16. HIV DrD.pptx - HIV AIDS IN CHILDREN For Health Officer Students Degalem T(MD;March 2019 1 Outlines Definition Etiology and Pathogenesis Clinical

16. HIV DrD.pptx - HIV AIDS IN CHILDREN For Health Officer...

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HIV / AIDS IN CHILDREN For Health Officer Students; Degalem T (MD);March 2019 1
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Definition Etiology and Pathogenesis Clinical manifestation and WHO staging Managements References 2 Outlines
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HIV / AIDS is a chronic infectious disease which is not curable One of the devastating disease difficult to control Killed millions of lives in the world In Ethiopia the first report was by 1984 There are millions of people living with HIV / AIDS currently 3 Introduction
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Current prevalence based on the 2017 data projection is about 1.16% in Ethiopia Based on the EDHS 2011; about 4.2% is in the urban as compared with 0.6% in rurar area 21,686 children under 15 on ART -2016 High disease burden for the country 4 Cont…
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“Acquired Immunodeficiency syndrome” Multi system disease affecting any age ;sex and race Progressive and fatal disease which is not curable Disease of a human beings only! 5 Definition
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‘Human immunodeficiency virus’-HIV Ideally is non live unlike other viruses but is genetic material coated with protein ( RNA ) so that to replicate it needs human body Various serotypes HIV-1 and HIV-2 types 6 Etiopathogenesis
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HIV 1 Commonest type Single stranded RNA Has different diversities/groups highly variable mutates very readily many different strains 8
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M (main) O (Outlier) N (Non-M, Non-O) Group O : west-central Africa Group N : extremely rare. > 90% of HIV-1( HIV-1 group M) Within group M (at least nine genetically distinct subtypes /clades A, B, C, D, F, G, H, J and K. A & D are common in east and central Africa C is more common in Ethiopia 9
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Subtype C: Responsible for >50% of infection in Africa Faster progression of disease Higher rate of MTCT Higher transcription rates More virulent than other subtypes HIV 2 Less pathogenic Little contribution to pediatric AIDS Has longer time of progression western & south Africa Dx is more difficult 10
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RNA ssDNA (single strand DNA) dsDNA (double strand DNA) RNA protein synthesis The 3 enzymes inside a retrovirion are: Reverse transcriptase Integrase , and Protease . 11
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HIV 13
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HIV genome has 3 sections 1-GAG region ; encodes the vital core proteins (P24, P17,P9) 2-POL region ; encodes vital enzymes (Reverse Transcriptase, Protease & Integrase) 3-ENV region ; encodes vital envelope proteins (gp120 ,gp41 ) 14
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Transmission in Children Modes of transmission to children: Mother to child (MTCT)-95% -vertical Sexual (abuse?) Blood or blood products Unsterile injections 15
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Vertical /MTC Transmission Intrauterine Peripartum (commonest mode) Postnatal/breast feeding With out intervention rate of transmission is 30- 40% 16
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Risk factors for MTCT: Maternal/Obstetric factors High viral load Low CD4 Micronutrient deficiencies (e.g. Vit A) ROM (>4hrs) Chorioamnionitis, STIs Cracked nipples, breast abscess Subtype C HIV 1 17
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Pathogenesis Gp41 : very immunogenic & used to detect HIV-1
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