HIV AND AIDS

Basic Facts
! The Immune System

T Cells (CD4 Cells) = Part of body’s immune system

CD4
The average person has between 800 & 1500
CD4 cells per cubic millimetre of blood

The immune system helps fight diseases

CD4 Disease Disease

IMMUNE ATTACKS DISEASE KILLS DISEASE

SYSTEM
 What does HIV stands for?
H Human

I Immuno-deficiency: because the virus causes a

deficiency which means that the body’s immune
system is unable to work properly

V Virus: because the HIV is a virus it is unable to

reproduce by itself. It has to take over the other cells
in the body and use them to help it reproduce.
 ? How can you get HIV?

1. Through these bodily fluids

VAGINAL BREAST
SECRETION MILK
BLOOD S
CERVICAL
SECRETION
SEMEN
S

2. Through these acts:

H

INFECTED MOTHER: UNPROTECTED PENETRATIVE 1. INJECTION OR TRANSFUSION OR

DURING INTERCOURSE (HOMOSEXUAL INFECTED BLOOD / BLOOD PRODUCTS
1. PREGNANCY OR HETEROSEXUAL) WITH 2. SHARING UNSTERALISED NEEDLES
2. BIRTH SOMEONE WHO IS INFECTED WITH SOMEONE WHO IS INFECTED
3. BREAST FEEDING
 ! HIV Myths of transmission:

1. You cannot catch HIV from kissing.

2. You cannot catch HIV from sitting on a toilet
seat
3. You cannot catch HIV from coughing or
sneezing
4. You cannot catch HIV from sharing cutlery
5. You cannot catch HIV from drinking out of the
same glass
6. You cannot catch HIV from holding hands
7. You cannot catch HIV from hugging
 Are some people more susceptible HIV?
Females are 3 times more easily infected compared to males as the vagina is
more susceptible to lesions allowing the virus to pass into the body, and semen
can remain in the body for up to three days.
People with other STIs are up to 10 times more at risk as many of the STI will
result in cuts and open sores giving the HIV more chance to enter the body.

! Some Statistics
●Worldwide 75% of HIV is transmitted sexually. ¾ of infections are through
heterosexual sex and ¼ are homosexual sex.
●In the UK in 2002 54% of infections were through heterosexual sex, 32%
through homosexual and 2% through drug use.
●300,000 young people (15-24) get infected with an STI every day.
●In the UK there has been a sharp rise in STIs in young people these include
gonorrhoea, herpes, thrush and Chlamydia. Chlamydia has risen 108% from
1996 to 2001.
? How can HIV be prevented?
• Unprotected Penetrative Intercourse:
A latex condom used correctly every time you have sex, is highly effective in
providing protection against HIV. Female condoms also prevent
transmission. The only way to be 100% safe is to abstain from sexual
intercourse.
• Mother to child transmission:
Pregnant women can take a short course of anti-HIV drug just before the
birth which she must keep using after. Caesarean section for delivery, and
avoiding breast feeding also reduce the risk. All three can reduce the
chance of transmission to 2%.
• Sharing non sterilised needles:
By not sharing needles when injecting drugs a person will reduce the
chance of infection. Many places have needle exchange programmes
where old needles can be swapped for new ones.
• 4. Contaminated blood and blood products:
In the UK all blood and tissue donations are tested for HIV and have been
since1985.
 HIV and the Immune System
When HIV enters the body it must enter a cell to live and reproduce.
The HIV virus attacks CD4 cells, eventually killing them

CD4 HI
H
V
I HI CD4
HIV
V V HI
V

HIV Enters CD4 Cells HIV Replicates Kills CD4

Cells

The newly produced HIV then moves into new CD4 cells and infects
them. The body’s immune system tries to replace the lost CD4 cells,
but over time it is unable to keep these levels up.
 HIV and the CD4 Count
As the amount of HIV in the body increases the amount of
CD4 cells in the body decreases
CD4
Amount in Body

HIV

When the CD4 count becomes low the body is less able to
fight off any disease.
 What is AIDS?
A Acquired: because it is a condition that the
person must acquire or get infected with. It is not
transmitted through genes.
I Immune: because it effects the immune system
D Deficiency: because it makes the immune
system deficient, it stops it working
S Syndrome: because someone with AIDS may
experience a wide range of symptoms

Many doctors no longer use the term AIDS

Instead they will refer to late-stage or advanced HIV infection. This is because
a persons CD4 count can vary around the 200 level, sometimes it may be
higher or lower
 When does HIV become AIDS?

1500 to 800 CD4 - Average healthy person

CD4 Below 500 CD4 - HIV+ person at risk from

COUNT Opportunistic Infections

200 CD4 Person is considered to have AIDS

In many developing countries they are unable to conduct the

! difficult CD4 count tests. In these countries AIDS is
diagnosed by looking at the symptoms that the person has.
 What are Opportunistic
Infections?
As the CD4 count of the HIV infected person drops their immune
system becomes less effective. They are more vulnerable to other
infections which would be effectively kept under control with a healthy
immune system. These infections are known as opportunistic
infections, as they take the opportunity to take advantage of the weak
immune system. It is gradually these infections rather than the HIV
that will kill the infected person.

Some of the most common opportunistic infections are:

– PCP: a rare type of pneumonia.
– CMV: a type of herpes that can cause blindness, brain and lung
problems.
– Cancers: as the immune system is unable to keep the growth of cells
under control.
– TB
 How long does it take for
HIV to turn into AIDS?
There is not just one straight forward answer. A lot depends on
what part of the world the HIV+ person is from.

• Developed World: On average a person can live for up to 10 years

before they get ill. Without treatment the time between AIDS and
death is about 12-24 months. Now that there are anti-HIV drugs it
is thought that people will be able to live longer.

• Developing World: On average an HIV+ person can live up to

between 6 and 8 years before they get ill. In most developing
countries there is minimum access to drugs and the time between
illness and death is shorter. This is because people in developing
countries are unable to eat enough nutritious food; they lead
stressed filled lives and are often exposed to multiple infections.
 What are Anti Retroviral (ARV’s)
Drugs and how do they work?
They stop HIV replicating in the CD4 Cells and stop newly produced HIV from
infecting other cells. This means that the amount of HIV in the body is reduced
and the damage that it can do to the immune system is limited.

! The Science Bit!

Chemicals, called enzymes, are important in making the HIV copies.
There are two important enzymes involved in HIV:
Reverse Transcriptase: drugs that stop this enzyme from working stop
HIV from being made.
Protese: drugs that stop this enzyme from working results in ‘bad’ HIV being
made. This HIV is unable to infect CD4 cells

Most people will take a combination of these drugs known as Combination

therapy, as this works better than just taking one.
 Does Combination therapy
always work?
Combination therapy can fail for a number of reasons. In order for the drug to
work effectively the person has to keep a certain level of the drug in their blood.
If a person misses doses, doesn’t take drugs on time and doesn’t follow dietary
instructions, then the levels of the drug in their blood will fall and the drug will
be unable to work.

The problem of Resistance:

• A person’s body may develop resistance to one the drugs in the
combination therapy. Studies have shown that resistance is growing.
• How? The HIV in the body can change (mutate) slightly which means that it
can carry on replicating and damaging the CD4 cells even when the person
is taking the drug.
• Cross- resistance: if HIV is resistant to one type of drug it may also be
resistant to all drugs in the same group.
• Drug-resistant HIV infection: some people have become infected with
drug-resistant HIV which means that their treatment options are limited.
 Are there side effects?
Yes! Some are general and others vary depending on the drugs that are being taken.

General side effects:

• Tiredness.
• Nausea.
• Vomiting.
• Diarrhoea.
• Muscle pains.
• Headaches.
• Skin rashes.

Side effects specific to certain drugs:

• Numbness or pain in the hands or feet.
• Skin rashes and liver problems.
• Increased blood sugar levels
• Increased levels of fats in the blood.
 Is combination therapy
available to everyone?
Although the price of these drugs has been lowered due to public
pressure and generic drug companies (which make cheaper versions of
the drug) they are still too expensive for many people in less developed
countries.

Some statistics
• Only 5% of those people who require treatment in these developing
countries have access to the medicines.
• In Africa only 1 in 1000 HIV+ people are receiving the drug.

Is combination therapy a cure for HIV and AIDS?

• NO! It only reduces the amount of HIV, and allows them to manage
the infection and delay the onset of death. No drug has been found
which eliminates or destroys HIV. That is why it important to protect
yourself against the disease.
 WORLD VIEW
34 - 46 MILLION INFECTED
AT END OF 2003
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

2.7 MILLION PEOPLE HALF OF NEW

WITH AIDS ARE INFECTIONS OCCUR IN 15- 17.6 MILLION PEOPLE
24 YEAR OLDS WITH AIDS ARE WOMEN.
CHILDREN UNDER 15.