How is HIV transmitted-HIV-AIDS

 Human immunodeficiency virus (HIV) is a virus that attacks the immune system of body. If it is not treated in time, it can leads to the Acquired immunodeficiency syndrome (AIDS). AIDS is not a disease, it is a spectrum of conditions. HIV virus mainly target the WBCs cell which help the body to fight against infections. AIDS is also known as 'Slim disease or Wasting syndrome'.

The studies shows that HIV came from Chimpanzees to human in late 1800s. Chimpanzees version virus called "Simian immunodeficiency virus", when human hunted Chimpanzees foods and came in contact with their infected blood. The first case of HIV/AIDS identified in USA (1981 AD) resident gay sex worker 'Ken Horne' in 24 April 1981 AD.

How is HIV AIDS transmitted ?

How is HIV transmitted HIV AIDS transmitted-Ans: The reservoir of HIV/AIDS is case and carrier, the infections can transmitted from case & carrier. Following are the routes of transmission of infections:

(a). The major route or most common route of HIV/AIDS transmission is Hetero-sexual contact (0.01-1%)

(b). Contaminated blood transfusion and blood product, the studies shows that there is highest efficiency of transmission  through this route. So that, it is compulsory to test HIV before blood donations. (more than 90%)

(c). The drug abuser, use multiple times surgical items such as: needle, syringe, blades. Through the contaminated these items, HIV can be transmitted. (0.3%)

(d). During the pregnancy, there is chance of HIV transmission  from mother to child transmission (MTCT) about 3%.

HIV transmission

• The greatest concentration of HIV viruses found in semen, Blood & CSF and lower concentration in tear, saliva, urine, breast milk, cervical or vaginal secretions.
• There is 8-10 times increases transmission rate in presence of STDs.

WHO clinical staging for HIV infection:

stage 1.

Asymptomatic carrier stage or persistant generalized lymphadenopathy.

Stage 2.

In this stage, patient manifests following features:

• Weight loss <10% of body weight
• Minor muco-cutaneous manifestation
• History of Herpes zoster in last 5 years
• Recurrent URTIs

Stage 3.

In this stage patients shows:

• Weight loss >10% of body weight
• Chronic diarrhoea with fever >1 month
• Oral candidiasis
• Pulmonary leucoplakia
• Severe bacterial infections

Stage 4.

• HIV wasting syndrome + chronic diarrhoea + prolong fever
• Opportunistic infections seen like: Pneumocystic carinii pneumonia, Toxoplasmosis if brain, Cryptosporidiosis with diarrhoea, Herpes zoster infection increases, Oral candidiasis spreads to esophagus-trachea-bronchus of lungs, Kaposi's sarcoma, HIV encephalopathy.

How to diagnose HIV/AIDS ?

Western blot assay

It is diagnosed by ELISA (enzyme linked immuno-sorbant assay) and Western blot assay. Among these ELISA test is used for the screening of HIV and Western blot assay is used for confirmatory test.

Important facts on HIV/AIDS:

1. Most common cause of meningitis in HIV patient is Cryptococcus
2. Most common cause of focal neurological deficit is Toxoplasma
3. Most common dermatological manifestation: Seborrheic dermatitis
4. Window period for HIV: 3-12 weeks
5. Weight loss is a very common finding in HIV infection
6. Zidovudine & Lamivudine combination is used for post exposure prophylaxis in HIV, which should be started within 72 hours of exposure
7. The drug of choice for HIV/AIDS is Zidovudine
8. Death in AIDS is due to uncontrolled or untreatable infections
9. Most common hematological manifestation is Anemia
10. World AIDS day celebrated on 1th December