The following is in note-list
form and is designed for a power point presentation.
AIDS is a retroviral disease
Caused by the Human Immunodeficiency Virus
Characterised by profound Immunosuppression
Secondary neoplasms, and
Truly staggering epidemic
HIV-1 and HIV-2
HIV-1 global and HIV-2 discovered in West
Africa and found principally in West Africa
HIV-2 more virulent, faster progression
and associated with greater morbidity
According to the U.N. by the year 2000
there were 40,000,000 people infected with HIV.
90% of these people were in the developing
More than 600,000 cases were reported
in the United States as at 1999
60% of these people were dead
Despite modern research and a frantic
search for cure, mortality rate was approaching 100%
In the U.S. leading cause of death in
men between the ages of 25 and 44.
Although first described in the U.S. the
pool of people with AIDS in Africa and Asia is expanding
First described as GRIDS in gay men in
San Francisco in 1983
Was mainly spread through promiscuous
homosexual men, intravenous drug users and also haemophiliacs.
Heterosexual mode of transmission is now
rising in the US and is the main mode of transmission in Africa and Ghana.
In Ghana main modes of transmission have
been through sexual contact, recipients of blood and blood components and
mother to child transmission in children.
Routes of spread
Sexual Contact – 75%
Parental Inoculation – intravenous drug
abusers and recipients of blood and blood products.
Passage of virus from Infected mothers
to children through the placenta or through breast milk.
Virus is carried in the semen and enters
the recipient's body through abrasions in the rectal mucosa.
Virus also enters the body of the female
through sexual contact.
Female to male spread is 20 times less
than male to female spread
All forms of spread of HIV is aided and
abetted by all forms of sexually transmitted disease especially those associated
with genital ulcerations – syphilis, herpes and chancroid.
Other sexually transmitted diseases like
Gonorrhoea associated with increased transmission of HIV due to the increased
concentration of virus in the seminal fluid due to increased number of
inflammatory cells in the Semen.
IV drug abusers
Haemophiliacs – factor VIII
Random recipients of blood
Screening of donated blood
Extremely small risk of acquiring infection
through sero-negative blood because of window period 1:493,000
Mother to Child
In utero by transplacental spread
During delivery by an infected birth canal
After birth through breast milk and handling
of the cord.
Spread Outside High Risk Groups
Not spread my casual personal contact
in the workplace, household or school.(hugging, kissing, food, water)
No convincing evidence that the virus
is spread by insect (mosquito) bites.
Small but definite risk of transmission
of HIV infection to health workers – accidental needle stick injury –
or exposure of non intact skin to infected blood.
Phases of HIV Infection (CDC)
Group I : Acute Infection
Group II: Asymptomatic Infection
Group III: Persistent generalised lymphadenopathy
A: constitutional disease
B: Neurologic disease
C: Secondary infection
D: Secondary neoplasm
E: Other conditions
Initial response of the person – 50-70%
show sore throat, fever, muscle pain, weight loss, fatigue, diarrhoea and
Middle phase CDC group II and III asymptomatic
or generalised lymphadenopathy
Final phase is characterised by the breakdown
of the host immune system – long lasting fever(> I month), fatigue weight
loss and diarrhoea
CDC Classification cont’d
In the absence of treatment, most but not
all patients with HIV infection progress to AIDS after a chronic phase
lasting 7 – 10 years. Exceptions to this typical course are Long term
progressors and Rapid progressors.
Long term progressors are HIV – 1 positive
individuals who remain asymptomatic for 10 years or more and maintain stable
CD4 counts with low plasma viremia.
Rapid progressors the middle phase is telescoped
to 2-3 years after the primary infection.