Development of HIV, How HIV causes AIDS

2.  Scientists believe HIV came from a particular
kind of chimpanzee in Western Africa.
 Humans probably came in contact with HIV
when they hunted and ate infected animals.
 Recent studies indicate that HIV may have
jumped from monkeys to humans as far back
as the late 1800s
WHERE DID HIV COME FROM ?

4. The History of HIV
The Earliest Known Case
The first case of HIV infection in a human was identified in 1959.
(The transfer of the HIV disease from animal to human likely
occurred several decades earlier, however.)
The infected individual lived in the Democratic Republic of the
Congo. He did not know (and research could not identify) how
he was infected.

5. HIV in the
U.S.
The first cases of HIV in the United States date
back to 1981. Homosexual men began dying from
mysterious, pneumonia-like infections.
In June 1981, the U.S. Centers for Disease Control and
Prevention (CDC) first described the symptoms of this unknown
disease in one of their publications.
Soon, healthcare providers from around the country began
reporting similar cases.
The number of people with the disease increased. Sadly, so did
the number of people dying from the unidentified disease.

6. Losing Famous
Faces
America’s romantic leading man in the 1950s and ’60s,
Rock Hudson, passed away from complications related to AIDS
in 1985.
When he passed, he willed $250,000 to help establish the
American Foundation for AIDS Research (amfAR).
Today, amfAR helps fund research and education around the
globe.
Also this year, the U.S. Food and Drug Administration (FDA)
approved the first commercial blood test, ELISA. The ELISA test
allowed hospitals and healthcare facilities to quickly screen
blood for the disease.

7. First American AIDS Clinic Opens
In September 1982, the CDC uses the term acquired immune
deficiency syndrome (AIDS) for the first time when describing
the mystery disease.
That same year, the first AIDS clinic opened in San Francisco.
San Francisco AIDS Foundation

8. A Tiny Discovery
In 1984, Dr. Robert Gallo and colleagues at the National Cancer
Institute discovered what causes AIDS.
Gallo found the human immunodeficiency virus (HIV), which is
the virus responsible for HIV infections.
The infection is distinct from AIDS, the full-blown syndrome that,
along with the consequences of a damaged immune system
(such as pneumonia and Kaposi’s sarcoma),
is most often fatal.

9. A Tragic Milestone
Once the diseases were identified,
HIV and AIDS quickly became an
epidemic in the country.
…..By 1994,
AIDS was the leading cause of
death among Americans
ages 25 to 44.

10. HAART Becomes Popular
The FDA approved the first protease inhibitor in 1995.
This began a new era of strong treatment and response called
highly active antiretroviral therapy (HAART).
By 1997, HAART was the standard of treatment for HIV. Soon,
the number of deaths caused by AIDS begins to fall.
This medicine plan nearly cut the number of AIDS-related deaths
in half in just one year.
However, HAART had its detractors. Many were worried the
treatment plan was too aggressive and might actually make
treatment-resistant HIV strains.

11. Advances in Home
Testing
The FDA approved the first at-home HIV test kit in 2002.
The test was 99.6 percent accurate.
This opened up the possibility for people to test their
status in the privacy of their own homes.

12. Prevention Before Cure
HIV and AIDS do not yet have cures.
Once a person is infected with the virus,
they cannot get rid of the virus.
They can treat it and slow the progression of the disease.
For people who are not infected, there is hope you may
be able to prevent an infection.
In 2013, the CDC released a study that found that a daily
dose of medication may be able to halt the transfer of
HIV from a positive person to a negative person.

13. Prevalence of
HIV/AIDS

14. WHAT IS HIV ?
To understand what HIV is, let’s break it down :
H – Human:
This particular virus can only infect human beings.
I – Immunodeficiency:
HIV weakens your immune system by destroying important cells
that fight disease and infection. A "deficient" immune system
can't protect you.
V – Virus:
A virus can only reproduce itself by taking over a cell in the body
of its host.

15. The Human Immunodeficiency Virus
• HIV, like all viruses, is an intracellular parasite
• Parasitizes macrophages and T-cells of immune
system
• Uses cells enzymatic machinery to copy itself. Kills
host cell in process.
• HIV binds to two protein receptors on cell’s surface :
CD4 and a co-receptor, usually CCR5.
• Host cell membrane and viral coat fuse and virus
contents enter cell.

17. How HIV causes AIDS
• HIV invades immune system cells especially helper T
cells.
• These helper T cells have a vital role in the immune
system.
• When a helper T cell is activated (by having an
antigen [a piece of foreign protein] presented to it, it
begins to divide into memory T cells and effector T
cells.

18. Memory T cells
• Memory T cells do not engage in current fight against
the virus.
• Instead they are long-lived and can generate an
immune response quickly if the same foreign protein is
encountered again.

19. Effector T cells
• Effector T cells attack the virus. They produce
signaling molecules called chemokines that stimulate B
cells to produce antibodies to the virus.
• Effector T cells also stimulate macrophages to ingest
cells infected with the virus.
• In addition effector T cells stimulate killer T cells to
destroy infected cells displaying viral proteins.

23. WHAT IS AIDS ?
• To understand what AIDS is, let’s break it
down:
• A – Acquired:
• AIDS is not something you inherit from your parents.
You acquire AIDS after birth.
• I – Immuno:
• Your body's immune system includes all the organs and cells that
work to fight off infection or disease.
• D – Deficiency:
• You get AIDS when your immune system is "deficient," or isn't working
the way it should.
• S – Syndrome – A syndrome is a collection of symptoms and signs of
disease. AIDS is a syndrome, rather than a single disease

25. Risk Factors For Transmitting HIV During Pregnancy
?
*
• Smoking
• Substance abuse
*
• Vitamin A deficiency
• Malnutrition
• Breastfeeding
*
• Infections such as STD’s
• Clinical stage of HIV, including viral load (quantity of HIV virus in
the blood)
• Factors related to labor and childbirth
If a woman is infected with HIV, her risk of transmitting the
virus to her baby is reduced if she stays as healthy as
possible. According to the March of Dimes, new treatments
can reduce the risk of a treated mother passing HIV to her
baby to a 2 percent or less chance.
Factors which increase the risk of transmission include:

27. HOW DO YOU GET HIV…?
• HIV is found in specific human body fluids.
• If any of those fluids enter your body, you can
become infected with HIV.

28. WHICH BODY FLUIDS CONTAIN HIV ?
• Blood
• Semen (cum)
• Pre-seminal fluid (pre-cum)
• Breast milk
• Vaginal fluids
• Rectal (anal) mucous
HIV lives and reproduces in blood and other body fluids.
We know that the following fluids can contain high levels
of HIV ( Human Immunodeficiency Virus )

29. Other body fluids and waste products, like feces, nasal fluid,
saliva, sweat, tears, urine, or vomit — don’t contain enough
HIV to infect you, unless they have blood mixed in them and
you have significant and direct contact with them.
Healthcare workers may be exposed to some other
body fluids with high concentrations of HIV, including:
• Amniotic fluid
• Cerebrospinal fluid
• Synovial fluid
HIV can enter the body through:
 Lining of the anus or rectum
 Lining of the vagina and/or cervix
 Opening to the penis
 Mouth that has sores or bleeding gums
 Cuts and sores
 Needles (syringes)

30. Average per act risk of getting HIV
by exposure route to an infected source

31. Healthy skin is an excellent barrier against HIV and other
viruses and bacteria.
HIV cannot enter the body through unbroken skin.
• Having sex (anal, vaginal, or oral) with someone
who is HIV-positive
• Sharing needles or injection equipment ("works")
with a user who is HIV-positive
• From HIV-positive women to their babies—before
or during birth, or through breastfeeding after birth
These are the most common ways that HIV is transmitted
from one person to another:
Some healthcare workers have been infected after being stuck with needles
contaminated with HIV-infected blood—or, less frequently, by having infected
blood splashed into their eyes, nose, mouth, or into an open cut or sore.

33. Risk factors of HIV/AIDS
• having unprotected anal or vaginal sex
• having another sexually transmitted infection such as syphilis,
herpes, Chlamydia, gonorrhea, and bacterial vaginosis
• sharing contaminated needles, syringes and other injecting
equipment and drug solutions when injecting drugs
• receiving unsafe injections, blood transfusions, medical procedures
that involve unsterile cutting or piercing, and
• experiencing accidental needle stick injuries, including among health
workers.
Behaviors and conditions that put individuals at greater risk
of contracting HIV include:

35. HOW DO YOU GET AIDS ?
AIDS is the late stage of HIV infection, when a
person’s immune system is severely damaged and
has difficulty fighting diseases and certain cancers.
Before the development of certain medications,
people with HIV could progress to AIDS in just a few
years. Currently, people can live much longer - even
decades - with HIV before they develop AIDS. This is
because of “highly active” combinations of
medications that were introduced in the mid 1990s.

37. WHAT ARE THE SYMPTOMS OF HIV ?
The symptoms of HIV vary, depending on the individual
and what stage of the disease you are in.
Within 2-4 weeks after HIV infection, many, but not
all, people experience flu-like symptoms, often
described as the “worst flu ever.” This is called
“acute retroviral syndrome” (ARS) or “primary HIV
infection,” and it’s the body’s natural response to
the HIV infection

39. • Fever (this is the most common symptom)
• Swollen glands
• Sore throat
• Rash
• Fatigue
• Muscle and joint aches and pains
• Headache
EARLY STAGE OF HIV SYMPTOMS CAN INCLUDE:

40. THE CLINICAL LATENCY STAGE
After the early stage of HIV infection, the disease moves into a
stage called the “clinical latency” stage.
“Latency” means a period where a virus is living or developing
in a person without producing symptoms.
During the clinical latency stage, people who are infected with
HIV experience no HIV-related symptoms,
or only mild ones.
This stage is sometimes called
“asymptomatic HIV infection
” or “ chronic HIV infection.”

42. PROGRESSION TO AIDS: SYMPTOMS
If you have HIV and you are not taking HIV medication (antiretroviral
therapy), eventually the HIV virus will weaken your body’s immune system.
The onset of symptoms signals the transition from the clinical latency stage
to AIDS (Acquired Immunodeficiency Syndrome).
During this late stage of HIV infection, people infected with HIV may
have the following symptoms:
• Rapid weight loss
• Recurring fever or profuse night sweats
• Extreme and unexplained tiredness
• Prolonged swelling of the lymph glands in the armpits, groin, or neck
• Diarrhea that lasts for more than a week
• Sores of the mouth, anus, or genitals
• Pneumonia
• Red, brown, pink, or purplish blotches on or under the skin or
inside the mouth, nose, or eyelids
• Memory loss, depression, and other neurologic disorders.
Each of these symptoms can be related to other illnesses. So, as noted above, the
only way to know for sure if you are infected with HIV is to get tested.

43. Controlling HIV
transmission
• Some success has been achieved in reducing
transmission of the virus.
• Education is the single most effective weapon in fighting
infection.
• Increased latex condom use reduces transmission.

44. THE GLOBAL
HIV/AIDS CRISIS TODAY

45. THE GLOBAL HIV/AIDS CRISIS TODAY
HIV, the virus that causes AIDS, has become one of the world’s most serious
health and development challenges:
• At the end of 2012, 35.3 million people were living with HIV.
• More than 36 million people have died of AIDS worldwide since the first
cases were reported in 1981.
• In 2011, 1.6 million people died due to HIV/AIDS, and another 2.3 million
were newly infected.
• 9.7 million people in low and middle-income countries had access to
antiretroviral therapy at the end of 2012
• 26 million close to 26 million are eligible for antiretroviral therapy, under
WHO 2013 consolidated ARV guidelines.

48. • 14.8 million People eligible for HIV treatment
• 8 million People on HIV treatment
• According to the World Health Organization (WHO), most people living with HIV
or at risk for HIV do not have access to prevention, care, and treatment, and
there is still no cure.
• Sub-Saharan Africa is the most affected region, with nearly 1 in every 20 adults
living with HIV. 69 % of all people living with HIV are living in this region.
• There is no cure for HIV infection. However, effective treatment with
antiretroviral drugs can control the virus so that people with HIV can enjoy
healthy and productive lives.

50. • It is estimated that the return on such an investment would be 12 million new
HIV infections averted and 7.4 million AIDS-related deaths averted by the year
2020. The number of new infections would decline from about 2.6 million in
2009 to about 1 million in 2015
• The HIV epidemic not only affects the health of individuals, it impacts
households, communities, and the development and economic growth of
nations. Many of the countries hardest hit by HIV also suffer from other
infectious diseases, food insecurity, and other serious problems.
• Despite these challenges, there have been successes and promising signs.
New global efforts have been mounted to address the epidemic, particularly
in the last decade.
• Prevention has helped to reduce HIV prevalence rates in a small but growing
number of countries and new HIV infections are believed to be on the decline.
In addition, the number of people with HIV receiving treatment in resource
poor countries has increased 10-fold since 2002, reaching an estimated 4
million by 2008.
Overview compiled with information from WHO , USAID and Kaiser Family Foundation

52. Global_estimates

53. 2012 global and regional statistics

54. Glossary of acronyms and definitions
• HIV - Human Immunodeficiency Virus
• AIDS - Acquired Immunodeficiency Syndrome
• PLWHA - People Living with HIV/AIDS
• MSM - Men who have Sex with Men
• CSW - Commercial Sex Worker
• IDU - Injecting Drug User
• STI - Sexually Transmitted Infections
• ART - Anti-Retroviral Treatment
• LAC - Lithuanian AIDS Centre
• EMCDDA - European Monitoring Centre for Drugs and Drug Addiction
• CRIS -The Country Response Information System
• UNAIDS - Joint United Nations Programme on HIV/AIDS
• UNDP - United Nations Development Programme
• WHO - World Health Organization
• NGO - Non-governmental Organization
• NACP - National AIDS Control Programm

55. HIV/AIDS
Prevalence In
Pakistan

56. HIV/AIDS Pakistan

57. HIV/AIDS Prevalence In Pakistan
• Government of Pakistan’s Enhanced HIV/AIDS Control
Programme, and a growing understanding of the potential
impact of HIV/AIDS on young people in Pakistan
• In 2009, UNAIDS Pakistan and the national AIDS control
programme estimated that there were around 98 000
(79 000–120 000) HIV cases in Pakistan, with an overall
general population prevalence of less then 0.05%
• As of November 2010, the total number of registered HIV
patients was 3,983, of which 1,725 are undergoing
treatment.

58. http://www.indexmundi.com/pakistan/hiv_aids_adult_prevalence_rate.html

59. HIV/AIDS Prevalence In Pakistan
• In 2010, the NACP launched the National Guidelines for the Care
and Support of Children Affected by HIV and AIDS.
• However, the epidemic is expanding among injecting drug users,
with an estimated prevalence of 20%, and their sexual contacts,
including male and transgender hijra sex workers, low condom use
among female sex workers, with rates of 2%–3% and 4%,
respectively.

60. Pakistan
http://www.indexmundi.com/pakistan/hiv_aids_adult_prevalence_rate.html

61. • AIDS in Pakistan and has gone through numerous policy
reforms since its formation.
• The country remains at a considerably high risk for a HIV/AIDS
epidemic due to socioeconomic conditions such as poverty,
low levels of education and high unemployment.
• There is a great need to effectively implement all the relevant
programmes and policies immediately to protect potential
victims, especially young people and children from the
epidemic of HIV/AIDS.
HIV/AIDS Prevalence In Pakistan

63. Some of the recent achievements of NACP include;
• ECNEC approval of the AIDS Progamme PC-1s,
• Approval of Revised HIV/AIDS Control Programme PC-1s (6) by CDWP,
• CDWP Approves Safe Blood Transfusion Project PC-1s,
• Award of US $ 44 million Global Fund R-9 HIV Proposal,
• Award of US $ 9.0 million Global Fund Regional Proposal,
• Revival of the German funded Safe Blood Transfusion project,
• Revision of National HIV estimates,
• Strengthening of the National HIV/STI Referral laboratory,
• Operationalization of the National M&E framework,
• Organization of the Ministerial Meeting on Migrant Workers during the 2009 World
Health Assembly Session,
• National consultations on scaling-up the response among IDUs, FSWs, and MSMs.
• Agreement on Oral Substitution Treatment Pilot Project
• Signing of FSW Technical Assistance contract
• Continuous provision of ARVS through GFATM R- 2 grant
• Special Surveillance Round for Female Sex Workers in Punjab, and Sindh with UNAIDS
collaboration
• Collaboration with FELTP, and CDC, Atlanta-USA for TA on HIV outbreak surveillance
and Referral laboratory
• 2-year Cost Extension of CIDA funded Surveillance project,
• Ongoing dialogue with USAID – forthcoming HIV project for addressing the gaps in
NSF-II

64. Pakistan
http://www.indexmundi.com/pakistan/hiv_aids_adult_prevalence_rate.html

65. HIV/AIDS Prevalence In Pakistan
• Other factors include use of non-sterilised of medical
instruments, labor migration, transfusion of unscreened
blood, reuse of syringes, quackery, street barbers and
rising number of drug addicts.
• National surveillance data shows rates
of infection in most major cities
ranging from 15% to 50% among
the country's estimated 150 000
injecting drug users.

66. Pakistan
http://www.indexmundi.com/pakistan/hiv_aids_adult_prevalence_rate.html