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Hiv

1) HIV/AIDS affects millions of people worldwide, with over 5 million cases in Nigeria where prevalence ranges from 1.2% to 12% depending on the state. 2) The three major modes of HIV transmission are sexual intercourse (80%), transfusion of blood/components (10%), and mother-to-child transmission (5-10%). Factors affecting mother-to-child transmission include maternal viral load, stage of maternal disease, stage of pregnancy, mode of delivery, and duration of ruptured membranes. 3) HIV progresses from an initial asymptomatic incubation period of 2-10 years to a symptomatic phase with weight loss, fever, diarrhea, and opportunistic infections like tuberculosis, followed by

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812 views14 pages

Hiv

1) HIV/AIDS affects millions of people worldwide, with over 5 million cases in Nigeria where prevalence ranges from 1.2% to 12% depending on the state. 2) The three major modes of HIV transmission are sexual intercourse (80%), transfusion of blood/components (10%), and mother-to-child transmission (5-10%). Factors affecting mother-to-child transmission include maternal viral load, stage of maternal disease, stage of pregnancy, mode of delivery, and duration of ruptured membranes. 3) HIV progresses from an initial asymptomatic incubation period of 2-10 years to a symptomatic phase with weight loss, fever, diarrhea, and opportunistic infections like tuberculosis, followed by

Uploaded by

api-3705046
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© Attribution Non-Commercial (BY-NC)
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HIV/AIDS IN PREGNANCY

INTRODUCTION
HIV-Human Immunodeficiency Virus
AIDS- Acquired immunodeficiency
Syndrome
CD4 cells
EPIDEMIOLOGY
Affects all age groups
Reproductive age group
Affects both sexes
Female / male 55:45
AIDS– 4th commonest cause of death
worldwide
40 million people living with HIV/AIDS
– About 18 million women & 3 million children
IN NIGERIA
Prevalence is 5.2% (5-6 million people)
No state or community is spared by this
epidemic
Ranges from 1.2% in Osun state to 12% in
Cross River State
13 States & FCT- prevalence over 5%
Rivers State -9%
UPTH antenatal patients - 8-10%
TRANSMISSION

3 MAJOR MODES OF TRANSMISSION


1- SEXUAL INTERCOURSE -(80%)
Homosexual, Heterosexual > in Dev. Countries

2-TRANSFUSSION OF BLOOD & COMPONENTS


(10%)

3-MOTHER TO CHILD TRANSMISSIOM - MTCT


(5-10%)
FACTORS AFFECTING MTCT
Maternal Viral Load
Stage of Maternal Disease
Stage of Pregnancy 1st<2nd<3rd trimester
Mode of Delivery
Duration of Rupture of Membranes
Prematurity
Breastfeeding
PATHOPHYSIOLOGY
INCUBATION PERIOD
Generally, 2-3 months
6 months in some individuals
1 month with current Anti HIV assays
Asymptomatic Period 2-10 years, may be shorter,
depending on;
-Virulence of organism
-Viral load
-Viral resistance
Pathophysiology Contd.
HIV –RNA retroviruses
2 serotypes; HIV 1 & HIV 2
HIV 1 more widespread & more virulent
HIV 2 milder & commoner in West Africa
HIV primarily affects CD4 T-lymphocytes
HIV membrane protein gp 120 + CD4 receptors
Infected cell+reverse transcriptase =Proviral DNA
Viral replication = gradual depletion of CD4 count
Absence of ART= devp. of disease manifestations
EFFECTS OF HIV/AIDS ON
PREGNANCY
More marked in developing countries;
These include;
Spontaneus abortion
Ectopic pregnancy
Maternal infections
Vaginal candidiasis
Preterm labour & low birth weight
IUGR
Stillbirth
Anaemia
EFFECTS OF PREGNANCY ON
HIV/AIDS

Little or no effect on the asymptomatic in


early stages of HIV disease

More rapid progression in late HIV/AIDS


CLINICAL PRESENTATION
Broad spectrum of illness in severity & diversity
Primary infection associated with a brief illness about the time
sero-conversion
Symptoms include;
Fever
Malaise
Headache
Arthralgia
Maculopapular rash
Tender lymphadenopathy
Diarrhoea
Mouth ulcers
Followed by an asymptomatic phase (2-10 YEARS)
Clinical presentation
Symptomatic phase;
Weght loss - 10% of body weight
Fever of 1 month duration
Diarrhoea of 1month duration
Herpes zooster
Lymphadenopathy
Dermatitis
Oral hairy leucoplacia
This phase termed – AIDS RELATED COMPLEX
FULL BLOWN AIDS
Occurrence of opportunistic infections
Tuberculosis
Pneumocystic carini pneumonia
Cerebral toxoplasmosis
Cryptococcal meningitis
AIDS dementia
Diarrhoea & wasting syndrome
Oesophageal candidiasis
Cytomegalovirus retinitis
Malignancies like;
Kaposi’s sarcoma
Non Hodgson’s lymphoma
Mycobactrium avium intra celulare complex infections (mac)
INVESTIGATIONS
GENERAL;
FBC
E/U/Cr
URINALYSIS & URINE M/C/S
CXR
LFT
Pap smear
SPECIFIC;
HIV SEROLOGY TEST (ELISA)
VIRAL LOAD
CD4 COUNT
CD8 COUNT
WESTERN BLOT (CONFIRMATORY)
POLYMERASE CHAIN REACTION especially in children
THANK YOU

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