HIV/AIDS BASICS

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BASIC FACTS
ABOUT HIV/AIDS
a presentation by
Global Health International

Definitions
 HIV – Human Immunodeficiency Virus
The virus which causes AIDS
 SIV – Simian Immunodeficiency Virus
Retrovirus found in numerous strains in primates; the
specific strains infecting humans are HIV-1 & HIV-2
 AIDS – Acquired Immune Deficiency
Syndrome
A collection of symptoms & signs of illnesses due to
immune depletion
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Types of HIV
HIV Type 1 HIV Type 2
- Most predominant
world wide
- More virulent
- Has subtypes M, N, O
and P (M is most
predominant)
- Subtype M has
strains A, B, C, D,
F, G, H, J and K
- Mainly in West Africa
- Less easily
transmitted
- Longer period from
initial infection and
onset of illness

HIV origin: the theories
 Hunter theory:
Most accepted theory. That SIV was
transferred to humans after chimps being
killed & eaten or their blood getting into
hunters’ cuts/wounds
 Oral Polio vaccine theory:
Congo, Ruanda & Burundi in the late 1950s.
That the vaccine was cultivated using kidney
cells of local chimps infected with SIV
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 Conspiracy theory:
-HIV manufactured as a biological warfare
programme, to wipe out black &
homosexual people.
-HIV was developed by the US as a weapon
of germ warfare
-Right wing American groups blamed the
Soviets for the AIDS epidemic.
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 Colonialism theory: Locals were forced into
labour camps where SIV could have infected
them. They were inoculated with unsterile
needles against diseases e.g. smallpox. Many
camps employed prostitutes to keep workers
happy
 Heavenly theory: HIV came from an angry
God who was unhappy with gays, IVDUs &
promiscuity. Others believed that HIV came as
a cosmic debris as part of the tail of a comet
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Origin of HIV/AIDS
 HIV is a zoonotic infection-resembles SIV
 Genetic analysis indicates HIV introduced
into humans ~ 1931
 1959 serum sample from Congo HIV+
 Here chimpanzees are kept as pets and
butchered forfood
 HIV 1st
discovered in 1980s by Luc
Montagnier (Paris); Later in 1980s by
Robert Gallo (US)

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Origin of HIV/AIDS
 No. of people who developed AIDS before
the 1980s are unknown
 First cases of AIDS recognized in early
1980s
 In 1984, 1st
AIDS (‘slim disease’) case in
Uganda was reported

Modes of HIV transmission
 Sexual intercourse (heterosexual & same
sex; commonest mode of transmission)
 Mother to Child transmission (pregnancy,
labour, birth, breast feeding)
 Occupational exposure
 Blood products infusion
 Donor organ and tissue transplantation
 (Intravenous) Injection drug use
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Phase 1
 Rapid spread through urban sexual
networks along major highways from its
origin in the Lake Victoria region
 The fight against HIV began only after the
civil war in 1986. ACP set up in 1987
 By this time Urban areas had prevalence
rates of up to 29% .
HIV/AIDS trend in Uganda

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Phase 1 cont’d
 CBOs came up targeting education, HIV
prevention(ABC) & stigma reduction
TASO was one of the first
 Philly Bongoley Lutaaya (19 October 1951 –
15 December 1989), a Ugandan musician
spent his life writing songs about his battle
with AIDS; toured many places spreading
messages of prevention & hope.

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Phase 2: 1992 to 2000
 HIV prevalence fell dramatically, from about
15% in 1991 in adults to about 5% in 2001
 Reason: Gov’t. ABC prevention campaign & the
high numbers of AIDS-related deaths
 Prevention initiatives continued through the
nineties with high levels of funding from both
the gov’t & international donors e.g. World
Bank

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Phase 3: 2000 to 2005
 The third phase saw the stabilization of
HIV prevalence at 6.4%
 Free ARV drugs were introduced in 2004
 Funders included World Bank, Global
Health, PEPFAR, CDC

WHO 2010 HIV epidemiology report & 2011 Uganda demographics
report:
 HIV prevalence rate 6.5% among adults
 HIV prevalence rate 0.7% among children
 1.2 million people living with HIV/AIDS in Uganda
 1.2 million children are orphans due to AIDS
 130,000 new HIV infections occur annually
 60,000 deaths occur annually
 540,000 adults & children in need of ARVs
 240,000 adults & children on ARVs
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Global distribution of HIV by sex &
age (Source WHO & UNAIDS 2010)
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Urban-Rural HIV Infection
Prevalence: (Source WHO & UNAIDS 2010)
10.2
12.8
6.7
1.4
5.7
6.5
4.8
0.6
0
2
4
6
8
10
12
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All Females Males Children <5yrs
Urban Rural  Urban
residents have
a significantly
higher risk of
HIV infection
 The urban-
rural disparity
stronger for
women and
children than
for men.

So, What happens when HIV
enters the Human body?
1. Window Period
 Time from initial infection with HIV to time antibodies are
detectable (usually 3-8 weeks)
 Period varies between individuals & depends on the test used
 95% of people develop antibodies within 3-4 months
 HIV antibody tests may give negative results in an infected
person during this period
 Very high Viral Load
 Victim highly infectious
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2. Seroconversion
 The change from non-detectable antibody test
(Negative test) to detectable antibody levels (Positive
test) is referred to as seroconversion
 Seroconversion marks end of the window period
 Presents with unspecific symptoms e.g. fever, flu,
headache, general weakness, poor appetite, etc
 Symptoms short lived; patient improves in 2-4 weeks
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3. Development of Symptoms & Signs i.e.
Stage I
 Asymptomatic stage of HIV infection
 There may only be enlarged lymph nodes

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….when HIV enters the Human
body
Stage II
Multiple symptoms and conditions e.g.
 Skin rash
 Herpes zoster
 Oral ulcers
 Fungal nail infections
 Recurrent Respiratory Tract Infections

2323
body
Stage III
Multiple symptoms & conditions e.g.
 TB of the lungs
 Diarrhoea > a month
 Oral thrush
 >10% unintended weight loss
 Persistent fevers (unexplained) for > a
month

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body
Stage IV
Multiple symptoms and conditions e.g.
 Cancers like Kaposi’s sarcoma
 Oesophageal candidiasis
 Pneumocystis jiroveci pneumonia
 Cryptococcal meningitis
 TB outside the lungs

AND HOW WILL A PERSON WITH
HIV/AIDS PRESENT CLINICALLY?
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MANIFESTATIONS OF
HIV/AIDS
1. Manifestations due to Opportunistic
Infections
2. Manifestations due to HIV/AIDS
Associated Cancers
3. Manifestations due to Drugs used in
treatment of HIV/AIDS
4. Other HIV/AIDS related conditions

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Infections
Fungal skin infections
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Infections
Oral thrush

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Infections
Oral Hairy Leukoplakia

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Infections
Angular Cheilitis (Candidiasis)

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Infections
Mixed Infections

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Infections
Herpes simplex virus

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Infections
Extensive H.S. infection of lips & nose

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Infections
Molluscum contagiosum

Infections
Molluscum contagiosum
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Infections
Herpes zooster
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Infections
Generalised itchy
Skin rash
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Infections
TB of the skin
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Infections
Herpes simplex genitalia
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Infections
HPV
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Infections
HPV
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Infections
Vaginal Candidiasis
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MANIFESTATIONS OF
HIV/AIDS
2. HIV/AIDS Associated
Cancers
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2. HIV/AIDS Associated Cancers
Kaposi’s sarcoma: gum & legs affected

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Kaposi’s sarcoma: palate involvement
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Lymphoma

Squamous cell carcinoma of the eye
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Kaposi’s sarcoma
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MANIFESTATIONS OF
HIV/AIDS
3. Manifestations due to Drugs
used in HIV/AIDS Treatment
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3. Manifestations due to drugs
Nevirapine rash
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Steven Johnson’s
Syndrome
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Nevirapine side effects
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Severe
Anaemia
of AZT
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Fat maldistribution
(Stavudine induced)
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Loss of body fat
(as with Protease
Inhibitors)
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MANIFESTATIONS OF
HIV/AIDS
4. Other HIV/AIDS Associated
Conditions

conditions
Psoriasis
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conditions
Eczema
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conditions
HIV wasting
syndrome
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May God have mercy
upon mankind

HIV/AIDS BASICS

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