Human Immunodeficiency Virus & Acquired Immunodeficiency Syndrome Community Medicine - Reporting October 10, 2011

Human Immunodeficiency Virus Viral infection that would eventually lead to the weakening of the body’s immune system leading increased risk for infection. Transmitted through body fluids (ex. Sexual contact, blood transfusion, etc.)

Current Situation in the Philippines

HIV Transmission Among OFWs

Current Situation (as of 2008) HIV-positive indivduals  33.4 million Newly infected  2.7 million Deaths  2.0 million

Current Situation 7400 newly diagnosed cases of HIV each day ▫97% come from low and middle income countries ▫1200 are children < 15 y/o ▫6200 adults > 15 y/o ▫48% are women ▫40% belong to the y/o age bracket

Risk factors for HIV transmission Parenteral drug use Blood transfusion Vertical transmission (mother  child) Occupational transmission (needle stick injuries) Sexual transmission (men having sex with men (MSM), etc.)

Natural Stages of HIV Infection Initial event: viral transmission 2-3 weeks later: acute retroviral syndrome ▫Fever (87%) ▫Rashes (68%) ▫Pharyngitis (48%) ▫Oral ulcers (40%) ▫Genital ulcers / discharge (36%) ▫Myalgia (42%) ▫Headache, diarrhea, abdominal pain (29-39%)

Natural Stages of HIV Infection Asymptomatic chronic HIV infection (8-10 years) AIDS (Death in 1.3 years after the onset of an AIDS-defining illness) ▫Pneumocystis carnii pneumonia ▫Recurrent bacterial pneumonia ▫Candidiasis – Esophagus, trachea, bronchi, lungs ▫Extrapulmonary Cryptococcosis ▫M. Tuberculosis – pulmonary/extrapulmonary ▫HIV-associated wasting

HIV screening HIV antibody testing ▫(+) result 2 months after contact ▫High sensitivity and specificity HIV-1 p24 antigen ▫Used for blood screening HIV PCR ▫Used for screening newborns ▫Expensive

HIV Prevention Routine perinatal screening for expectant mothers Screening of blood products for transmission Preventive measures in handling needles or other materials that have come in contact with body fluids Safe sexual practices (use of male/female condoms, circumcision, abstinence, etc.)

HIV Management Highly active anti-retroviral therapy (HAART) ▫Medications used to prevent the further spread of the virus Prevention of opportunistic infections ▫Use of prophylactic medications to prevent onsent of infections usually associated with AIDS  Pneumocystis carinii pneumonia  Mycobacterium avium intracellulare  Cryptococcus neoformans