Dr. Amaj Saeed MB.CH.B MSc PhD Clinical virologist
4 th commonest cause of death 34.5 x 10 6 infections worldwide 24.5 x 10 6 in sub-Saharan Africa 33% 15 year olds infected in some African countries impact on social, civil and economic stability
Sexually- heterosexual - same sex Vertically- in utero - during delivery (15-40%) - breast milk (20%) Contaminated- IV drug misuse needles- needle stick injuries Blood products- transfusion/tissues factor VIII
Candidiasis of bronchi, trachea or lungs Candidiasis, oesophageal Cervical carcinoma, invasive Coccidioidomycocis, disseminated or extrapulmonary Cryptococcosis, extrapulmonary Cryptosporidiosis, chronic intestinal (1-month duration) Cytomegalovirus (CMV) disease (other than liver, spleen or nodes) CMV retinitis (with loss of vision) Encephalopathy, HIV-related Herpes simplex, chronic ulcers (1-month duration); or bronchitis, pneumonitis or oesophagitis Histoplasmosis, disseminated or extrapulmonary Isosporiasis; chronic intestinal (1-month durations) Kaposis sarcoma
Lymphoma, Burkitts Lymphoma, immunoblastic (or equivalent term) Lymphoma (primary) of brain Mycobacterium avium complex or M. kansasii, disseminated or extrapulmonary Mycobacterium tubereculosis, any site Mycobacterium, other species or unidentified species, disseminated or extrapulmonary Pneumocystis carinii pneumonia Pneumonia, recurrent Progressive multifocal leucoencephalopathy Salmonella septicaemia, recurrent Toxoplasmosis of brain Wasting syndrome, due to HIV
establish diagnosis - HIV antibody present (ELISA, Western blot) - determine VL (HIV RNA assays – bDNA, RT-PCR, NASBA) determine past exposure to OI - hepatitis A, B, C - CMV - toxoplasmosis exclude other active infection - syphilis, other STI - cervical cytology immune status - CD4/CD8 lymphocyte counts
Chemically inactivated whole virus vaccine (in effective) Recombinant DNA technology (expression of HIV env protein) Live attenuated HIV vaccine is under investigation (nef gene has been mutated) Prime boost approach : HIV env gene has been cloned in to harmless pox virus (canary pox), injection to the arm and subsequent replication of the pox virus DNA containing the HIV env gene prime the immune system, this will be followed by injection of recombinant env protein.