What is AIDS?

O Acquired immune deficiency syndrome or acquired immunodeficiency syndrome

(AIDS) is a disease oI the human immune system caused by the Human
Immunodeficiency Virus (HIV)
O %his condition progressively reduces the eIIectiveness oI the immune system and leaves
individuals susceptible to opportunistic inIections and tumors.
O %he time between inIection and the appearance oI symptoms tends to be much longer,
allowing more opportunities Ior these microorganisms to be transmitted to other hosts.
%he period between inIection and the appearance oI AIDS can take Irom 7 to 12 years.
O AIDS is now a pandemic. In 2007, an estimated 33.2 million people lived with the
disease worldwide, and it killed an estimated 2.1 million people, including 330,000
children.
AGENT:
Human Immunodeficiency Jirus -1 and -2
(HIJ -1 and HIJ - 2)
- 'slow virus long incubation period (7-12 yrs)
History:
O enetic research indicates that HIV originated in west-central AIrica during the late
nineteenth or early twentieth century.
O AIDS was Iirst recognized by the U.S. Centers Ior Disease Control and Prevention in
1981 and its cause, HIV, identiIied in the early 1980s.
O ot hereditary or inborn
O AIIects CD4 % Lymphocytes decreasing the body`s immune response(increase susceptibility
to inIection)
O Antibodies develop in 2 weeks to 6 months
O ay remain asymptomatic Ior several years














PATHOPHYSIOLOGY OF AIDS
Plv

(dendrlLlc cells ln Lhe mucosa of Lhe genlLal LracL)

1ransporLed Lo Lhe lymph nodes

Plv lnfecLs lymphocyLes

SysLemlc lnfecLlon

8ody's lmmune response

AnLlbodles (cyLoLoxlc Lcells)

Speclflc for Plv lnfecLed cells

vlremla level decreased Lo a plaLeau level"

When Plv lnfecLlon Lakes place AnLlPlv bodles are produced buL Lhey do noL appear lmmedlaLely

WlnuCW LllLC1

ln some cases anLlbodles Lo Plv become deLecLable 46 weeks afLer lnfecLlon

Plv ln clrculaLlon lL lnvades several Lypes of cells (lymphocyLes macrophages langehans cell

Plv aLLacks lmmune sysLem mlcroorganlsm aLLaches Lo CPCn molecule called Cu4 whlch ls found ln Lhe
surface of 1 cells

Cnce Lhe vlrus enLers Lhe 14 lL lnserLs lLs geneLlc maLerlals lnLo Lhe 14's nucleus Laklng over Lhe cell Lo
repllcaLe lLself

14 cell dles afLer belng used by Plv for repllcaLlon

vlrus muLaLes rapldly maklng lL dlfflculL for Lhe body Lo recognlze" Lhe lnvaders

8everse LranscrlpLase whlch copy lnformaLlon for vlrus Lo repllcaLe

nALLMAkk progress|ve decreased |n CD4 1 ce||s










Signs and Symptoms
Minor Signs:
1. Persistent Cough Ior one month
2. eneralized pruritic dermatitis
3. Recurrent herpes zoster
4. Oropharyngeal candidiasis
5. Chronic disseminated herpes simplex
6. eneralized lymphadenopathy
Major Signs:
1. Loss oI weight 10 percent oI body weight
2. Chronic diarrhea Ior more than one month
3. Prolonged Iever Ior one month
ommon Opportunistic Infections
1. Pneumocystis carinii pneumonia
2. Oral candidiasis
3. %oxoplasmosis oI the CS
4. Chronic diarrhea/wasting
syndrome
5. Pulmonary/extra-pulmonary
tuberculosis
6. Cancers
a. aposi`s sarcoma aIIects
small blood vessels and
internal organs
b. Cervical dysplasia and
cancer. Researchers Iound
out that women with HIV have higher rates oI this type oI cancer. Cervial
carcinoma is associated with Human Papilloma Virus (HPV).
c. on-Hodgkin`s lymphoma cancerous tumor oI the lymph nodes. %his is usually
a late maniIestation oI HIV
inIection.
Mode of Transmission:
1. Sexual intercourse
2. Blood transIusion and sharing oI
inIected syringes and needles among
intravenous drug users
3. Vertical or perinatal transmission
(Irom a pregnant woman to the Ietus
during pregnancy, child delivery or
breast-Ieeding)
%here are several ways oI receiving inIected
blood:
1. Blood transIusion
2. Sharing oI unsterilized syringes and needles used Ior intravenous injections
3. %ransmission during pregnancy
a. aybe transplacental
b. %here is greater risk oI transmission when mother has developed advanced AIDS
4. Organ donation
5. Accidental exposure in hospitals or clinics



Diagnostic Examination:
1. LA or LISA nzyme link immunosorbent assay
2. Particle agglutination (PA) test
3. Western blot analysis conIirmatory diagnostic test
4. ImmunoIluorescent test
5. Radio immuno-precipitation assay (RIPA)
O any people are unaware that they are inIected with HIV.
O HIV tests are usually perIormed on venous blood.
O any laboratories use fourth generation screening tests which detect anti-HIV antibody
(Ig and Ig) and the HIV p24 antigen.
O %he detection oI HIV antibody or antigen in a patient previously known to be negative is
evidence oI HIV inIection.
O Individuals whose Iirst specimen indicates evidence oI HIV inIection will have a repeat
test on a second blood sample to conIirm the results.
Treatment Modalities:
O 'AIDS Drugs are medicines used to treat but not to cure HIV inIection.
O %hese drugs are sometimes reIerred to as 'anteroviral drugs.
O %hese work by inhibiting the reproduction oI the virus. %here are two groups oI
anteroviral drugs:
1. Reverse trancriptase inhibitors they inhibit the enzyme called reverse transcriptase
which is needed to 'copy inIormation Ior the virus to replicate. %hese drugs are:
a. Zedovudine (ZDV) Retirvir
b. Zalcitabine Havid
c. Stavudine Zerit
d. Lamivudine pivir
e. evirapine Viramune
I. Didanosine Videx
2. Protease inhibitors. %hey work by inhibiting the enzyme protease which are needed Ior
the assembly oI viral particles. %hese drugs are:
a. Saquinavir Invarase
b. Ritonavir orvir
c. Indinavir Crixivan





Nursing Management:
1. Health education %he healthcare worker must:
a. Know the patient
b. Avoid Iear tactics
c. Avoid judgmental and moralistic messages
d. Be consistent and concise
e. Use positive statement
I. ive practical advice
2. Practice universal/standard precaution
a. %here is a need Ior a thorough medical handwashing aIter every contact with
patient and aIter removing the gown and gloves, and beIore leaving the room oI
an AIDS suspect or known AIDS patient.
b. Use oI universal barrier or Personal Protective quipment (PP) e.g., cap, mask,
gloves, CD gown, Iace shield/goggles are very necessary.
3. Prevention
a. Care should be taken to avoid accidental pricks Irom sharp instruments
contaminated with potentially inIectious materials Iorm AIDS patient.
b. loves should be worn when handling blood specimens and other body secretions
as well as surIaces, materials and objects exposed to them.
c. Blood and other specimens should be labeled with special warning 'AIDS
Precaution.
d. Blood spills should be cleaned immediately using common household
disinIectants, like 'chlorox.
e. eedles should not be bent aIter use, but should be disposed into a puncture-
resistant container.
I. Personal articles like razor or razor blades, toothbrush should not be shared with
other members oI the Iamily. Razor blades may be disposed in the same manner
as needles are disposed.
g. Patients with active AIDS should be isolated.
The Four s in the Management of HIV/AIDS
1. ompliance giving oI inIormation and counseling the client which results to the
client`s successIul treatment, prevention and recommendation.
2. Counseling/education
a. iving instruction about the treatment
b. Disseminating inIormation about the disease
c. Providing guidance on how to avoid contracting S%D again
d. Sharing Iacts about HIV and AIDS
3. Contact tracing
a. %racing out and providing treatment or partners
4. Condoms
a. Promoting the use oI condom, giving instructions about its use, and giving
away available condoms