“It is estimated that by the end of the 20th century there were 40 million people infected with HIV all over the world. India has been leading with the highest number of cases (ranging from 10-20 million). We may not be a direct victim but will definitely be affected indirectly by it. Hence it is a duty of every citizen of India to have detailed knowledge about this disease. The average survival rate after full-blown Acquired Immune Deficiency Syndrome is 18-24 months, by which time 90% of the patients would die. 25-30% develops clinical illness after 5yrs of Infection. By 10yrs, 40-50%may become symptomatic. Other co-factors like repeated STD, infections, etc. will modify the rate of prognosis.

MODE OF TRANSMISSION

1.     Sexual intercourse

  • Anal, Vaginal, Oral Route with Infected Person
  • Men to Men
  • Men to Women
  • Women to Men

2.   Transfusion of Blood

3.    Contaminated needles and syringes

4.   Organ and tissue donations

5.   Mother to child

INVASION OF HIV ON IMMUNE SYSTEM

  • Infects the entire immune system
  • Especially T cells / T 4 cells or CD 4
  • HIV virus can evade antibodies
  • Antibodies unable to reach and neutralized the viral effect
  • HIV virus replication is faster than the immune mechanism
  • Depletion of CD 4 lymphocytes

 

TARGET OF HIV INFECTION

  • CD 4 and T- Lymphocytes
  • CD 4 and Monocytes, Macrophages, including Microglia
  • CD 4 and Dendrite cells, Langerhans Cells , Payer’s Patches and Galactosyl in Brain and Gut
  • CD 8 and cytotoxic T cells – Help to clear load of HIV Virus but fail to eradicate

EXPECTED HISTORY OF HIV INFECTION

  • Primary infection (Seroconversion)
  • Early Stage (Asymptomatic Phase)
  • Late Stage Of HIV Infection

 PRIMARY INFECTION (SEROCONVERSION)

  • The time gap between exposure and response (2 months)
  • May vary on the mode of transmission

CLINICAL FEATURES

  1. Acute febrile myalgic illness
  2. Oral and oesophageal ulceration
  3. Mauco-popular rash
  4. Generalized lymphadenopathy

EARLY STAGE (ASYMPTOMATIC PHASE)

  • Silent stage
  • Symptoms are mild and unbearable
  • CLINICAL FEATURES
  • Generalized lymphadenopathy
  • Irregular fever
  • Hypersensitivity reaction

LATE STAGE OF HIV INFECTION

  • Profound immune deficiency
  • CD 4 and lymphocytes fall
  • CLINICAL FEATURES
  • Pneumonia
  • Tuberculosis
  • Candidiasis oral and oesophageal
  • Herpes simplex and virus infection
  • Gastrointestinal
  • Neurological

INVESTIGATION

  • Diagnosed by blood tests
  • Antibody tests
  • RNA tests
  • Combination test that detects both antibodies
  • ELISA
  • Western Blot

WINDOW PERIOD

The initial antibody test is negative, a repeat test should be performed 3 months later. Takes some time for the immune system to produce enough antibodies for the antibody test to turn positive. May last six weeks to 3 months following infection.

AYURVEDIC PERSPECTIVE of HIV
According to Ayurveda the HIV may be correlated with “Kshaya’ or “Ojakshaya’ meaning loss of immunity.

Human Body Have 7 Dhatus – Rasa, Rakt