2011 HIV Om in Burmese
2011 HIV Om in Burmese
2011 HIV Om in Burmese
March 14-16,2011.
Mae Tao Clinic.
HIV/AIDS
HIV
AIDS AIDS
HIV
ART ART
Services
VCT
PMCT
PEP
HIV/AIDS
HIV/AIDS
WORLD VIEW
33 million persons infected in 2007
AIDS HAS CLAIMED
JUST UNDER 25
MILLION LIVES
SINCE IT WAS
SINCE HIV/AIDS WAS
Eastern Europe DISCOVERED 20
Western Europe & Central Asia
DISC0VERED 60 YEARS AGO.
520,000 – 680,000 1.2 – 1.8 Million
North America
MILLION PEOPLE 790,000 – 1.2 million East Asia & Pacific
(THE POPULATION OF North Africa & 700,000 - 1.3 million
UK) HAVE BEEN Caribbean Middle East
South
INFECTED 350,000 – 590,000 470,000 – 730,000
& South–East Asia
4.6 – 8.2 million
Latin America
1.3 – 1.9 million Sub-Saharan
Africa Australia
25.0 – 28.2 million & New Zealand
12,000 – 18,000
I Immuno-deficiency :
Immune :
Deficiency :
V Virus: (HIV
HIV AND HUMAN BODY
HIV
HIVReceptors
Receptors
HIV and Cellular Receptors
CD4 HIV
HIV
HIV HIV CD4
HIV
CD4
CD4
AIDS
HIV and the CD4 Count
HIV CD4
CD4
Amount in Body
HIV
CD4
HIV AIDS
?
CD4
! AIDS
HIV
HIV AIDS
?
• Developed World:
ART
HIV
• Developing World:
AIDS ?
A Acquired:
I Immune:
D Deficiency:
S Syndrome: AIDS
Opportunistic Infections(OIs)
?
HIV CD4
opportunistic
infections
HIV opportunistic infections
AIDS
opportunistic infections (OIs)
• CMV:
• Cancer and other many other infections and disorders
Clinical Staging of HIV/AIDS
• Stage I; Asymptomatic
H
! HIV
HIV
HIV
HIV
HIV
HIV
HIV
HIV
HIV
HIV HIV
HIV
?
HIV
HIV
!
Some Statistics
HIV
-UK
HIV
?
?
HIV
HIV
HIV (ART)
HIV
Programme
UK HIV
Whom of them are high risk
people?
• Sex worker
• Sexually promiscuous man
• House wife
• Highway driver
• Old lady
• Sex worker
• House wife
• Highway driver
• Old lady
Brain Storm
• A friend of you though that HIV infected
people are bad people and he would avoid
them.
• Are you agree with him?
• What will you tell him?
Anti Retroviral (ARV’s) Drugs
?
CD4 Cells HIV
HIV
HIV
HIV
NRTI NNRTI PI
AZT NVP Lopinavir
3TC FEV Ritonavir
D4T Saquinavir
ABC
The Science Bit!
enzymes HIV
NRTI & NNRTI Reverse Transcriptase enzyme
PI Protease enzyme
HIV
combination therapy regime
*2NRTIs+1NNRTI
*2NRTIs+PI
ARV’s ?
OIs
HIV expert
• combination therapy HIV expert
ARV’s (ART)
Side effects
( ?
YES!
• HIV
– Doublecheck
• If positive, test is positive
• If negative, test is negative
ELISA
Laboratory Tests for HIV
• EIA – Enzyme Immunosorbent Assay
– Same as ELISA = Enzyme-Linked Immuno-Sorbent
Assay
• WB – Western Blot (confirmatory test)
• CD4 Count
• B
B C HIV (Ag &Ab)
HIV
Post-Exposure Prophylaxis (PEP)
• Occupational Exposure
– Needle stick and Percutaneous
• Non-Occupational Exposure
– Sexual Assault Survivors
– Children
– Prisoners
– Pregnant Women
Case Study for VCCT
• Case. 1
• 35 yr man, single, has high risk behavior
• Now very worried for his status
• His close friend died of AIDS recently
• Concerned with discrimination from friends
and family member
• Has girl friend and has sex without
condom
Points for Case. 1
• Explain implication of HIV test.
• Explain how we will keep confidentiality
not to be discriminated.
• Discuss about safe sex & disclosure
depend on test result.
Case. 2
• 35yr old man, married
• Now ill with s/s of AIDS.
• Already tested at private clinic arranged by
family without pretest counseling. Result is
positive. Family didn’t disclose him as pt is
very angry when family suggest to test
HIV.
• Now family brought him to meet you
Points for case.2
• First try to understand pt’s feeling and how
he understand his condition.
• Try to build rapport with pt, and help to find
the best way for him.
Case.3
• 28 yr lady come with STI complaints.
• Her husband has mobile job and has to
travel frequently.
• She trust her husband for extramarital sex.
She herself had never had extramarital
sex. So they never used condom.
Points to discuss
• First, to confirm is it pure STI
• If it is pure STI, & it is sure that she had
never had extramarital sex, Explain nature
of men.
• Be careful not to blame on husband and
assess her respond while discussing on
extramarital sex.
• Suggest to bring husband, offer VCT.
Case.4
• Pregnant woman 36 yr old, G1P0, at 36
wks, come to clinic for AN care.
• Husband traveled to border to find a job.
• Lives with in-laws and depend on them.
• Now she is in front of you for PMCT.
Caes.5
• Pregnant woman,28yr,G2P3,30 wks
comes to clinic with complaint of prolong
fever, chronic cough, sore mouth d/t
thrush. How you proceed?
Case.6
• In post test counseling of 23yr lady, the
result is HIV (-).Is it necessary to test
again? When? How many times?