By Siena Kathleen V.

Placino
BSN – IV
IDENTIFICATION:
BACKGROUND

 BACKGROUND

HIV – is a virus that infects humans.
It attacks your immune system causing it
to malfunction and makes you very ill.
HIV stands for human immunodeficiency
virus, the virus that causes AIDS.
 BACKGROUND

AIDS – is a serious medical condition
comprising of a variety of diseases that occur
because HIV interferes with the body’s ability
to fight off other infections.
 AIDS stands for acquired immunodeficiency
syndrome.
 THE BASICS

 First identified in 1981, HIV is the cause of one of
humanity’s deadliest and most persistent epidemics.

 Without HIV medicine, people with AIDS typically

survive about 3 years!

 Once someone has a dangerous opportunistic

illness, life expectancy without treatment falls to
about 1 year.
 To put it briefly…

 “HIV is a virus spread through certain body fluids that attacks
the body\s immune system, specifically the CD4 cells, often
called T cells. Over time, HIV can destroy so many of these cells
that the body can’t fight off infections and disease. …Untreated,
HIV reduces the number of CD4 cells (T cells) in the body. This
damage to the immune system makes it harder and harder for
the body to fight off infections and some other diseases.
Opportunistic infections or cancers take advantage of a very
weak immune system and signal that the person has AIDS
…(the last stage of HIV infection).”
-CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)
 BACKGROUND

 NO EFFECTIVE CURE currently exists, but
with proper medical care, HIV can be
controlled.

 The medicine used to treat HIV is called

 “antiretroviral therapy” or ART.
 IDENTIFICATION:
INFECTIOUS AGENT

 INFECTIOUS AGENT

RETROVIRUS - HUMAN
IMMUNODEFICIENCY VIRUS (HIV) is the
causative agent for AIDS.

Previously called Human T-cell

lymphotropic virus III (HTLV-3)
 phased out now
 INFECTIOUS AGENT

 General characteristics of the virus:
 Double stranded RNA retrovirus (reverse
transcriptase – proviral DNA integrates into
HOST DNA  ready to be transcribed and
replicated)
 Envelope
 Capsid
 ERRORS during REPLICATION different
strains of the virus/ frequent mutations  makes
it very difficult to cure!
HIV VIRUS
 Healthy T-cell
A scanning electron micrograph of a human T-lymphocyte from the immune
system of a healthy donor.
 HIV-Infected CD4-cell
A scanning electron micrograph of an HIV-infected CD4 cell. Computer
colorization helps differentiate the budding HIV virions (in yellow) as they emerge
from the infected cell (in green and turquoise).
 Note!

 A CD4 cell is a type of T-lymphocyte cell (or T-cell)
which have a glycoprotein called CD4 on their
surface.
 Also known as "helper" cells, CD4 does not
neutralize infection, but rather prompt the body's
immune system to act upon an infective agent.
HIV Budding From an Infected CD4 Cell
HIV virions are shown budding and releasing from an infected CD4 cell.
INFECTIOUS AGENT:
ETIOLOGY

 INFECTIOUS AGENT:
ETIOLOGY

 Scientists identified a type of chimpanzee in Central
Africa as the source of HIV infection in humans.

THE ORIGIN THEORY:

 Chimpanzee version of the immunodeficiency virus
(SIMIAN IMMUNODEFICIENCY VIRUS or SIV)
most likely transmitted to humans and MUTATED
into HIV!
 Over decades, the virus slowly spread across Africa
and later to other parts of the world! (existed in the U.S.
at least from the mid-late 1970s)
IDENTIFICATION:
OCCURENCE

According to the WHO (World Health Organization (2018)
 OCCURENCE

 Since the beginning of the epidemic: 75 million
people have been infected with HIV and about 32
million people have died of HIV. (WHO, 2018)
 According to the Joint United Nations Program on
HIV/AIDS, approximately 33.4 million people
worldwide are living with HIV/AIDS, and more
than 2.7 million people were newly infected in
2008—about 7,400 each day.(NIH, 2018)
 OCCURENCE

 In the United States, more than 1 million people are living
with HIV/AIDS, with one fifth of the people unaware of
their status, and approximately 56,000 new infections
occur each year. HIV/AIDS disproportionately affects
racial and ethnic minorities, women of color, and men
who have sex with men. (NIH, 2018)
 At the end of 2016, an estimated 1.1 million people aged
13 and older had HIV infection in the United States,
including an estimated 162,500 (14%) people whose
infections had not been diagnosed. CDC. Estimated HIV
incidence and prevalence in the United States, 2010-
2016.Apr 12, 2019 (CDC, 2016)
IDENTIFICATION:
RESERVOIR OF
INFECTION

THE HUMAN BODY

RESERVOIR OF INFECTION


 The reason why HIV causes so much trouble when it gets

inside the human body is because it targets CD4 cells,
infects them, multiplies, and fills them with hundreds of
new viruses.
Reservoir of Infection


 The new viruses can bud off from the infected cells, but
eventually there are so many that the cells burst and die.
Newly formed viruses are then released into the bloodstream
where they can infect other uninfected CD4 cells.
 Reservoir of Infection

 Over time  HIV infection causes a MASSIVE
DROP in the total number of CD4 cells from about
1000 cells/ microliter of blood to less than 200 per
microliter!
  RESULTING IN IMMUNODEFICIENCY
Summary of how the human immunodeficiency virus invades the human body’s
immune system
IDENTIFICATION:
MODE OF
TRANSMISSION

 Mode of Transmission

 The most common way to get HIV is by having sex with an HIV
infected person!
 HIV spreads when certain body fluids (BLOOD, SEMEN,
VAGINAL SECRETIONS, RECTAL FLUIDS, and BREAST
MILK) from an HIV infected person come into contact with a
mucous membrane in the NOSE, MOUTH, RECTUM, VAGINA,
or PENIS of an uninfected person.
 VAGINAL, ANAL, and ORAL SEX may all be means of
transmission for HIV.
 The 2nd most common way to get HIV is by injecting HIV
directly into the body.
 Most commonly: HIV contaminated needles or syringes, or other
drug injecting equipment is shared by injection drug users
from CDC HIV 101 pamphlet
HIV is NOT spread via…

 Air/ water
 Touching
 Hugging
 Sneezing or coughing
 Eating or drinking from common utensils
 Saliva, tears or sweat
 Insects (mosquitoes or ticks)
 According to Planned
Parenthood

 HIV is carried in semen, vaginal fluids, anal mucus,
blood, and breast milk.

 The virus gets in your body through CUTS or

SORES in your skin, and through mucous
membranes (like the inside of the vagina, rectum,
and opening of the penis)
 According to Planned
Parenthood

 You can get HIV from:
 Having vaginal or anal sex
 Sharing needles or syringes for shooting drugs,
piercings, tattoos, etc.
 Getting stuck with a needle that has HIV-infected
blood on it (accidental needle-sticks!)
 Getting HIV- infected blood, semen, or vaginal fluids
into open cuts or sores on your body
 HIV usually spreads through UNPROTECTED SEX.
 HIV can also be passed to babies during PREGNANCY,
BIRTH or BREASTFEEDING. (via placenta, delivery,
and breast milk)
 IDENTIFICATION:
INCUBATION PERIOD

Incubation period time line in accordance with stages of HIV
 What are the stages of
HIV?

 STAGE 1: ACUTE HIV INFECTION
 Within 2-4 weeks, the infection takes hold
 Fever
 Headache
 Fatigue
 Swollen lymph glands
 a.k.a.  Flu-like illness for a few weeks

 Large amount of virus in their blood  VERY

CONTAGIOUS!
 People at this stage are often UNAWARE because they may
not feel sick right away.
 What are the stages of
HIV?

 STAGE 2: CLINICAL LATENCY (HIV Inactivity or
Dormancy)
 HIV is still active but reproduces at very low levels
 May not have any symptoms or get sick during this stage
 The virus is STILL TRANSMITABLE at this stage!
 But people who take HIV medicine as prescribed and stay
VIRALLY SUPRESSED have effectively NO RISK of
TRANSMISSION

 At the end of this phase, a person’s viral load starts to go up

and the CD4 cell count begins to go down  immunodeficiency
 increased symptom manifestation!
 What are the stages of
HIV?

 STAGE 3: ACQUIRED IMMUNODEFICIENCY SYNDROME
(AIDS)
 AIDS is the MOST SEVERE PHASE of HIV infection.

 NOTE!
 A person with HIV is considered to have progressed to AIDS when:
 The number of their CD4 cells fall below 200 cells per cubic
millimeter of blood (200 cells/mm3)
 A healthy immune system has CD4 counts between 500 and 1,600
cells/mm3
 They develop one or more opportunistic infections regardless of
their CD4 count.
 People with AIDS can have HIGH VIRAL LOAD and be VERY INFECTIOUS.
 What are the stages of
HIV?

 Common AIDS symptoms:  (Rapid) weight loss
 Chills  Chronic diarrhea
 Fever  Sores in mouth,
 Extreme fatigue anus, or genitals
 Night sweats  Pneumonia
 Swollen lymph glands  Purplish lesions on
 Weakness skin or in mouth
 Memory loss and
depression
 US CDC:
AIDS-defining diseases

 IDENTIFICATION:
PERIOD OF
COMMUNICABILITY

 Period of
Communicability

All antibody-positive people carry the HIV
virus.

Infectivity is presumed to be LIFE-LONG,

although successful therapy with cART can
lower the viral load in blood and semen to
undetectable levels.
IDENTIFICATION:
SUSCEPTIBILITY

 SUSCEPTIBILITY

Everyone is susceptible to infection.

The presence of other sexually transmissible

infections, especially those with skin or
mucosal ulceration, may increase
susceptibility.
 SUSCEPTIBILITY

CDC HIV Risk Behaviors Research Study:

The table lists the risk of transmission per

10,000 exposures for various types of
exposures.
 IDENTIFICATION:
METHODS OF CONTROL

Preventive Measures

 #1 Get tested. People who spread
HIV easily are often unaware of their
own HIV status.
 ANTIBODY BASED DIAGNOSTIC TESTS: 
 Screening tests
 ELISA (enzyme-linked immunosorbent assay)
 (detects HIV antibodies in the blood)
 Rapid tests
 Supplemental or confirmatory
 IFA (immunofluorescent assay)
 Western blot (confirmatory)
 LIA- lineimmuno assay
 RIPA- radio immune precipitation assay
 Other tests
 P24 antigen
 Culture
 PCR (Polymerase Chain Reaction – detect proviral DNA sequences)
 Plasma/ serum viral load
 Preventive Measures

 To avoid getting HIV, you must prevent any
contaminated body fluids from entering your body
through your nose or mouth, vagina, anus, penis, or
breaks in your skin. This can be done by practicing safe
sex and safe drug use, which means:
 Consistent and proper condom use
 Get tested regularly - this is a must if you are having sex
with someone you know has HIV, or if you are worried
you might have been exposed to HIV, and
 Never share intravenous needles, syringes, cookers,
cotton, cocaine spoons, or eye droppers if you use drugs.
 What is PrEP and how
does it prevent HIV?

 PrEP = pre-exposure prophylaxis.

 Taken once a day that can help prevent HIV –

consult with physician
 What is PEP and how
does it prevent HIV?

 PEP = post-exposure prophylaxis

 Series of pills you start taking after you’ve been

exposed to HIV that lowers your chances of getting
HIV.
 MUST START PEP WITHIN 72 HOURS (3 DAYS)
 What is ART and how
does it prevent HIV?

 Antiretroviral Therapy (ART) is a combination of
medicines that slows down the effects of HIV in your
body and can help you stay healthy for many years
(can also lower or even stop your chances of giving
HIV to anyone else)
 ART lowers amount of HIV in your body (even up
to undetectable level)
 Control of Case

 STANDARD or UNIVERSAL PRECAUTIONS:
prevent transmission of blood and body-fluid borne
pathogens

 No donations of blood, organs or other human

tissue from patients or their sexual partners
 Treatment

 Antivirals : shorten the clinical course, prevent
complications, prevent development of latency and
decrease transmission
 Ex. ZIDOVUDINE (trade name: RETROVIR),
NEVIRAPINE (trade name: VIRAMUNE)
 Treatment of opportunistic infection
 References (Links)

https://www.cdc.gov/hiv/basics/whatishiv.html
https://www.who.int/gho/hiv/en/
https://aidsinfo.nih.gov/understanding-hiv-aids/glossary/325/human-
immunodeficiency-virus
https://news.illinois.edu/view/6367/205875
https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids
https://www.khanacademy.org/science/health-and-medicine/infectious-diseases/hiv-
and-aids/a/what-is-hivaids?modal=1
https://www.researchgate.net/figure/Reservoirs-of-HIV-in-human-body_fig2_260376811
https://www2.health.vic.gov.au/public-health/infectious-diseases/disease-information-
advice/hiv-and-aids
https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hiv-aids
https://www.cdc.gov/hiv/risk/estimates/riskbehaviors.html
http://medind.nic.in/ibo/t08/i1/ibot08i1p42.pdf
https://www.austincc.edu/microbio/2704q/hiv
https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/19/45/hiv-aids--the-basics