1. PREVENTION
AND
PRECAUTION
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2. o AIDS is Acquired Immunodeficiency
Syndrome.
o The final stage of HIV disease which
severely damages the immune system.
o It is caused by Human Immunodeficiency
virus.
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3.  It interferes with the immune system
making people more vulnerable to
infections , including opportunistic
infections and tumors that do not affect
people with working immune systems.
This susceptibility gets worse as the
disease continues.

4. o AIDS – the ultimate clinical consequence
of infection with HIV.
o HIV is a retrovirus that primarily infects
vital organs of the human immune system
such as CD4+ T cells (a subset of T
cells), macrophages and dendritic cells.
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5. causes
o HIV Virus , directly and indirectly destroys
CD4+ T cells. Once the number of CD4+ T
cells per microliters (µL) of blood drops below
200, cellular immunity is lost.
o Acute HIV infection usually progresses over
time to clinical latent HIV infection and then to
early symptomatic HIV infection and later to
AIDS, which is identified either on the basis of
the amount of CD4+ T cells remaining in the
blood , and / or the presence of certain
infections.

6. The virus can be spread (transmitted):
o Through sexual contact
o Through blood -- via blood transfusions or
needle sharing
o From mother to child -- a pregnant woman
can transmit the virus to her fetus through
their shared blood circulation, or a nursing
mother can transmit it to her baby in her breast
milk
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8. o Loss of appetite, weight loss, constant
fever, prolonged
fatigue, diarrhea, constipation, changing bowel
patterns, swollen glands, chills coupled with
excessive sweating, especially at nights, lesions in
the mouth, sore throat, persistent
cough, shortness of breath, tumours, skin
rashes, headaches, memory lapses, swelling in
the joints, pain in various parts of the
body, vision problems and a regular feeling of
lethargy and ill health .
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9.  With immune systems out of harmony, HIV-
positive persons are susceptible to several types
of cancer, particularly Kaposi`s sarcoma
(KS), an uncommon form also known as AIDS-
associated Kaposi sarcoma or KS-AIDS .

10. o KS-AIDS presents with cutaneous lesions that
begin as one or several red to purple-red
macules , rapidly progressing to
papules, nodules, and plaques, with a
predilection for the head, neck, trunk, and
mucous membranes.
o In the early stages, a mild flu and swollen glands
are typical. But the symptoms are often
unmistakable when full-blown AIDS develops.

11. 
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12. o With the rise of the AIDS epidemic, KS, was initially
one of the most common AIDS symptoms , and was
erroneously referred to as the "AIDS rash".
o Different from the classic form of Kaposi
sarcoma, KS-AIDS tumors usually appear on the
head, back, neck, muscular palate and the area of the
gingiva .
o In more advanced cases, they can be found in the
stomach and intestines, the lymph nodes, and the lungs.
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13. o There is currently no publicly available HIV vaccine or
cure for HIV or AIDS.
o The only known methods of prevention are based on
avoiding exposure to the virus or, failing that, an
antiretroviral treatment directly after a highly significant
exposure, called post-exposure prophylaxis (PEP ).
o PEP has a very demanding four week schedule of
dosage. It also has very unpleasant side effects
including diarrhea, malaise, nausea and fatigue.
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14. o Treatment should begin within an hour of infection.
After 72 hours post-exposure PEP is much less
effective, and may not be effective at all .
o Prophylactic treatment for HIV typically lasts four
weeks.
o In the case of HIV infection, post-exposure prophylaxis
is administered which includes course of antiretroviral
drugs which reduces the risk of seroconversion after
events with high risk of exposure to HIV (e.g.,
unprotected sexual contact, needlestick injuries, or
sharing needles.
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15. o In the case of HIV infection, post-exposure
prophylaxis is administered which includes
course of antiretroviral drugs which reduces the
risk of sero conversion after events with high
risk of exposure to HIV (e.g., unprotected sexual
contact, needle stick injuries, or sharing needles.

16. o Antiretroviral drugs are medications for the treatment
of infection by retroviruses, primarily HIV. When
several such drugs, typically three or four, are taken in
combination, the approach is known as Highly Active
Antiretroviral Therapy, or HAART.
o The anti-retroviral drugs used are AZT – Zidovudine ,
Lamivudine and Indinavir. , should be given for health
workers following exposures of susceptible areas to
infected material from AIDS patient.
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17. In The Out Patient Department (OPD)
surgeons/health care
workers follow some precautions :
o Use Gloves to examine the patients with open
wounds.
o During proctoscopy or sigmoidoscopy use
gloves.
o Hand gloves and eye protection during flexible
endoscopy.
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18. o Use disposable instruments.
o Re-usable instruments like endoscopes - cleaned
in soap and water and immersed in
gluataraldehyde.
o No surgical procedure involving sharp
instruments in OPD.

19. o Operating room should be covered with a single
sheet of polyethylene.
o Minimum number of theatre personnel.
o No Staff with abrasions or lacerations on their
hands.
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20. o Shoes, Gloves and Disposable , Water Resistant
gowns and Eye Protection for anyone entering
the room.
o Double gloves and Eye Protection for staffs
directly involved with operation (surgeon,
assistant, scrub nurse).

21. Surgical technique
o Avoid sharp injury
o Prefer scissors/ diathermy to the scalpel
o Use skin clips.

22. o Avoid needle stick injuries.
o Proper Autoclaving at the end of surgery.
o Apply AZT- Zidovudine , Lamivudine
, and Indinavir in exposed areas while
interacting with patients.
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23. o Necrotising Ulcerative Periodontitis (NUP)
o Necrotising Ulcerative Stomatitis
o Kaposi’s Sarcoma
o Non-Hodgkin’s Sarcoma
o Tooth extraction
o Implant surgery
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24.  Necrotizing Ulcerative Periodontitis (NUP),an
acute type of necrotizing periodontal disease
characterized by erythema of the gingival and
alveolar mucosa, ulcerated interdental
papillae, interdental craters of the soft tissue and
bone, and loss of periodontal attachment. May
become chronic.

25.  Necrotizing Ulcerative Stomatitis : It’s
a disease with shallow ulcers on the
cheeks, tongue, and lips.

26.  The non-Hodgkin lymphomas (NHLs) are a
diverse group of blood cancers that include any
kind of lymphoma except Hodgkin's lymphomas
.Types of NHL vary significantly in their
severity, from indolent to very aggressive.

27.  Lymphomas are types of cancer derived from
lymphocytes , a type of white blood cell .
Lymphomas are treated by combinations of
chemotherapy , monoclonal antibodies
, immunotherapy , radiation , and hematopoietic
stem cell transplantation.
 Non-Hodgkin lymphomas were classified
according to the 1982 Working Formulation
which recognizes 16 types. The Working
Formulation is now considered obsolete.

28.  Non-Hodgkin lymphoma and HIV
 The Centre for Disease Control and Prevention
(CDC) included non-Hodgkin's lymphoma
(NHL) as AIDS-defining cancers in 1987.[3

29.  Immune suppression rather than HIV itself is
implicated in the pathogenesis of this
malignancy, with a clear correlation between the
degree of immune suppression and the risk of
developing NHL. HIV-infected patients are at
an increased risk for developing both Hodgkin
lymphoma and NHL when compared with the
general population

30. o Seroconversion: Development of detectable specific antibodies
to microorganisms in the blood serum as a result of infection or
immunization.
• Often used in reference to blood testing for anti-HIV
antibodies. In particular, “Seroconvert” is referred to the
process of "becoming HIV positive.
o Serology: The testing for antibodies, used to determine antibody
positivity.
o Serostatus: The presence or absence of particular antibodies in
an individual's blood. Prior to seroconversion, the blood test is
seronegative for the antibody; after seroconversion, the blood test
is seropositive for the antibody.
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31. o Seroreversion : The opposite of seroconversion. This is when
the tests can no longer detect antibodies in a patient’s serum
o Debridement : The medical removal of dead, damaged, or
infected tissue to improve the healing potential of the remaining
healthy tissue.
• Removal may be surgical , mechanical, chemical, autolytic
(self-digestion), and by maggot therapy, where certain species
of live maggots selectively eat only necrotic tissue.
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