Acquired Immunodefiency

8/8/2019 Acquired Immunodefiency

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ACQUIRED IMMUNODEFIENCYSYNDROME

AIDS-is a disease that slowlyand steadily destroys theimmune system. It is caused byHIV, a virus which wipes outcertain types of lymphocytescalled T-helper cells.

HIV is a retrovirus also calledslow virusMT: transmited though direct

contact with blood products andsome body secretions

Persons at risk:Anyone who engaged inunprotected sexual activity withinfected individual.Recipients of transfused blood orblood components.IV drug usersChildren of mothers with HIVHealth care workers exposed toHIV by needle stick.T cells shed from thymus undergotransformationHelper T cell also called CD4 chonmolecules on the surface of the Tacells. where HIV attached

themselves

HIV binds to t4 receptorVirus enters the T4 cell

Sheds its protein coatViral RNA is transcribed into thehost DNAUsing Reverse Transcriptase

(Enzyme found in the virus)Viral RNA is integrated into host cellDNAReprograms the genetic material ofT4HIV produces virus instead of T4Virus infects other T4 cells

Incubation period---cantake for as long 7-12 yearss/s

1.Primary acute infection: viraloutburst

(Few days or weeksafter infection)

Flu, mononucleosis,fatigue, headache, fever,sore throat,lymphadenopathy andsweating2. Asymptomatic stage- nosigns and symptoms

Person look and feelhealthyCan transmit the disease

PGL stage---persistent generalizedlymphadenopathy (AIDS relatedcomplex)Swollen lymph nodesseveral

months.

Unexplained wt loss, Night sweats,diarrheaPerson with Aids has a CD4 countof below 200mm3 N- is above

1000mm3Opportunistic infection:Viruses: cytomegalovirusHerpes simplex

BacteriaMycobacteriumsalmonella

Fungi pneumocystis cariniiCancers:

1.Kaposis sarcomaaffects the

blood vesselnon itchy purplish-red blotches appear on skin2.Cervical dysplasia associatedwith human papilloma virus.

3.Non hodgkins lymphomacancerous tumors of lymphnodeslate manifestationDIAGNOStics

ELISA--- enzyme linkedimmunosorbenht assay

Western blot---identifiesHIV antibodySUDS single usediagnostic testMedical mgt:

a.ZDV- Ziduvudineb.DDL- Didanosine nucleoside

reverse


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c.DDC- zalcitabine transcriptase

inhibitorsd.D4T stavudine

Action: suppresses

synthesis of viral DNA byreverse transcriptase

Noncleoside reverse transcriptaseDelavirdineNeviradine

Action: direct inhibition of HIV bybinding to active center or reverse

transcriptaseProtease inhibitorsIndinavirRitonavir

Action: bind to the active site of HIVprotease therebypreventing theenzyme from cleaving HIV

polyCHONS; virus remainsimmature and non infectious---viralload reduced.RABIEShydrophobia/ lyssais a viral zoonotic disease thatcauses acute encephalitis

In non-vaccinated humans, rabiesis almost fatal after neurologicalsymptoms have developed,but prompt post-exposure

vaccination may prevent the virusfrom progressing.s/s:

irritabilityexcessive movements or agitation

confusionhallucinationsaggressivenessbizarre or abnormal thoughts

muscle spasmsabnormal posturesweakness or paralysisextreme sensitivity to bright lights,sounds, or touchincreased production of saliva ortears

difficulty speakingseizures (convulsions)

In the advanced stage :double visionproblems moving facial musclesabnormal movements of the

diaphragm and muscles that controlbreathingdifficulty swallowingincreased production of

saliva,(causing the "foaming at themouth" usually associated with arabies infection )

Mgt:MEASLES (RUBEOLA)Rubeola, is an infection of therespiratory system caused byavirus,C/A : paramyxovirus of thegenusMorbillivirus.

Incubation: 6 19 daysS/S

First Stage: fever, colds, cough, redeyes

Kopliks spotsSecond Stage:

Rashesgeneralized,maculopapular, erythematous rash that begins severaldays after the fever causing itching.M/T: Airborne, dropletComplications:diarrhea,

pneumonia andencephalitis (subacute sclerosing

panencephalitis),corneal ulceration leading

to corneal scarring.[4]German Measles (Rubella)

A comtagious respiratory disease

caused by a virus. (Rubella virus)Symptoms:

Rash and fever for two to threedays (mild disease in children andyoung adults).Birth defects if acquired by apregnant

woman: deafness, cataracts, heartdefects, mental retardation, andliver and spleen damageSpread by contact with an infectedperson, through coughing andsneezingMumps

Mumps and epidemic parotitisisa viral disease of


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the humanspecies, caused bythe mumps virusPainful swelling of the salivary

glands (classically the parotid

gland) is the most typicalpresentation.[2] Painful testicularswelling (orchitis) and rash maymumpsTREATMENT:(SELF LIMITED)LEPROSY

Leprosy orHansen'sdisease(HD), namedafter physicianGerhard ArmauerHansen,chronic disease caused by

bacteria Mycobacterium lepraeand Mycobacterium lepromatosis.

a granulomatous disease ofthe peripheral nervesand mucosa of the upperrespiratory tractS/S:Skin lesionsThe mechanism of transmission:

prolonged close contactnasal droplet.

TreatmentPauci-bacillary leprosy (1-5 skinlesions) Treat with rifampicin anddapsone for 6 monthsMulti-bacillary leprosy (>5 skin

lesions) Treat with rifampicin,

clofazimine and dapsone for 12months.Chickenpox (varicella)

orchicken pox is ahighly contagious illness caused byprimary infection with varicellazoster virus (VZV).

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It usually starts with vesicular skinrash mainly on the body and headrather than at the periphery

prodromeanorexia, myalgia, nausea, fever,headache, sore throat, pain in bothears, malaise in adolescents andadults, w papular rash,Rarely cough, rhinitis, abdominalpain, and gastrointestinal distress

M/T: dropletDirect contact on lesionsTreatmentantiviral drugs (e.g. acyclovir)Calamine lotionZinc oxideChickenpox was first identified

byPersian scientist Muhammad ibnZakariya ar-Razi (865925), knownto the West as Giovanni Filippo (15101580)

of Palermolater provided a moredetailed description of varicella(chickenpox).

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Acquired Immunodefiency