What is AIDS ? Write down the epidemiology clinical features and prevention of AIDS ?

Q. 48. What is AIDS ? Write down the epidemiology clinical features and prevention of AIDS ?
Acquired immunodeficiency syndrome :- Acquired immunodeficiency syndrome (AIDS) is defined as the development of one or more AIDS indicating condition in the presence of HIV infection.
 Epidemiology of AIDS :-
A. Occurrence : AIDS is now pandemic world wide, which consists of many different region epidemic in  different countries.
B. Ecological triad :
1. Agent : HIV (human immunodeficiency Virus)
2. Host :-
a. Age :- 90% of known cases occur among sexually active persons aged 20-49 years.
b. Sex :- Male and female are both affected.
c. High risk group :-
(i) Male homosexuals and bisexuals
(ii) Intravenous drug abusers
(iii) Hemophiliacs
(iv) hetero sexual partners.
(v) Recipient of blood and blood products.

C. Natural history :-
1. Reservoir :- Cases and carriers.
2. Source of infection : blood, semen, vaginal and other body secretion, breast milk.
3. Mode of transmission.
(i) Mucosal
- Sexual intercourse
- Perianal
(ii) Parenteral.
- Infected blood or blood products
- Contaminated needles.

4. Incubation period :- From a few month to 6 years or even more.

 Clinical features of AIDS :-
A. Features of zero conversion illness. (lasts for 1-2 weeks)
1. Fever
2. Malaise
3. Myalgia
4. Lymphadenopathy
5. Rash- Erythematous, macula popular and affecting the face and trunk
B. Asymptomatic period ( Lasting for about 10 years without antiretroviral therapy)
1. Physical examination may be normal.
2. About one third of patient have persistent generalized Lymphadenopathy.

C. Persistent generalized Lymphadenopathy (PGL)
1. Enlarged lymph nodes are painless, symmetrical and mobile.
2. The most commonly affected nodes are cervical and auxiliary.

D. Group IV disease (AIDS indicating condition):-
1. Disseminated clinical cytomegalovirus infection
2. Chronic mucocutanous disseminated herpes simplex infection.
3. Progressive multifocal leucoencephalpathy.
4. Extrapulmonary or pulmonary tuberculosis CD 4 count <200/mm3
5. Candidacies of esophagus, bronchi and pulmonary tree.
6. Toxoplasmosis of brain.
7. Secondary neoplasm.
- Kaposis sarcoma
- primary lymphoma of brain

 Prevention of AIDS :-
1. Public awareness campaigns for HIV
2. Safe sex practices
3. Regular venereological screening for high risk group.
4. Targeting safe sex methods at sex works
5. Control of STD.
6. Not to share needles razors and tooth brushes.
7. Screening of donated blood and also other blood products.
8. Reduction of unnecessary blood transfusion
9. Perinatal :
- Routine HIV testing in antenatal clinic
- Avoidance of breastfeeding