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HIV/AIDS: An Overview

HIV/AIDS: An Overview. Andrea A. Howard, MD, MS Montefiore Medical Center. Overview. 3 rd decade of the epidemic 60 million have been infected 20 million have died Half of newly infected under age 25 HIV is preventable. The Basics. What is HIV?. Human Immunodeficiency Virus

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HIV/AIDS: An Overview

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  1. HIV/AIDS:An Overview Andrea A. Howard, MD, MS Montefiore Medical Center

  2. Overview • 3rd decade of the epidemic • 60 million have been infected • 20 million have died • Half of newly infected under age 25 • HIV is preventable

  3. The Basics

  4. What is HIV? • Human Immunodeficiency Virus • Causes AIDS • Harms the immune system • Attacks helper T cells (CD4+ cells)

  5. What is AIDS? • Acquired Immunodeficiency Syndrome • Most advanced stage of HIV disease • Immune system very weakened by HIV • Opportunistic Infections—take advantage of weakened immune system • Cd4+ count falls to <200 cells/mm3

  6. How does someone get HIV? • Unprotected sexual contact • Sharing a needle to inject drugs • Pregnancy, delivery, and breast milk • Blood products (unlikely) • NOT by hugging, shaking hands, coughing, toilets, water fountains…

  7. ANYONEcan look healthyand still be infected

  8. Signs and Symptoms • Acute Retroviral Syndrome • Clinical latency • Constitutional symptoms • AIDS

  9. Acute Retroviral Syndrome

  10. Aphthous Ulcer

  11. Rash Kahn and Walker, N Engl J Med 1998; 339:36.

  12. Clinical Latency • No signs and symptoms • Viral replication • T helper cell destruction • 8-10 years without meds • Reservoirs of latently infected cells

  13. Constitutional Symptoms • Swollen glands (neck, underarm, groin) • Fevers, night sweats • Rapid weight loss • Fatigue • Diarrhea, poor appetite • White spots in mouth

  14. Thrush

  15. AIDS • Infections • Neoplasms • Neurologic manifestations • Wasting • CD4+ count <200 cells/mm3

  16. Pneumocystis pneumonia http://aidshistory.nih.gov/first_encounters/rayx.html

  17. Herpes Simplex Virus

  18. Varicella zoster virus

  19. Toxoplasma gondii

  20. Kaposi’s Sarcoma

  21. What are ways to reduce the risk of getting HIV? • Choose not to have sex • Agree to be faithful with HIV- partner • Use latex condoms, dental dams • Get prenatal care • Do not share needles or syringes • Get Tested! Ask partners to do the same.

  22. HIV & other Sexually Transmitted Diseases (STDs) • Increases risk of contracting HIV • Increases risk of transmitting HIV

  23. HIV Testing • HOW? • HIV test is quick, free, confidential • WHY? • Know your status • Keep yourself and others safe • Get treated

  24. WHAT does an HIV test tell you? • Positive test • Person is infected with HIV • Person can infect others • Does not mean person has AIDS • Negative test • Probably not infected • Does not mean person can’t get infected

  25. HIV Testing: WHERE? • 718-881-TEST • BRONX • Montefiore 718-882-0023 • BROOKLYN • Project HEAT 718-467-4446 • MANHATTAN • GMHC 800-AIDS-NYC • Mt Sinai 212-423-2971 • NY Presbyterian 212-342-3201

  26. How is HIV treated? • No cure • No vaccine • Highly Active Antiretroviral Therapy (HAART) • keep infected persons healthy longer • Dietary requirements • Side effects • Importance of adherence

  27. Statistics

  28. HIV/AIDS in the US • >500,000 Americans have died • 1 million are living with HIV • One-quarter do not know they are HIV+ • 40,000 new infections each year • # deaths down since the mid 1990’s, but has remained steady in recent years

  29. HIV/AIDS in the Young • Half of new infections in those under 25 • Most infected through sex • People of color represent the majority of: • New HIV infections • New AIDS cases • People living with AIDS • Survival after AIDS is lower among African Americans

  30. HIV/AIDS in Women • 8% of AIDS in 1985, to 27% in 2003 • New AIDS cases among women in 2003 • 67% African American • 16% Latina

  31. Global HIV/AIDS Epidemic • 40 million people living with HIV/AIDS • 20 million have died • Sub-Saharan Africa • 2/3 of people with HIV/AIDS • 3/4 of deaths • Next wave • Russia (860,000) • India (5.1 million) • China

  32. For more information • ahoward@montefiore.org • 1-800-342-AIDS (CDC AIDS Hotline) • 1-800-458-5231 (National AIDS Information Clearinghouse) • www.AdolescentAIDS.org • www.GettinBusy.org

  33. Eastern Europe & Central Asia 1.4 million [920 000 – 2.1 million] Western & Central Europe 610 000 [480 000 – 760 000] North America 1.0 million [540 000 – 1.6 million] East Asia 1.1 million [560 000 – 1.8 million] North Africa & Middle East 540 000 [230 000 – 1.5 million] Caribbean 440 000 [270 000 – 780 000] South & South-East Asia 7.1 million [4.4 – 10.6 million] Sub-Saharan Africa 25.4 million [23.4 – 28.4 million] Latin America 1.7 million [1.3 – 2.2 million] Oceania 35 000 [25 000 – 48 000] People living with HIV, end 2004 Prevalence (range) • 39.4 M living with HIV/AIDS; 50% women • 4.9 M new HIV infections in 2004 • 3.1 M deaths due to HIV/AIDS in 2004 Source: UNAIDS

  34. Distribution of 50,886 PersonsLiving with AIDS in NYC (2004) Staten Island 2% Queens 15% Manhattan 34% Brooklyn 27% Bronx 22%

  35. Structure of HIV Particle capsid matrix Adapted from http://osms.otago.ac.nz/main/bursary/hiv.html

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