Hiv aids part 1

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

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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.

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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