1. AIDS (acquired immune deficiency syndrome) was first recognized in North America in the early 1980s. It is caused by a virus known as HIV (human immunodeficiency virus). HIV infection has become a worldwide epidemic. About 33 million people are currently infected with the virus.
  2. HIV is more common among certain populations at risk, such as people who inject illicit drugs, and bisexual and gay men. HIV infections are also increasing among women and children.
  3. The virus can be found in the blood, semen, vaginal fluid, and breast milk of infected people. HIV is also found in saliva, sweat, and tears, though not in high enough amounts to transmit the virus to another person. There are no known cases of anyone catching HIV through sneezing, shaking hands, or from toilet seats or mosquito bites.
  4. The two most common ways to be infected with HIV are through unprotected sex and sharing needles. HIV may be transmitted through unprotected heterosexual or homosexual, vaginal, anal, or oral sex. Although the risk of infection is lower with oral sex, it is still important to use protection during oral sex, such as a dental dam (a piece of latex to cover the vagina during oral sex) or a condom.
  5. Once HIV enters the bloodstream, it takes over cells vital to the immune response, known as CD4+ lymphocytes. The virus then inserts its own genes into the cell, turning it into a miniature factory that produces more copies of the virus. Slowly, the amount of virus in the blood goes up and the number of healthy CD4+ cells goes down. The destruction of CD4+ cells interferes with the body's ability to fight off infections and other diseases.
  6. We suggest you to be aware of following to avoid HIV infection
    During sex. You may become infected if you have vaginal, anal or oral sex with an infected partner whose blood, semen or vaginal secretions enter your body. The virus can enter your body through mouth sores or small tears that sometimes develop in the rectum or vagina during sexual activity. Blood transfusions. In some cases, the virus may be transmitted through blood transfusions. American hospitals and blood banks now screen the blood supply for HIV antibodies, so this risk is very small. Sharing needles. HIV can be transmitted through needles and syringes contaminated with infected blood. Sharing intravenous drug paraphernalia puts you at high risk of HIV and other infectious diseases such as hepatitis. From mother to child. Infected mothers can infect their babies during pregnancy or delivery, or through breast-feeding. But if women receive treatment for HIV infection during pregnancy, the risk to their babies is significantly reduced.

Many people with HIV do not know they are infected.

Many people do not develop symptoms after they first get infected with HIV. Others have a history of a flu-like illness within several days to weeks after exposure to the virus. Early HIV symptoms also include fever, headache, tiredness, and enlarged lymph nodes in the neck. These symptoms usually disappear on their own within a few weeks. After that, the person feels normal and has no symptoms. This asymptomatic phase often lasts for years.

The progression of disease varies widely among individuals. This state may last from a few months to more than 10 years.

  • During this period, the virus continues to multiply actively and infects and kills the cells of the immune system.
  • The virus destroys the cells that are the primary infection fighters, a type of white blood cell called CD4 cells.
  • Even though the person has no symptoms, he or she is contagious and can pass HIV to others through the routes listed above.

Once the CD4 cell count falls low enough, an infected person is said to have AIDS. Sometimes, the diagnosis of AIDS is made because the person has unusual infections or cancers that show how weak the immune system is.

The infections that happen with AIDS are called opportunistic infections because they take advantage of the opportunity to infect a weakened host. The infections include (but are not limited to)

  • pneumonia caused by Pneumocystis, which causes wheezing
  • brain infection with toxoplasmosis which can cause trouble thinking or symptoms that mimic a stroke
  • widespread infection with a bacteria called MAC (mycobacterium avium complex) which can cause fever and weight loss
  • yeast infection of the swallowing tube (esophagus) which causes pain with swallowing
  • widespread diseases with certain fungi like histoplasmosis, which can cause fever, cough, anemia, and other problems

A weakened immune system can also lead to other unusual conditions

  • lymphoma in (a form of cancer of the lymphoid tissue) in the brain, which can causefever and trouble thinking
  • a cancer of the soft tissues called Kaposi's sarcoma, which causes brown, reddish,or purple spots that develop on the skin or in the mouth

Later Signs and Symptoms of HIV/AIDS
The Centers for Disease Control (CDC) says the following signs and symptoms may be warning signs of late-stage HIV infection:

  • rapid weight loss
  • dry cough
  • recurring fever or profuse night sweats
  • profound and unexplained fatigue
  • swollen lymph glands in the armpits, groin, or neck
  • diarrhea lasting more than a week
  • white spots or unusual blemishes on the tongue, in the mouth, or in the throat
  • pneumonia
  • red, brown, pink, or purplish blotches on or under the skin or inside the mouth,nose, or eyelids
  • memory loss, depression, and other neurological disorders

HIV can be transmitted in three main ways:

  • Sexual transmission
  • Transmission through blood
  • Mother-to-child transmission

Prevention is needed for both

  • People who do not have HIV need interventions that will enable them to protect themselves from becoming infected.
  • People who are already living with HIV need knowledge and support to protect their own health and to ensure that they don’t transmit HIV to others - known as “positive prevention”. Positive prevention has become increasingly important as improvements in treatment have led to a rise in the number of people living with HIV.

For people who do not have HIV following are some precautions to be taken.

  • Abstinence. Refraining from sexual activity is the surest way of preventing sexually transmitted HIV infection.
  • Know the HIV status of your partner. It is best to maintain a monogamous, long-term relationship with a partner who has been tested and found to be free from HIV.
  • If you and your partner are both infected with HIV, always use a latex condom to prevent other STDs.
  • If one of you is infected with HIV, use a latex condom and a lubricant during sex.
  • If you plan on having more than one sex partner, get tested for HIV.
  • Women who plan on becoming pregnant, or who are pregnant, should be tested before they have the infant.

For the people who have HIV infection shall remember following things
HIV counselling and testing are fundamental for HIV prevention. People living with HIV are less likely to transmit the virus to others if they know they are infected and if they have received counselling about safer behaviour. For example, a pregnant woman who has HIV will not be able to benefit from interventions to protect her child unless her infection is diagnosed. Those who discover they are not infected can also benefit, by receiving counselling on how to remain uninfected.
The availability and accessibility of antiretroviral treatment is crucial; it enables people living with HIV to enjoy longer, healthier lives, and as such acts as an incentive for HIV testing. Continued contact with health care workers also provides further opportunities for prevention messages and interventions. Studies suggest that HIV-positive people may be less likely to engage in risky behaviour if they are enrolled in treatment programmes.
The preventative effect of antiretroviral treatment is another reason for scaling up access to HIV treatment. Since 2008 and the Swiss Statement (for more information read AVERT's HIV transmission and antiretroviral therapy briefing sheet), a number of studies have shown that an HIV positive person on antiretroviral treatment with an undetectable viral load has a very low risk of transmitting HIV to someone else.

The term “Post-exposure prophylaxis” or PEP refers to the prophylactic use of antiretrovirals to prevent establishment of HIV infection after an occupational exposure to HIV.

Who is at risk?

All Health Care Personnel, including emergency care providers, laboratory personnel, autopsy personnel, hospital employees, interns and medical students, nursing staff and students, physicians, surgeons, dentists, labour and delivery room personnel, laboratory technicians, health facility sanitary staff and clinical waste handlers and health care professionals at all levels. Also at risk are public safety workers, including law enforcement personnel, prison staff, fire-fighters, workers in needle exchange programme and workers in HIV programmes.

What is the risk?

Health Care Personnel are at risk of blood-borne infection transmission through exposure of a percutaneous injury (e.g. needle-stick or cut with a sharp instrument), contact with the mucous membranes of the eye or mouth of an infected person, contact with non-intact skin (particularly when the exposed skin is chapped, abraded, or afflicted with dermatitis or contact with blood or other potentially infectious body fluids.

What is infectious and what is not?

Exposure to blood, semen, vaginal secretions, cerebrospinal fluid, synovial, pleural, peritoneal, pericardial fluid, amniotic fluid and other body fluids contaminated with visible blood can lead to infection. Exposure to tears, sweat, saliva, urine and faeces is non-infectious unless these secretions contain visible blood.

To view complete technical document on PEP (Specially for Doctors) Click here