传染病--AIDS艾滋病--课件

AIDSlCONCEPTCONCEPTlETIOLOGYETIOLOGYlEPIDEMIOLOGY&PREVENTIONEPIDEMIOLOGY&PREVENTIONlCLINICAL MANIFESTATIONCLINICAL MANIFESTATIONlDIAGNOSISDIAGNOSISlTREATMENT TREATMENT 1ppt课件AIDS Acquired Immune Deficiency Syndrome,is the most severe manifestation of a clinical spectrum of illness caused by human immuno-Deficiency virus(HIV).The syndrome is definedby the development of serious oppoutunisticinfections,neoplasms,or other life-threateningmanifestations resulting from progressive HIV-induced immunosuppression.2ppt课件Viral etiology-HIV(human immunodeficiency virus)lHIV belongs to retroviridae family and includes HIV 1 and 2.lContaining positive-sense,single-stranded RNA.lThe major target of HIV infection is CD4+T cell.3ppt课件EPIDEMIOLOGYIn mid-1981,the first AIDS case was identified in New York City,USA.4ppt课件Until Dec.1,2010,Cumulative Number of Reported Cases of AIDSlAll over the world,total number of HIV infection is more than 70 millions,death number is about 46 millions.5ppt课件Until Dec.1,2010,Cumulative Number of Reported Cases of AIDSlIn China,total number of HIV infection is about more than 1 million,living HIV/AIDS cases are about 0.74 million.6ppt课件Contents of Chinese HIV infection and AIDS Cases:lDrug users and blood donators,about 40%;lSexual workers,more than 20%；lFamily members and common people,about 20%；7ppt课件Contents of Chinese HIV infection and AIDS Cases:lBlood or blood products users,about 10%;lMale gay,about 8%；lMather to infant,about 2%.8ppt课件Until Dec.1,2009,Cumulative Number of Reported Cases of AIDSlIn Chongqing,from 1989 to Oct.30,2006,there were about 2509 cases of HIV infection,lIn 2009,more than 6000 HIV infection.lIn Chongqing,there are about 30 thousand female sexual workers,about 5%have been infected by HIV.9ppt课件EPIDEMIOLOGYlSource of infection:HIV infections and AIDS patients.10ppt课件EPIDEMIOLOGYlMajor routes of transmission:via blood,tissues and body fluids either through inoculation;by sexual contact;Vertical transmission.11ppt课件EPIDEMIOLOGYlSusceptibility of population:all ages are susceptible,but most cases occur in young adults.12ppt课件PREVENTION1.Case finding and early isolation of asymptomatic individuals.2.Cut off the route of transmission:Heightening infection control in high-risk situations.Quarantine of high-risk populations.3.Protection of susceptible population:Public education about AIDS.13ppt课件Little Bush asked teenagers in USA to be safersexbehaviors：lAbstainlBefaithful lCondomuse 14ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlIncubation period:210 years in adults,several months to 2 years in infants and young children.15ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlNatural history of the disease:Phase 1:lasting for days to weeks Patients initially develop mononucleosis-like symptoms:fever,lymphadenopathy,sweats,malaise,myalgia,headache,and rigors.16ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlNatural history of the disease:Phase 2:lasting for 2 to 10 years Asymptomatic period.17ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlNatural history of the disease:Phase 3:PGL,persistent generalized lymphadenopathy.It is defined as the presence of two or more extra inguinal sites of lymphadenopathy for 3 to 6 months for which no other explanation.18ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlNatural history of the disease:Phase 3:PGL,Its pathogenesis is related to the rapid infection of CD4+cells in lymph nodes by HIV.Biopsy specimens of lymph nodes usually reveal a follicular hyperplasia without specific pathogens.19ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlNatural history of the disease:Phase 4:AIDS,lARC,AIDS related complications.persistent fever,weight loss and PGL.20ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlNatural history of the disease:Phase 4:AIDS,lSevere opportunistic infections,pathogens include fungi,such as pneumocystisJiroveci(PJ,PC,p.carinii),tubercle bacillus,herpes virus,cta.21ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlNatural history of the disease:Phase 4:AIDS,lSarcoma followed immune compromise,such as Kaposis Sarcoma(KS),human herpesvirus type 8 is related to the pathogenesis of KS.22ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlNatural history of the disease:Phase 4:AIDS,lKS is a vascular neoplastic disorder in AIDS patients.Although KS also affects visceral organs,the characteristic findings are cutaneous red-purple nodules or plaques.Sites commonly involved include the legs,feet,mucous membranes,hard palate,nose,trunk,and scalp.23ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlPulmonary manifestations of AIDS:PJP,pneumocystis jiroveci pneumonia,occurring in about 80%of AIDS patients.Symptoms:Radiographic abnormality:24ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlGastrointestinal and hepatobiliary manifestations of AIDS:such as Candida esophagitis,cryptosporidiosis,and cytomegalovirus(CMV)colitis,chronic viralhepatitis.25ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlOral diseases:oral candidiasis oral hairy leukoplakia oral ulcers:caused by herpes simplex virus type 1 and 2,CMV,cta.other oral lesions:KS26ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlAnus diseases:anus ulcers:caused by herpes simplex virus type 1 and 2,cta.27ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlpudendum diseases:Condyloma acuminatum28ppt课件CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONSlNeurologic manifestations of AIDS:opportunistic infections of CNS,encephalar toxoplasmosis,viral encephalitis opportunistic cancer involved in CNS,Symptoms:headache,seizures,disturbance of cognitive function,and focal neurologic deficits.29ppt课件clinical typesCD4+TL L A B C (109/L)asymptomatic mildly symptomatic AIDS infection or PGLinfection 0.5 2.0 A I B I C I0.20.49 1.01.9 A II B II C II 0.2 1.0 A III B III C III CDC&WHOs classify standard30ppt课件DIAGNOSIS DIAGNOSIS lClinical diagnosislPathogenic diagnosis31ppt课件Clinical diagnosis High risk populations appear one of following manifestations:lFever lasting for more than 1 month;lChronic cough and/or diarrhea;lPGL;lopportunistic infections,especially caused by fungi;lCNS disorders in young adults;lKC.32ppt课件Pathogen diagnosis HIV antibody positive(ELISA);HIV antigen p24 postive(Western blotting)33ppt课件Treatment 1.Antiretroviral chemotherapy:lReverse transcriptase inhibitors:AZT,ddc,ddi,lamivudinelProtease inhibitors:ritonair,indnavirlCombination therapy34ppt课件Treatment 2.Immune therapy:3.Genetherapy:4.Treatment of complication:lPCP:pentamine,coSMZ5.Supporting therapy:nutrition,vitamines35ppt课件Thank you!Thank you!Wish you have a bright future!36ppt课件 HIV virion under electron microscope 37ppt课件HIV virion under electron microscope38ppt课件39ppt课件EnvPolGag40ppt课件 Viral RNA41ppt课件 Pneumocystis carinii pneumonia42ppt课件