HIV is a virus that causes AIDS by depleting the immune system. It originated from chimpanzees in West Africa and was likely transmitted to humans in the early 20th century. There are two types of HIV, with Type 1 being more prevalent and virulent worldwide. HIV is transmitted through unprotected sex, blood transfusions, needle sharing, and from mother to child. Untreated, it progresses from initial infection to AIDS in stages. People with AIDS experience opportunistic infections like oral thrush, pneumonia, and cancers like Kaposi's sarcoma due to a weakened immune system. Treatment involves antiretroviral drugs which can cause side effects.

1. 1
BASIC FACTS
ABOUT HIV/AIDS
a presentation by
Global Health International

2. Definitions
 HIV – Human Immunodeficiency Virus
The virus which causes AIDS
 SIV – Simian Immunodeficiency Virus
Retrovirus found in numerous strains in primates; the
specific strains infecting humans are HIV-1 & HIV-2
 AIDS – Acquired Immune Deficiency
Syndrome
A collection of symptoms & signs of illnesses due to
immune depletion
2

3. Relationship of HIV & AIDS
3

4. 4
The HIV virus

5. 5
Types of HIV
HIV Type 1 HIV Type 2
- Most predominant
world wide
- More virulent
- Has subtypes M, N, O
and P (M is most
predominant)
- Subtype M has
strains A, B, C, D,
F, G, H, J and K
- Mainly in West Africa
- Less easily
transmitted
- Longer period from
initial infection and
onset of illness

6. HIV origin: the theories
 Hunter theory:
Most accepted theory. That SIV was
transferred to humans after chimps being
killed & eaten or their blood getting into
hunters’ cuts/wounds
 Oral Polio vaccine theory:
Congo, Ruanda & Burundi in the late 1950s.
That the vaccine was cultivated using kidney
cells of local chimps infected with SIV
6

7. HIV origin: the theories
 Conspiracy theory:
-HIV manufactured as a biological warfare
programme, to wipe out black &
homosexual people.
-HIV was developed by the US as a weapon
of germ warfare
-Right wing American groups blamed the
Soviets for the AIDS epidemic.
7

8. HIV origin: the theories
 Colonialism theory: Locals were forced into
labour camps where SIV could have infected
them. They were inoculated with unsterile
needles against diseases e.g. smallpox. Many
camps employed prostitutes to keep workers
happy
 Heavenly theory: HIV came from an angry
God who was unhappy with gays, IVDUs &
promiscuity. Others believed that HIV came as
a cosmic debris as part of the tail of a comet
8

9. 9
Origin of HIV/AIDS
 HIV is a zoonotic infection-resembles SIV
 Genetic analysis indicates HIV introduced
into humans ~ 1931
 1959 serum sample from Congo HIV+
 Here chimpanzees are kept as pets and
butchered forfood
 HIV 1st
discovered in 1980s by Luc
Montagnier (Paris); Later in 1980s by
Robert Gallo (US)

10. 10
Origin of HIV/AIDS
 No. of people who developed AIDS before
the 1980s are unknown
 First cases of AIDS recognized in early
1980s
 In 1984, 1st
AIDS (‘slim disease’) case in
Uganda was reported

11. Modes of HIV transmission
 Sexual intercourse (heterosexual & same
sex; commonest mode of transmission)
 Mother to Child transmission (pregnancy,
labour, birth, breast feeding)
 Occupational exposure
 Blood products infusion
 Donor organ and tissue transplantation
 (Intravenous) Injection drug use
11

12. 12
Phase 1
 Rapid spread through urban sexual
networks along major highways from its
origin in the Lake Victoria region
 The fight against HIV began only after the
civil war in 1986. ACP set up in 1987
 By this time Urban areas had prevalence
rates of up to 29% .
HIV/AIDS trend in Uganda

13. 13
Phase 1 cont’d
 CBOs came up targeting education, HIV
prevention(ABC) & stigma reduction
TASO was one of the first
 Philly Bongoley Lutaaya (19 October 1951 –
15 December 1989), a Ugandan musician
spent his life writing songs about his battle
with AIDS; toured many places spreading
messages of prevention & hope.
HIV/AIDS trend in Uganda

14. 14
HIV/AIDS trend in Uganda
Phase 2: 1992 to 2000
 HIV prevalence fell dramatically, from about
15% in 1991 in adults to about 5% in 2001
 Reason: Gov’t. ABC prevention campaign & the
high numbers of AIDS-related deaths
 Prevention initiatives continued through the
nineties with high levels of funding from both
the gov’t & international donors e.g. World
Bank

15. 15
HIV/AIDS trend in Uganda
Phase 3: 2000 to 2005
 The third phase saw the stabilization of
HIV prevalence at 6.4%
 Free ARV drugs were introduced in 2004
 Funders included World Bank, Global
Health, PEPFAR, CDC

16. HIV/AIDS trend in Uganda
WHO 2010 HIV epidemiology report & 2011 Uganda demographics
report:
 HIV prevalence rate 6.5% among adults
 HIV prevalence rate 0.7% among children
 1.2 million people living with HIV/AIDS in Uganda
 1.2 million children are orphans due to AIDS
 130,000 new HIV infections occur annually
 60,000 deaths occur annually
 540,000 adults & children in need of ARVs
 240,000 adults & children on ARVs
16

17. Global distribution of HIV by sex &
age (Source WHO & UNAIDS 2010)
17

18. 18
18
Urban-Rural HIV Infection
Prevalence: (Source WHO & UNAIDS 2010)
10.2
12.8
6.7
1.4
5.7
6.5
4.8
0.6
0
2
4
6
8
10
12
14
All Females Males Children <5yrs
Urban Rural  Urban
residents have
a significantly
higher risk of
HIV infection
 The urban-
rural disparity
stronger for
women and
children than
for men.

19. So, What happens when HIV
enters the Human body?
1. Window Period
 Time from initial infection with HIV to time antibodies are
detectable (usually 3-8 weeks)
 Period varies between individuals & depends on the test used
 95% of people develop antibodies within 3-4 months
 HIV antibody tests may give negative results in an infected
person during this period
 Very high Viral Load
 Victim highly infectious
19

20. 2. Seroconversion
 The change from non-detectable antibody test
(Negative test) to detectable antibody levels (Positive
test) is referred to as seroconversion
 Seroconversion marks end of the window period
 Presents with unspecific symptoms e.g. fever, flu,
headache, general weakness, poor appetite, etc
 Symptoms short lived; patient improves in 2-4 weeks
20
So, What happens when HIV
enters the Human body?

21. 21
3. Development of Symptoms & Signs i.e.
Stage I
 Asymptomatic stage of HIV infection
 There may only be enlarged lymph nodes
So, What happens when HIV
enters the Human body?

22. 22
….when HIV enters the Human
body
Stage II
Multiple symptoms and conditions e.g.
 Skin rash
 Herpes zoster
 Oral ulcers
 Fungal nail infections
 Recurrent Respiratory Tract Infections

23. 2323
….when HIV enters the Human
body
Stage III
Multiple symptoms & conditions e.g.
 TB of the lungs
 Diarrhoea > a month
 Oral thrush
 >10% unintended weight loss
 Persistent fevers (unexplained) for > a
month

24. 2424
….when HIV enters the Human
body
Stage IV
Multiple symptoms and conditions e.g.
 Cancers like Kaposi’s sarcoma
 Oesophageal candidiasis
 Pneumocystis jiroveci pneumonia
 Cryptococcal meningitis
 TB outside the lungs

25. AND HOW WILL A PERSON WITH
HIV/AIDS PRESENT CLINICALLY?
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26. 26
MANIFESTATIONS OF
HIV/AIDS
1. Manifestations due to Opportunistic
Infections
2. Manifestations due to HIV/AIDS
Associated Cancers
3. Manifestations due to Drugs used in
treatment of HIV/AIDS
4. Other HIV/AIDS related conditions

27. 27
1. Manifestations due to Opportunistic
Infections
Fungal skin infections
27

28. 28
1. Manifestations due to Opportunistic
Infections
Oral thrush

29. 29
1. Manifestations due to Opportunistic
Infections
Oral Hairy Leukoplakia

30. 30
1. Manifestations due to Opportunistic
Infections
Angular Cheilitis (Candidiasis)

31. 31
1. Manifestations due to Opportunistic
Infections
Mixed Infections

32. 32
1. Manifestations due to Opportunistic
Infections
Herpes simplex virus

33. 33
1. Manifestations due to Opportunistic
Infections
Extensive H.S. infection of lips & nose

34. 34
1. Manifestations due to Opportunistic
Infections
Molluscum contagiosum

35. 1. Manifestations due to Opportunistic
Infections
Molluscum contagiosum
35

36. 1. Manifestations due to Opportunistic
Infections
Herpes zooster
36

37. 1. Manifestations due to Opportunistic
Infections
Generalised itchy
Skin rash
37

38. 1. Manifestations due to Opportunistic
Infections
TB of the skin
38

39. 1. Manifestations due to Opportunistic
Infections
Herpes simplex genitalia
39

40. 1. Manifestations due to Opportunistic
Infections
HPV
40

41. 41
1. Manifestations due to Opportunistic
Infections
HPV
41

42. 42
1. Manifestations due to Opportunistic
Infections
Vaginal Candidiasis
42

43. MANIFESTATIONS OF
HIV/AIDS
2. HIV/AIDS Associated
Cancers
43

44. 44
2. HIV/AIDS Associated Cancers
Kaposi’s sarcoma: gum & legs affected

45. 45
2. HIV/AIDS Associated Cancers
Kaposi’s sarcoma: palate involvement
45

46. 46
2. HIV/AIDS Associated Cancers
Lymphoma

47. 2. HIV/AIDS Associated Cancers
Squamous cell carcinoma of the eye
47

48. 2. HIV/AIDS Associated Cancers
Kaposi’s sarcoma
48

49. 49
MANIFESTATIONS OF
HIV/AIDS
3. Manifestations due to Drugs
used in HIV/AIDS Treatment
49

50. 3. Manifestations due to drugs
Nevirapine rash
50

51. 51
3. Manifestations due to drugs
Steven Johnson’s
Syndrome
51

52. 52
3. Manifestations due to drugs
Nevirapine side effects
52

53. 53
3. Manifestations due to drugs
Severe
Anaemia
of AZT
53

54. 54
3. Manifestations due to drugs
Fat maldistribution
(Stavudine induced)
54

55. 55
3. Manifestations due to drugs
Loss of body fat
(as with Protease
Inhibitors)
55

56. 56
MANIFESTATIONS OF
HIV/AIDS
4. Other HIV/AIDS Associated
Conditions

57. 4. Other HIV/AIDS Associated
conditions
Psoriasis
57

58. 58
4. Other HIV/AIDS Associated
conditions
Eczema
58

59. 59
4. Other HIV/AIDS Associated
conditions
HIV wasting
syndrome
59

60. 60
May God have mercy
upon mankind