Transcript
HIV/AIDS
Elaine Kauschinger PhD, MS, ARNP, FNP-BC
Assistant Professor of ClinicalLead Faculty, Family Nurse Practitioner Program
University of MiamiSchool of Nursing & Health Studies
2
Objectives Discuss the epidemiology of HIV/AIDS at the
international, national and state level Describe HIV-infected patients in terms of age,
gender, ethnicity, and sexual orientation Discuss modes of transmission of HIV Identify clinical management and treatment Discuss counseling and testing Describe prevention & infection control Identify risk factors associated with occupational
exposure
Florida License Requirements FS381.004.5
1 hour on HIV/AIDS CE requirement to be completed prior to the first renewal
This HIV/AIDS presentation will be divided into 4 parts:Part 1: Epidemiology & transmissionPart 2: Counseling & TestingPart 3: Clinical management & treatmentPart 4: Prevention & infection control
HIV/AIDS: Part I Epidemiology &
Transmission
HIV/AIDS: Basic Definitions
Human Immune Deficiency Virus: HIV• Infected with HIV virus• Virus is a retrovirus – meaning that its genetic
information is stored on a single-stranded RNA instead of the double-strand DNA found in most organisms
Acquired Immune Deficiency Virus: AIDS• An incurable infectious viral disease that results in
damage to the immune system in otherwise healthy people
• Average progression, without treatment, from HIV infection to AIDS diagnosis is 10 years.
Basic Definitions
Opportunistic Infections (OIs):• Infections by common microorganisms that usually
do not cause problems in healthy individuals• OIs are the major health problems for AIDS
patients CD4:
• Type of lymphocyte (white blood cell)• Important part of the immune system• HIV most often infects CD4 cells to replicate the
virus inside of these cells• HIV+ patients have their CD4 cells monitored
routinely to gauge their progress.
HIV vs AIDS AIDS definition: Once an HIV
patient receives a diagnosis of the following disorders, they receive a diagnosis of AIDS:• Candida
Pulmonary Esophageal Not thrush
• Pneumocystis carinii pneumonia (PCP)
• Coccidiodomycosis – extrapulmonary
• Cervical cancer• Cytomgalovirus (CMV)• HIV encephalopathy• Chronic Herpes Simples Virus
infections• Kaposi’s sarcoma• Lymphoma
• Mycobacterium TB Mycobacterium
avium complex • Progressive multifocal
leukoencephalopathy• Recurrent pneumonia• Toxoplasmosis• Wasting syndrome• CD4 < 200 or < 14%
lymph• Cryptosporidium• Isospora• Recurrent bacterial
infection• Recurrent pneumonia
History of HIV/AIDS
History of HIV/AIDS epidemic in the U.S. is very recent.
June 1981: the first description of what would soon be referred to as AIDS appeared in the Center for Disease Control’s (CDC) Morbidity and Mortality Weekly Report.
Initial Reports
June 5, 1981: 5 cases of PCP in gay men from UCLA (MMWR)
Gottlieb MS NEJM 2001;344:1788-91
Introduction
CDC (2009) estimates 1.2 million people in the United States (US) are living with HIV infection. • About 33 million people living with HIV worldwide
One in five (20%) of those people are unaware of their infection.
Despite increases in the total number of people in the US living with HIV infection in recent years, the annual number of new HIV infections has remained relatively stable. • New infections continue at far too high of a level, with
approximately 50,000 Americans becoming infected with HIV each year.
16
HIV/AIDS Total: >40 million
N. America
~1 million
Caribbean 440,000
Latin/South America
1.5 million
W. Europe
570,000
N. Africa & Middle East 500,000
Sub-Saharan Africa
29.5 million
E. Europe/C. Asia 1.2 million
E. Asia/Pacific 1.2 million
SE Asia
6.0 million
Australia 15,000
Modes of Transmission
Sexual Perinatal
• Intrapartum• Labor & Delivery• Breastfeeding
Blood• IV drug use (IVDU)• Occupational exposure
Healthcare workers infected in the work environment due to accidental exposure
• Transfusion & blood products
Prevention of Transmission
Avoidance of direct contact with sexual fluids
Abstinence
Safer sex & condom use
Infection control practices
Safer blood supply
Mother-to-child (MTC)
IVDU
Please continue to part 2
top related