Mod 5 - HIV and TB

Can people with HIV have a normal life expectancy?

yes

Where did HIV come from?

Cut-Hunter’s Hypothesis

• SIV in Chimp —> hunter comes in contact with blood —> mutates to HIV

Opportunistic Infection

a disease that wouldn’t normally cause sickness in a healthy human but causes sickness in an immunocompromised one

What bacteria causes TB

mycobacterium tuberculosis

Symptoms of TB

unexplained weight loss

loss of appetite

night sweats

fever

fatigue

coughing for 3+ weeks

coughing up blood

chest pain

Transmission of TB

airborne when people with pulmonary TB cough

• have to be close contact

How many people worldwide have been infected by TB bacillus (prevalence)

1/3 - asymptomatic

How many people have TB disease (incidence)

5%-15% - symptomatic

Multi-Drug Resistant TB (MDR-TB)

doesnt respond to rifampicin or isoniazid

why is MDR-TB a public health emergency

• lower success rates

• hard to study

• treatment takes longer (20 months)

• more adverse effects on kidneys, hearing, liver

risk factors for TB

immunocompromised

HIV Status

LBW

Malnutrition

Certain cancers

very young or very old

poverty

substance abuse

refugee

Healthcare worker

why are home visits important for TB

• keeps patients more accountable

• produce better outcomes (80% cure)

• reduces amount of drug resistant TB

Trends for AIDs/HIV from 1990-2019

• Prevelance is increasing but new infections are staying the same

• Highest death rate is in 2005

• Drugs work bc ppl are living with HIV

Countries that get the most annual new cases of HIV

South Africa

• eswatini

• botswana

• eq guinea

• lesotwo

• nambia

How many people in the US have HIV

1.2 million diagnosed

158,500 undiagnosed

Racial Disparities in HIV prevalence

Black and hispanic are disproportionally effected

How does HIV cause death

1. virus multiplies and HIV kills CD4 cells

2. depletes CD4 until <200 cells/mm

3. Immune system is too weak to fight anything (AIDs)

4. Die of infection

Primary HIV Infection

flu like symptoms for 2-4 wks

clinical stage 1

persistent enlargement of lymph nodes

clinical stage 2

minor skin problems and upper respiratory infection

clinical stage 3 

chronic diarrehea and fevers

thrush

pulmonary TB

pneumonia

menigitis

clinical stage 4

chronic diarrehea and fevers

complex infections

HIV associated cancers

How many cases worldwide of TB have been diagnosed and how many were deadly

10 million and 1.3 million

antiretroviral therapy (art)

uses combinations (sometimes called “cocktails”) of three or more
different drugs to combat HIV.

how many people are living with aids/hiv

40 million

86% are aware globally of their status

how many people die of aids globally in a year

630,000
1 person per minute

challenges in HIV/AIDS

• Too many still unaware of their HIV status
• Many who come to hospital are too far along in disease for most effective treatment
• ART coverage lags in some places
• Life-long treatment is difficult
• new infections are with serodiscordant couples
• Disparities within populations for access to prevention, testing, and treatment.