Thursday, August 31, 2017

Medicollabowesome: HIV epidemiology

I have written those points that are important to know in PSM.

AIDS also known as "Acquired immunodeficiency syndrome" - It is the end stage of HIV infection.

1.Highest Burden :-
Sub Saharan Africa
Fatality rate is high in such parts.

2. Prevelance :-
- Global prevelance =0.8 ( 0.7-0.8)
- India = 0.3-0.4
*Prevelance is high in Africa = 4.5
3. Status of HIV epidemic
I) Concentrated epidemic I
II) Concentrated epidemic II
III) Low level epidemic
IV) No data available

4. Patterns of HIV epidemic at national level :-
There are 2 criteria to decide
- Prevelance in antenatal women
- Prevelance in high risk groups
I) High prevelant states = Prevelance in antenatal women 1% or more
II) Moderate prevelant states = Prevelance in antenatal women <1%
Other high risk group 5% or more
III) Low prevelant states =Prevelance is <1% antenatal women and <5% high risk groups.

5. High risk groups:
- Commercial sex workers (CSW)
- Transgender
- Men having sex with men
- Drug abusers
- Truck drivers
- Health workers
- Surgeons
- Hemophiliacs

6. Agents :- HIV ( Human immunodeficiency virus)
- Retrovirus
- Two types of HIV 1&2
-HIV-1 Sub saharan africa
-HIV-2 India

7. Reservoir :-
- These are the cases and carriers.
- Once infected ,person carries the virus lifelong.
- Main problem is due to this " HIV infection take years to manifest itself, the symptomless carrier can infect other for years."

8. Source of infection :-
- Greatest concentration in blood, semen, CSF.
- Low concentration in tears, saliva,breast milk,vaginal and cervical secretions,urine.

9.Modes of transmission
- Sexual route ( In India mostly heterosexual)
- Infected needles
- Blood and blood products
- Maternal to fetal transmission (Placental,breast feeding,during parturition)
STI other than HIV is more important cause of increase in transmission.
- Anal intercourse is higher risk.

10. Incubation period:-
- Uncertain
- Few months - 10 years

11. Window period :-
-2-12 weeks to form antibodies.
-That is why we repeat the test procedure every 3 month.

12. TB cases should be checked for HIV.

13. Absolute CD4 count = most widely used predictor of HIV progression .

14. Debate is on Breast feeding by HIV mothers .
- In developed countries, it is contraindicated.
- In other settings the disadvantages of not breast feeding is weighed against the risk of transmitting virus to an infant.

15. CCC( community care center) have ART centre.( Where ARV is given free)

16. ELISA is for Diagnosis. Western blot is confirmatory test.

That's all .
-Upasana Y. :)

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