Scribd
Upload
4 views

HIV lecture pp dec 2024 no QA (1)

The document outlines the chain of infection for HIV, detailing its agent, modes of transmission, and susceptible hosts. It emphasizes prevention strategies such as health education, condom use, voluntary medical male circumcision, and harm reduction for injecting drug users. Additionally, it discusses control measures including ART treatment, notification of cases, and post-exposure prophylaxis.

Uploaded by

vp72gqz69z
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
4 views

HIV lecture pp dec 2024 no QA (1)

The document outlines the chain of infection for HIV, detailing its agent, modes of transmission, and susceptible hosts. It emphasizes prevention strategies such as health education, condom use, voluntary medical male circumcision, and harm reduction for injecting drug users. Additionally, it discusses control measures including ART treatment, notification of cases, and post-exposure prophylaxis.

Uploaded by

vp72gqz69z
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 22

HIV

Professor Hany Ziady


2024
• Learning objectives:
• Identify the links of HIV chain of infection
• Identify the prevention and control measures
for HIV
• Apply prevention and control measures on
specific occasions
Chain of infection
• Agent:
– Human immunodeficiency virus
(HIV).
– There are two types: Type1
(HIV1) is the most common and
Type2 (HIV2) causes similar
symptoms but less severe.
Chain of infection
• Reservoir:
• Man: HIV infected persons from the time of infection until their death,
unless they start treatment.

• Source of infection:
• Body fluids from infected individuals namely
– blood, and its products
– breast milk,
– semen,
– vaginal secretions.
• Donated organs from infected individuals

• Period of communicability:
• Begins early after infection and extends throughout life if no treatment is
given.
Chain of infection
• Exit:
• Vagina: mucous discharges
• Urethra: seminal fluid
• Skin: syringes, skin piercing
instruments, site of donated organ
• Placenta: transplacental
transmission
• Breast nipples: breast milk
Chain of infection
• Modes of transmission:
• Direct modes
• Sexual transmission with infected partners )direct
physical contact).
• Vertical: from infected mother to child: during
pregnancy (direct-transplacental), labour or
breast feeding .(direct – perinatal transmission)
• Indirect modes
• Parenteral: infected blood or blood products
transfusion (indirect- vehicle-biological products),
contaminated needles, syringes, any
contaminated skin piercing instrument )indirect-
vehicle- fomites)
• Organ transplantation (indirect-vehicle-biological
products)
Chain of infection
• Inlet:
Skin:
injections, skin piercing instruments, blood
transfusion, site of transplanted organ

Mucous membranes:
– vagina (sexual transmission)
– urethra (sexual transmission)
– mouth (breast milk transmission).
Umbilical cord (transplacental to the fetus)
Chain of infection
• Susceptible host:
• Man: Susceptibility is general.
• Most cases have occurred among sexually active
person aged 20- 49 years.
Chain of infection
• Susceptible host:
• Behaviours and conditions that put individuals at
greater risk of contracting HIV include:
• having unprotected sex ;
• having another sexually transmitted infection
(especially when ulcerations are present) such as
syphilis, herpes, chlamydia, gonorrhoea, and
bacterial vaginosis
• sharing contaminated needles, syringes and other
injecting equipment and drug solutions when
injecting drugs;
• receiving unsafe injections, blood transfusions,
medical procedures that involve unsterile cutting or
piercing,
• experiencing accidental needle stick injuries, as
among health workers in health care settings.
Prevention
• Health education: about
nature of disease, modes of
transmission, protection,
health services.

• Recreation facilities for


young people
Prevention

• Male and female condom use


• Correct and consistent use of male
and female condoms can protect
against the spread of sexually
transmitted infections, including
HIV. Male latex condoms have an
85% or greater protective effect
against the sexual transmission of
HIV and other sexually transmitted
infections.
Prevention
• Voluntary medical male
circumcision
• Medical male circumcision, when
safely provided by well-trained
health professionals, reduces the
risk of heterosexually acquired HIV
infection in men by approximately
60%. This is a key intervention in
generalized epidemic settings in
Africa with high HIV prevalence
and low male circumcision rates.
Prevention

Harm reduction for injecting drug users


This refers to a comprehensive package of
interventions for HIV prevention and treatment
among injecting drug users and includes
• Needle and syringe programmes;
• Opioid substitution therapy for people
dependent on opioids by a longer acting but
less euphoric oral opioid (methadone or
buprenorphine) under medical supervision
• drug consumption rooms
Prevention

Harm reduction for injecting drug


users (cont.)
• HIV testing and counselling;
• Access to condoms
• HIV treatment and care,
• Management of STIs,
tuberculosis and viral hepatitis.
Prevention

Elimination of mother-to-child transmission of


HIV (eMTCT)
• The transmission of HIV from an HIV-positive
mother to her child during pregnancy, labour, or
breastfeeding is called vertical or mother-to-child
transmission (MTCT).
• In the absence of any interventions HIV
transmission rates are between 15-45%. MTCT
can be nearly fully prevented if both the mother
and the child are provided with antiretroviral
drugs throughout the stages when infection could
occur.
• ART is given to the newborn to reduce the risk of
perinatal transmission of HIV. ART is initiated as
soon as possible after delivery preferably within 6
to 12 hours of delivery administered at doses
determined based on maternal and infant factors:
Prevention

• Elimination of mother-to-child transmission


of HIV (eMTCT)
If infant is diagnosed as HIV positive ART is
started and continues for life.

If infant is HIV negative


• For non-breast-fed infants, ARV prophylaxis
given for 6 weeks after delivery. This is
recommended in settings where safe water
supply is available (high income countries) to
prepare formula food.
• For breast-fed infants: ARV prophylaxis should
continue, preferably throughout the
breastfeeding period and for one to four
weeks after cessation of breast feeding. This
is recommended in settings where safe water
supply is not available (in low-income
countries).
Prevention

• No vaccine is available
against HIV infection,
though trials are ongoing.
Control
– Notification: Notification of HIV
and AIDS cases
– Diagnosis of HIV infection: Usually
screening tests are based on
detection of HIV antibodies. (tests
of generations 1, 2, & 3) However,
antigen/antibody tests detect
both HIV antibodies and antigens.
(tests of generations 4 & 5).
– Isolation of AIDS and HIV infected
person is not required as
transmission occurs through
limited modes of transmission.
Control
– Treatment: HIV can be
suppressed by combination ART
(antiretroviral therapy),
consisting of three or more ARV
(antiretroviral) drugs.
– ART does not cure HIV infection
but controls viral replication
within a person's body and
allows an individual's immune
system to strengthen and regain
the capacity to fight off
infections.
– Treatment includes also drugs
for prophylaxis and treatment
of opportunistic infections.
Control
– Concurrent and terminal
disinfection: Contaminated
surfaces and articles soiled
with blood of infected
person should be cleaned
and then disinfected using
sodium hypochlorite
Control

– Contacts
A- Condom use: as discussed under prevention
B- Pre-exposure prophylaxis (PrEP) for HIV-
negative partner.
• Oral pre-exposure prophylaxis (PrEP) of HIV is
the daily use of ARV drugs by HIV-uninfected
people to block the acquisition of HIV. Studies
have demonstrated the effectiveness of PrEP in
reducing HIV transmission among sero-
discordant couples (where one partner is
infected and the other is not), and injecting drug
users. (Truvada=tenofovir+emtricitabine)
Control
– Contacts
C- Post-exposure prophylaxis for HIV (PEP): is the
use of ARV drugs (2 or 3 drugs regimes) within 48
hours of exposure to HIV in order to prevent
infection.
• PEP is often recommended for health-care
workers following needle stick injuries in the
workplace.
• In high prevalence countries PEP may be given
following rape assault.
• PEP includes counselling, first aid care, HIV
testing, and depending on risk level, and
administering a 28-day course of ARV drugs with
follow-up care.

You might also like