HIV/

AIDS
AIDS (Acquired Immune Deficiency
Syndrome)

▪ It is a syndrome, a combination of signs and symptoms that form a

distinct clinical picture of disorder.
▪ It can either be hereditary or inborn.
▪ It involves the immune system which when it breaks down an
individual may become susceptible to many infections, which
eventually lead to death.
▪ is the name used to describe a number of potentially life-threatening
infections and illnesses that happen when your immune system has
been severely damaged by the HIV virus.
HIV (Human Immunodeficiency
Virus)

▪ It is a retrovirus belonging to the family of lentiviruses,

which sometimes called “slow viruses”.
▪ It is the main virus that causes AIDS.
▪ is a virus spread through certain body fluids that attacks the
body's immune system, specifically the CD4 cells, often
called T cells
Statistic
UNAIDS (2017) Worldwide
▪ There were approximately 36.9 million people worldwide living with HIV/AIDS in 2017.
▪ Of these, 1.8 million were children (<15 years old).
▪ An estimated 1.8 million individuals worldwide became newly infected with HIV in 2017 – about 5,000 new
infections per day. This includes 180,000 children (<15 years). Most of these children live in sub-Saharan Africa
and were infected by their HIV-positive mothers during pregnancy, childbirth or breastfeeding.
▪ Approximately 75% of people living with HIV globally were aware of their HIV status in 2017. The remaining
25% (over 9 million people) still need access to HIV testing services. HIV testing is an essential gateway to HIV
prevention, treatment, care and support services.
▪ In 2017, 21.7 million people living with HIV (59%) were accessing antiretroviral therapy (ART) globally, an
increase of 2.3 million since 2016 and up from 8 million in 2010. HIV treatment access is key to the global effort
to end AIDS as a public health threat. People living with HIV who are aware of their status, take ART daily as
prescribed, and get and keep an undetectable viral load can live long, healthy lives. There is also a major
prevention benefit. People living with HIV who adhere to HIV treatment and get and keep an undetectable viral
load have effectively no risk of sexually transmitting HIV to their HIV-negative partners.
Statistic
▪ AIDS-related deaths have been reduced by more than 51% since the peak in 2004. In
2017, 940 000 people died from AIDS-related illnesses worldwide, compared to 1.4
million in 2010 and 1.9 million in 2004.
▪ The vast majority of people living with HIV are in low- and middle-income countries.
▪ In 2017, there were 19.6 million people living with HIV (53%) in eastern and
southern Africa, 6.1 million (16%) in western and central Africa, 5.2 million (14%) in
Asia and the Pacific, and 2.2 million (6%) in Western and Central Europe and North
America.
Statistic
DOH (2019)National
▪ The Philippines is a low-HIV-prevalence country, with less than 0.1 percent of the adult population estimated
to be HIV-positive, but the rate of increase in infections is one of the highest. As of June 2018, the Department
of Health(DOH) AIDS Registry in the Philippines reported 56,275 cumulative cases since 1984. In April 2015,
560 new cases were reported showing a 42% increase compared to the same period in the previous year. In the
year 2014, a total of 6,011 cases of HIV were reported with 91% of the cases being asymptomatic at the time of
reporting while 543 cases were diagnosed as AIDS. From 2001 to 2015 the number of cases diagnosed per year
increased 37 times, from 174 cases diagnosed in 2001 to 6,552 for the first 10 months on 2015.
▪ In the years 2010 to 2015, 91% (22,726) of cases were men with a median age of 28 years, with over half
(12,616) in the 25-34 age group. 26% (6,529) of men were 20–24 years of age, an increase from 12% in 2005-
2009. Since the year 2000, the high-prevalence age group has changed from the 30-39 year old age group
being the most affected from years 2000-2004, to the 25-34 age group from years 2005 to 2009, and to 20-29
age group from years 2010-2015.
▪ The infection rate among men having sex with men has multiplied 10 times from 2010 to 2015. The
Department of Health reported in November 2015, that the rate of prevalence has surpassed 5%, the UN's
definition of concentrated epidemic, in eight cities Cebu, Cagayan de Oro, Puerto Princesa, Davao, Quezon
City, Parañaque and Makati, with Cebu reaching 14%.
Statistic
▪ Between 1984 and 1990, 62% (133 of 216) of cases were female. From 2010 to 2015, females only comprised 5%
(1017) of the 20,512 reported cases.
▪ From January 2010 to April 2015, 82% (20,512) of all cases were reported. At the time of reporting, 93% of these
cases were still asymptomatic.
▪ As of June 2018, 28,045 people living with HIV were undergoing Anti-Retroviral Therapy in 23 treatment hubs.
The majority (97%) were males.
▪ Overseas Filipino workers account for about 20 percent of all cases.
 Municipality AIDS Asymptomatic Total
Bamban 2 5 7
INTERNATIONAL REVIEW OF
Camiling 1 18 19
HUMANITIES AND SCIENTIFIC
Capas 1 23 24
RESEARCH (2017)
Concepcion 2 19 21
Local Tarlac City
Gerona 1 12 13
La paz 1 6 7
Mayantoc 0 3 3
As shown in Table 2, Tarlac City (88)
Moncada 1 7 8
registered the highest cases out of 17
Paniqui 2 11 13
Pura 1 1 2
municipalities out of 223 total cases. This
Ramos 0 2 2
is the capital of Tarlac province. Capas is
San Clemente 0 1 1
next in rank with 24 cases followed by
San Jose 0 1 1 Concepcion with 21 cases. San Clemente,
San Manuel 0 3 3 San Jose and Sta. Ignacia had the lowest
Sta. Ignacia 0 1 1 cases with only one case each. According
Tarlac City 10 78 88 to the PHO, there were 44 total cases from
Victoria 0 10 10 OFW as of July 2016.
TOTAL 22 201 223
 Table 3 on the other hand, shows the new cases
of HIV/AIDS from January to June 2016.

Table 3. HIV/AIDS Cases from January 2016 to

July 2016
Municipality AIDS Asymptomatic Total
Bamban 0 1 1 The 35 new cases comprised the highest increase
Camiling 0 1 1 in a span of only six months. Data also revealed
Capas 0 2 2 that most patients with HIV/AIDS were
Concepcion 1 4 5 asymptomatic (32 out of 35 cases).
Gerona 0 6 5 Asymptomatic HIV infection is a phase of
La paz 1 0 1 HIV/AIDS during which there are no symptoms
Paniqui 0 1 1 of HIV infection. During this phase, the immune
Tarlac City 1 16 17 system in someone with HIV slowly deteriorates,
Victoria 0 1 1 but the person has no symptoms. How long this
TOTAL 3 32 35 phase lasts depends on how quickly the HIV
virus copies itself, and how the person's genes
affect the way the body handles the virus
(Medline Plus, 2015). Tarlac City had the most
number of infection followed by Gerona and
Concepcion. Most cases were men who had sex
with men.
CAUsative agent

▪ Human immunodeficiency virus (HIV) is the causative

agent for AIDS. The most common type is known as HIV-1
and is the infectious agent that has led to the worldwide
AIDS epidemic
Incubation period and period of
communicability

▪ 10 years for young adults

▪ From shortly after the onset of the HIV infection extending
throughout life.
▪ Infectivity during the first months is considered to be high;
it increases with viral load, with worsening clinical status
and with the presence of other STIs
Mode of transmission

▪ Sexual Contact
▪ Injection of infected blood or blood products, bodily fluid
▪ Perinatal or vertical transmission
pathophysiology
Exposure to infected person

Infection with HIV retrovirus

HIV invades nucleus of helper T Lymphocytes

(CD4 Surface Antigen)

HIV Replicates

Destruction of T Lymphocytes

Helper T Lymphocytes HIC released from cells

Immunosuppresion

Malaise, Fatigue, Fever, weight loss and Opportunistic infection, Oral-esophageal thrush
Neuropsychiatric Effects Herpes Simplex, TB, CMV and pneumocystitis
Signs and symptoms
Neurological Symptoms
▪ Memory loss
▪ Altered Gait
▪ Depression
▪ Sleep Disorders

Gastrointestinal Symptoms
▪ Chronic Diarrhea

Minor signs
▪ Persistent cough for 1 month
Common opportunistic infections
1. Bacterial
▪ MAC – Mycobacterium avium complex, a TB – like manifestation that usually occurs when the patient’s CD count
is below 50
▪ Tuberculosis
▪ Salmonillosis

2. Viral
▪ Herpes
▪ Hepatitis
▪ Genital Warts
▪ CMV (Cryptomegalovirus) can cause retinitis, pain on swallowing and numbness of the legs. This can be
transmitted through semen, vaginal secretions, blood and breast milk.
▪ Molluscum contagiosum – a disease of the skin and mucous membranes characterized by dome – shape papules
Common opportunistic infections
4. Pneumonias
▪ Bacterial
▪ Pneucystis carinii pneumonia (PCP) – an atypical type of pneumonia

5. Cancers
▪ Kaposi’s Sarcoma – cancerous lesions caused by overgrowth of blood vessels. Appears to be painless pink or
purple spots or nodules on the surface of the skin or oral cavity. It can also occur internally, especially on the
intestine, lymph nodes and lungs.
▪ Cervical dysplasia and cancer – researchers found out that women with HIV have higher rates of this type of
cancer. Cervical carcinoma is associated with human papilloma virus (HPV)
▪ Non – hodgkins lymphoma – cancerous tumor of the lymph nodes. This is usually a late manifestation of HIV
infection.

6. Parasitic
Common opportunistic infections
Signs and symptoms
▪ Watery diarrhea
▪ Abdominal cramps
▪ Low – grade fever
▪ Weight loss

Preventive measure against crypto

1. Wash hands thoroughly after contact with feces

2. Practice safe sex

3. Be careful not to swallow water when swimming

4. Wash and/or cook food properly

Modified Classification (Stages) of HIV
infection
Clinical Stage 1: Asymptomatic
- Asymptomatic/ acute HIV infection characterized by general lymphadenopathy.

Clinical Stage 2: Early (MILD)

- Weight loss greater than 10% of body weight

- Minor mucocutaneous manifestation, like;

a) Seborrheic Dermatitis - redness, scaly patches, and dandruff particularly in the head

b) Fungal Nail Infection

c) Recurrent Oral Ulceration

d) Angular Cheilitis – (Inflammation of the lips) inflammation of one or both corners of the mouth
Modified Classification (Stages) of HIV
infection
Clinical Stage 3: Intermediate (Moderate)
▪ Weight loss greater than 10%
▪ Chronic unexplained diarrhea for more than one month
▪ Oral candidiasis (Thrush) - yeast/fungi infection of the genus Candida that develops on the
mucous membranes of the mouth
▪ Oral Hairy Leukoplakia (white patch that forms in the mouth)
▪ Severe bacterial infection, like pneumonia

Clinical Stage 4: Late (Severe) AIDS

▪ HIV Wasting Syndrome
Diagnostic Examination
ELISA Test – Enzyme – linked immunosorbent assay
Particle Agglutination (PA) Test
Western Blot Analysis
Immunofluorescent Test
Antigen/antibody tests
Antibody tests
CD4 count or T cell count test
Treatment
Pharmacotherapy

AIDS Drugs
• Anti – retroviral drugs or Anteroviral drugs – inhibiting the reproduction of the virus

2 groups of anteroviral drugs:

1. Reverse Transcriptase Inhibitors – they inhibit the enzyme called reverse transcriptase, which is
needed to “copy” information for the virus to replicate these drugs are
▪ Zedovudine (ZDV) – Retirvir
▪ Zalcitabine – Havid
▪ Stavudine – Zerit
▪ Lamivudine – Epivir
Nursing Management
1. Practice universal/standard precaution
▪ Thorough medical hand washing after every contact with each patient and after removing the gown and gloves,
and before leaving the room of an AIDS patient.
▪ Use of PPE’s (Cap, mask, gloves, CD gown, face shield/goggles is very necessary)

2. Prevention
▪ Patient with active aids should be isolated
▪ Safety measures to avoid accidental pricks from sharp instruments contaminated by an AIDS patient
▪ Blood and other specimens should be labeled with a special warning such as “AIDS precaution”
▪ Blood spills should be cleaned immediately using common household disinfectants such as “chlorox”
▪ Personal articles should not be shared with family like razor blade, and toothbrushes
▪ Proper disposal of excreta of patient with AIDS