Uncategories AIDS

AIDS

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AIDS (Acquired Immunodeficiency Syndrome) is the caused by the HIV virus (Human Immunodeficiency Virus). There are 2 subtype that is HIV-1 and HIV-2. But the most common subtype worldwide is HIV-1. HIV-2 is found in West Africa.

Transmission

  1. Transfusion of blood and blood product
  2. Needle sharing in drug user
  3. Splash of body fluids on mucosa of eye, nose and mouth
  4. exual intercourse – homosexual and heterosexual
  5. Vertical transmission from mother to fetus
  6. During delivery of the child
  7. Breast feeding from infected mother

High Risk Groups

  1. Injecting Drug User
  2. Female Sex Workers
  3. Clients of Female Sex Worker
  4. Men sex with Men
  5. Labor Migrants

 Stages

 a. Primary Infection (2 – 12 weeks)

Symptoms of  HIV Infection
  1. Fever with rash
  2. Pharyngitis
  3. Headache
  4. Cervical Lymphadenopathy
  5. Arthralgia
  6. Myalgia

 b. Asymptomatic Infection ( 7 – 10 years)

  • No evidence of disease.
  • Except there may be persistent of generalized lymphadenopathy

c. AIDS Related Complex

  1. Impairment of cellular immunity.
  2. Unexplained diarrhea >1 month
  3. Fatigue
  4. Malaise
  5. >10 % of body weight loss
  6. Mild opportunistic infection – oral thrush, generalized lymphadenopathy

 d. AIDS

    Specific opportunistic infections:-
  1. Kaposi sarcoma
  2. Pulmonary and extra pulmonary TB
  3. Candidiasis
  4. Ulcerative stomatitis and gingivitis
  5. Toxoplasmosis

 Investigations

  • Rapid test for HIV
  • ELISA Test
  • Western Blot Test – Confirmatory Test
  • DNA PCR
  • CD4 count
  • Complete Blood Count
  • Liver and Renal Function Test
  • Hepatitis B and C


Management

    General Measures

  1. Balanced Diet
  2. Quitting smoking and drinking alcohol
  3. Adequate rest
  4. Safe sex
  5. Treat the opportunistic infections with proper antibiotics

    Antiretroviral Drug Combinations: -

2 NRTI + 1 NNRTI
OR
2 NRTI + 1 PI
  • NRTI (Nucleoside Reverse Transcriptase Inhibitor) – Zidovudine, Didanosine, Lamivudine, Stavudine, Abacavir, Tenofovir
  • NNRTI (Non- Nucleoside Reverse Transcriptase Inhibitor) – Nevirapine and Efavirenz
  • PI (Protease Inhibitor) – Indinavir, Ritinavir, Lopinavir

 Supportive Policy and Social Environment

  1. Psychological counselling
  2. Orphan care
  3. Community support service
  4. Spiritual support
  5. Stigma and discrimination reduction
  6. Economic security
  7. Preventive therapy
  8. Palliative care
  9. Nutritional support
  10. Management of STDs


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