Needle stick azt pep1 in 10000 transmission from

Info icon This preview shows pages 23–47. Sign up to view the full content.

View Full Document Right Arrow Icon
Needle stick /AZT PEP…………………1 in 10,000 Transmission from mother to infant a. Without AZT treatment………...…….1 in 4 b. With AZT treatment………………….Less than 1 in 10 Royce, Sena, Cates and Cohen, NEJM 336:1072-1078, 1997
Image of page 23

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
2.6% 9.4% 2.0% 6.0% 2.1% 4.0% 3.6% 4.1% 2.3% 11.0% 12.2% 7.9% 5.8% 13.8% 4.1% 14.4% 31.2% 25.0% 28.9% 26.3% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55% Age 15 Males Females 95% Confidence Interval Age 16 Age 17 Age 18 Age 19 Age 20 Age 21 Age 22 Age 23 Age 24 HIV Prevalence by Age and Gender among South African youth age 15-24 years Pettifor A, et al. AIDS 2005, 19: 1525-1534.
Image of page 24
Coital Frequency per Month by Age 10.02 8.98 9.11 7.44 15-24 25-29 30-34 35-59 Age 4 5 6 7 8 9 10 11 Coital frequency per Month
Image of page 25

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Determinants of HIV Sexual Transmission Infectiousness Level of Blood Viral Load Genital Viral Load Stage of Infection Lack of circumcision Genital ulcerations Inflammatory STDs Cervical ectopy Viral Subtype X4/R5 Phenotype Hormonal contraception Acquisition Viral Load in Index Case Genital ulcers Inflammatory STDs Cervical ectopy HLA Haplotype Chemokines/Cytokines Hormonal contraception
Image of page 26
Estimated HIV transmission probability Estimated HIV transmission probability Chakraborty Chakraborty et al et al ., AIDS 2001 ., AIDS 2001 0.004 0.008 0.008 0.012 0.016 0.016 3 3.5 3.5 4 4.5 4.5 5 5.5 5.5 Log Log 10 10 Seminal HIV RNA in one ejaculate Seminal HIV RNA in one ejaculate Probability of transmission Probability of transmission 25% 25% 50% 50% 75% 75% Cervical Cervical CCR5 CCR5 Receptor Receptor Density Density
Image of page 27

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
HIV RNA in Semen HIV RNA in Semen (Log (Log 10 10 copies/ml) copies/ml) Acute Infection Acute Infection 3 wks 3 wks Asymptomatic Asymptomatic Infection Infection HIV Progression HIV Progression AIDS AIDS 2 2 3 3 4 4 5 5 1/1000 - 1/1000 - 1/10,000 1/10,000 1/500 - 1/500 - 1/2000 1/2000 1/100- 1/1000 1/1000 Risk of Transmission Risk of Transmission Reflects Reflects Genital Genital Viral Burden Viral Burden 1/30- 1/30- 1/70 1/70 Sexual Transmission of HIV
Image of page 28
Image of page 29

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
HIV RNA in Semen HIV RNA in Semen (Log (Log 10 10 copies/ml) copies/ml) Acute HIV Infection Acute HIV Infection & STD Coinfection & STD Coinfection STD Episode STD Episode STD Episode STD Episode AIDS AIDS 2 2 3 3 4 4 5 5 Acute HIV/STD co-infection: Lethal Synergy? 1/30 or greater odds of transmission 1/30 or greater odds of transmission to a susceptible partner per coital act to a susceptible partner per coital act
Image of page 30
Image of page 31

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
How do STDs increase HIV-1 transmission? Reducing physical/mechanical barriers Increasing HIV in genital lesions, semen or both Evoking a more infectious HIV variant Increasing the number of receptor cells or the density of receptors per cell
Image of page 32
Differential Diagnosis of Genital Ulcer Disease
Image of page 33

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
"The Tip of the Iceberg" 90.8% Unrecognized and asymptomatic infection 9.2% Recognized infection Iceberg represents all those with HSV-2 antibody
Image of page 34
Where to Study HIV/STD Interactions?
Image of page 35

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 36
Malawi Overview Population 10 million 90% rural Per Capita income $190 AIDS impact 900,000 people living with HIV 15% adult HIV prevalence STD Clinic: 47% prevalence
Image of page 37

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 38
Image of page 39

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 40
Image of page 41

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 42
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern