Penguasa : rasa tanggung jawab &
moral yg tinggi membuat perilaku
seksual yg sehat.
 PENGOBATAN

• Sampai saat ini biasanya AIDS

berakhir dengan kematian karena

pengobatan untuk penyembuhan

sampai saat ini belum ada.

Obat yang dapat diberikan :
ANTIVIRUS, antara lain :
I. Nucleoside analog reverse transcriptase
inhibitors:
• Zidovudine (ZDU) • Didanosine
• Zalcitabine * Stavudine
• Lamivudine
II. Non nucleoside reverse
transcriptase inhibitors
• Nevirapine
• Delaviridine

III. Protease inhibitors

• Saguinavir • Ritonavir
• Indinavir • Nelvinavir
• Pengobatan terhadap infeksi

oportunistik :

Terapi antibiotik atau kemoterapi

disesuaikan dengan infeksi yg

berasal dari mikroorganisme

• Pengobatan thd keganasan:
Sarkoma Kaposi:
1. Lokal : pembedahan, cryotherapy,
intralesional kemoterapi, radiasi, laser
2. Sistemik : Paling efektif 
kombinasi doxorubicin (adriamycin),
bleomycin dan vineristin (ABV)