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ACQUIRED IMMUNODEFICIENCY SYNDROME

Updated: Nov 10, 2020

By

Santhiya B, B.Sc., Operation theatre and anaesthesia technology


Introduction

AIDS was first identified in the 1980s. In the world, several people are infected with this virus. There is no complete cure for AIDS.

Causes

A virus called HIV (Human Immunodeficiency Virus) that enters into the blood. If HIV enters the body, it attacks the immune system. Slowly it damages our total immune system. Our body, not be able to fight against the virus. It is a long-term process. It can cause weight loss, diarrhoea.

Spread and incidence

The condition is transmitted through the blood of an infected person. It can spread from a homosexual to another from blood in the anal region during intercourse as well as in heterosexual. It can be spread from through one person to another through this blood. HIV mainly spreads through unprotected blood and receiving blood from the infected person.

Primary HIV infection

The period between infection and the development of detectable levels of antibody to HIV is 2-6 months. A small percentage may remain negative for a longer period.


Approximately 50% develop an acute illness distinguished by frequent oral and esophageal ulceration; a maculopapular rash. Enlargement of the lymph glands. This early period damages the immune system. HIV antibody test becomes positive in 2-6 weeks. After the onset of the illness. Lymph node biopsy is taken.

Early HIV disease

Once the person recovers from the early illness, they enter an asymptomatic phase. Generally in this stage, lymph node enlargement is associated with unpredictable and irregular fever. Hypertensive reactions may develop with worsening eczema(itchy inflammation of the skin). HIV may be detectable in the plasma. There is an increase in the levels of immune globulins[ 1gG and 1gH ] and the number of CD8+ cells increases. (CD8+ - cytotoxic-T-cells)


Intermediate stage

The patient is all more susceptible to pathogens, and the patient may manifest infections secondary or Haemophilus. In this stage the CD4+- t cell count is 200- 500/µl vaginal thrush and pelvic inflammatory diseases are common Kaposi’s sarcoma can occur in this stage.

Last stage of HIV

It will take at least 10 years without treatment for AIDS. In this stage, it damages the brain, kidneys and heart causing cognitive impairment cardiomyopathy and renal insufficiency. In this phase, there is an immunity deficiency, and infected individuals become easily susceptible to infections. Depending on the level of CD4+ lymphocytes, a hierarchy of opportunistic infections occur. These cell levels become very low, less than 300/µl, tuberculosis and syphilis may be reactivated; at levels below 200/µl, pneumonia due to pneumocystis carinii and fungal infections are common. At low levels of immunity (50 cells/µl), gastrointestinal disease and cytomegalovirus infection may supervene.

Infections of the CNS

A dementing illness may manifest and spinal cord involvement may result in muscle weakness. These CNS infections cause multifocal leukoencephalopathy, toxoplasmosis and Cryptococcus.

Kaposi’s sarcoma

This infection is more common and aggressive at this stage: it affects the skin. The abnormal cells become purple, red or brown blotches or tumours on the skin. This is mostly seen in the legs or face.

Prognosis

It is defined as the outcome in the expected course of the disease. The conventional measure of prognosis is the time from infection to the development of an opportunistic infection. The prognosis is also dependent on lifestyle, cultural practices, housing and health care facilities.

Several predictions of the progression have been defined for ex; A consistent predictor of the risk of the progression is the level of CP4+ lymphocytes. The lower the counts, the greater the chance of progressing to an advanced stage.

These type of test are available

· Antigen test

· Antibody test

· Nucleic acid test

Antigen test

An antigen is a part of a virus that triggers the immune response This test usually occurs within 2-6 weeks of infection.

Antibody test

Proteins make your body fight against the virus. The small amount of blood is taken from the patient's vein. It can also use fluid from inside our mouths. These test results get in 30min.

Nucleic acid test

This looks for trails of HIV in your blood. The patient blood is sent to the lab for further testing. It will take place in a few days.

Medical intervention

· Antiretroviral therapy

· Prophylactic therapy

· Ancillary case, including earlier diagnosis and better symptomatic. Treatment of opportunistic infection.

. Zidovudine may prolong life. Over 2 years.

· Eating a high number of vegetables, whole grains, legumes.

· Limiting sweets, soft drinks with added sugar

· Eat lean beef, poultry, fish, egg, beans and nuts.

Antiretroviral therapy

It is a combination of antiretroviral drugs to suppress HIV and also the transmission of HIV drugs used are- abacavir, zidovudine, tenofovir, emtricitabine.

Conclusion

If the person is affected by AIDS, there is no complete treatment of this disease. If a 21 years patient is suffering from HIV with proper treatment, they extend their lifetime to 71 years.