HIV INFECTION

BY DR. SARAH
 Brief introduction.
• Human immunodeficiency virus.

• It’s in the group of retro viruses. These contain a special enzyme called
reverse transcriptase which translates its genetic information into DNA.
This DNA can then integrate (blend into) into the host’s cells DNA . Once
integrated, the virus then uses the host’s cells components to make
additional viral particles.

• HIV infects the immune cells (cd4- T cells),the white blood cells that play
a large role in helping one’s body fight infection.

• HIV is responsible for a condition called AIDS.

 Modes of transmission

• Un protected sexual intercourse with an infected person

• Transfusion with HIV infected blood.

• Mother to child transmission during pregnancy, delivery or breast feeding.

• Hiv contaminated sharps & instruments e.g needles, scapels, razors

• Exposure to HIV infected materials through open wounds or cut.

RISK FACTORS FOR HIV.
• Present or past high risk behavior- multiple sexual partners, PWIDs.

• Having recurrent STI especially Herpes simplex virus type 2

• Being uncircumcised man

• Being in an HIV discordant sexual relationship

• Loss of a spouse from HIV

SIGNS & SYMPTOMS AND WHO
CLINICAL STAGING
• CLINICAL STAGE 1

• Asymptomatic
• Persistent generalized lymphadenopathy.
• Performance scale 1
 CLINICAL STAGE 2
• Moderate body weight loss ( < 10 % of body weight)

• Minor mucocuteneous manifestations like prurigo, fungal

infections,recurrent oral ulcerations, angular stomatitis.

• Herpes zoster within last 5 years

• Recurrent URTI ,eg. Otitis media, bacterial sinusitis.

• Performance scale 2—symptomatic but normal activity

 CLINICAL STAGE 3

• Severe weight loss ( more than 10% of presumed body weight)

• Chronic diarrhea

• Persistent fever, or constant for longer than 1 month

• Oral hairy leukoplakia

• Pulmonary TB

• Un explained anemia

• Performance scale 3,--bed ridden for less than 50% of the day during the
last month.
 CLINICAL STAGE 4
• HIV wasting syndrome

• PCP
• Extra pulmonary TB

• Kaposis sarcoma
• Oesophageal candidiasis

• Performance scale 4--- bed ridden for more than 50% of the day
 Cont…
Diagnosis:
• This is only after HIV
testing ,which can either be,
• RTC -client initiated
• Diagnostic testing- provider
initiated
Treatment:
• Uganda has adopted the Test
and treat policy, -providing
lifelong anti retro viral therapy to
ALL people living with HIV
irrespective of CD4 count or
clinical staging.
 Prevention
• 1.Behavior changes e.g safe sex practices(ABC)
• Don’t share sharps,
• Delayed sexual encounters---abstinence
• 2. biomedical interventions
• PMTCT
• Safe male circumcision
• ART with viral suppression
• PEP
• PrEP
• Safe infusion and injection practices..
• Adherence to infection control procedures.